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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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 can take it once a day at the same time.
Choice A. Glulisine is wrong because glulisine is a rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 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 starts working within 15 minutes and lasts for 3 to 4 hours.
This would also require frequent injections and monitoring of blood glucose levels.
Choice C. Aspart is wrong because aspart is another rapid-acting insulin that starts working within 15 minutes and lasts for 3 to 4 hours.
This would also require frequent injections and monitoring of blood glucose levels.
Normal ranges for blood glucose levels are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals.
Correct Answer is B
Explanation
The nurse should caution the student to avoid using alcohol with trimethobenzamide because this combination can cause side effects such as drowsiness, dizziness, and impaired reactions. Alcohol can also worsen the symptoms of nausea and vomiting.
Choice A is wrong because St.
John’s wort is a herbal supplement that is used to treat depression and anxiety.
It does not interact with trimethobenzamide.
Choice C is wrong because calcium channel blockers are a class of medications that are used to treat high blood pressure and heart problems.
They do not interact with trimethobenzamide.
Choice D is wrong because selective serotonin reuptake inhibitors (SSRIs) are a class of medications that are used to treat depression and anxiety.
They do not interact with trimethobenzamide.
Trimethobenzamide is an antihistamine that works by blocking the D receptor in the brain and suppressing the chemoreceptor trigger zone that causes nausea and vomiting.
It is available as an oral capsule or an intramuscular injection.
It can cause side effects such as skin rash, tremors, parkinsonism, and jaundice.
It should not be used in children or people with liver or kidney disease.
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