The nurse is caring for a client who works night shift from 22:00 to 06:00 and normally sleeps from 08:00 (8 AM) until 16:00 (4 PM) each day.
The nurse should teach this client to take the prescribed corticosteroid at what time of the day?

08:00.

22:00.

06:00.

16:00.

Answer and Explanation

The Correct Answer is C

This is because cortisol exhibits a proper 24-h circadian rhythm that affects the cardiovascular system and other organs. Cortisol levels are normally low at the beginning of sleep and high at the moment of awakening. Taking corticosteroids at this time mimics the natural cortisol rhythm and may reduce side effects such as adrenal suppression, sleep disturbances and cardiovascular complications.

Choice A is wrong because taking corticosteroids at 08:00 may not coincide with the client’s natural cortisol peak and may cause insomnia or unpleasant dreams.

Choice B is wrong because taking corticosteroids at 22:00 may disrupt the client’s sleep quality and increase the risk of nocturnal hypertension.

Choice D is wrong because taking corticosteroids at 16:00 may interfere with the client’s natural cortisol decline and cause hyperglycemia or dyslipidemia.

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Correct Answer is D

Explanation

Guaifenesin is an expectorant that helps thin and loosen mucus in the lungs, making it easier to cough up the sputum. Some possible explanations for the other choices are:

Choice A. Benzonatate is wrong because benzonatate is an antitussive that suppresses the cough reflex by numbing the throat and lungs.

It does not help with sputum production or clearance.

Choice B. Dextromethorphan is wrong because dextromethorphan is also an antitussive that acts on the brain to reduce the urge to cough.

It does not affect the mucus or bronchial secretions.

Choice C. Hydrocodone is wrong because hydrocodone is a narcotic antitussive that works by binding to opioid receptors in the brain and spinal cord, blocking pain signals and decreasing cough.

It can cause sedation, respiratory depression, and dependence, and is not indicated for bronchitis.

Normal ranges for sputum production vary depending on the individual and the cause of the cough, but generally range from 10 to 100 mL per day.

Excessive or abnormal sputum may indicate an infection, inflammation, or obstruction of the airways.

A. Liver failure. B. Radiation injury. C. Malignancy. D. Hypothyroidism.

Correct Answer is C

Explanation

Hypercalcemia is a condition caused by having too much calcium in the blood, which can affect the function of nerves, muscles, kidneys and heart. Hypercalcemia can occur in children due to various causes, both acquired and genetic. One of the most common causes of hypercalcemia in children is cancer, especially cancers that affect the bones or produce substances that mimic parathyroid hormone (PTH), which regulates calcium levels.

Choice A is wrong because liver failure does not directly cause hypercalcemia, although it can affect vitamin D metabolism and calcium absorption.

Choice B is wrong because radiation injury does not cause hypercalcemia, unless it damages the parathyroid glands or causes bone destruction.

Choice D is wrong because hypothyroidism does not cause hypercalcemia, although it can affect bone turnover and calcium excretion.

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The nurse is caring for a client who works night shift from 22:00 to 06:00 and normally sleeps from 08:00 (8 AM) until 16:00 (4 PM) each day. The nurse should teach this client to take the prescribed corticosteroid at what time of the day?

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Naxlex Comprehensive Predictor Exams

A client presents at the clinic with a dry nonproductive cough. The client is diagnosed with bronchitis, and it has been determined that assistance is needed in thinning the sputum so the cough can become productive. What does the nurse expect the provider will prescribe?

Correct Answer is D

Explanation

The nurse is caring for a pediatric client with a new onset of hypercalcemia. What condition would be most likely to cause this altered serum calcium level?

Correct Answer is C

Explanation

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The nurse is caring for a client who works night shift from 22:00 to 06:00 and normally sleeps from 08:00 (8 AM) until 16:00 (4 PM) each day.
The nurse should teach this client to take the prescribed corticosteroid at what time of the day?