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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Glargine is a long-acting insulin that can provide a steady level of insulin for up to 24 hours. This would be suitable for a client who does not want to administer insulin on the plane, as they would only need one injection per day.
Choice A. Aspart is wrong because aspart is a rapid-acting insulin that has a peak effect within 1 to 3 hours and lasts for 3 to 5 hours.
This would require frequent injections and monitoring of blood glucose levels.
Choice B. Lispro is wrong because lispro is also a rapid-acting insulin that has a similar onset and duration as aspart.
It would not provide adequate coverage for a long international flight.
Choice C. Glulisine is wrong because glulisine is another rapid-acting insulin that has an onset of 15 minutes and a duration of 2 to 4 hours.
It would also require multiple injections and frequent blood glucose checks.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL after meals.
Correct Answer is B
Explanation
It works by relaxing the smooth muscles of the airways and increasing airflow to the lungs.
However, theophylline has a narrow therapeutic range and can cause side effects such as nausea, vomiting, insomnia, tremors, and cardiac arrhythmias if the blood level is too high.
Caffeine is a stimulant that can increase the effects of theophylline and raise the risk of toxicity.
Therefore, patients taking theophylline should avoid caffeine-containing beverages such as coffee, tea, cola, and energy drinks.
Choice A is wrong because eating foods high in potassium has no effect on theophylline metabolism or action.
Potassium is an electrolyte that is important for nerve and muscle function, but it does not interact with theophylline.
Choice C is wrong because taking the medication on an empty stomach can increase the absorption of theophylline and cause gastric irritation.
Theophylline should be taken with food or milk to reduce stomach upset and prevent fluctuations in blood levels.
Choice D is wrong because limiting fluid intake to 1,000 mL a day can cause dehydration and increase the concentration of theophylline in the blood.
Theophylline
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