A 50-year-old male patient presents with facial rounding, central obesity, and purple striae on the abdomen. Laboratory results show high levels of ACTH. What is the most likely underlying cause of his condition?

Adrenal insufficiency.

Pheochromocytoma.

Cushing Disease.

Hyperthyroidism.

Answer and Explanation

The Correct Answer is C

Choice A Reason:

Adrenal insufficiency, also known as Addison’s disease, is characterized by insufficient production of cortisol and aldosterone by the adrenal glands. Symptoms typically include fatigue, weight loss, low blood pressure, and hyperpigmentation of the skin. High levels of ACTH are not associated with adrenal insufficiency; instead, ACTH levels are usually elevated in response to low cortisol levels.

Choice B Reason:

Pheochromocytoma is a rare tumor of the adrenal gland that produces excess catecholamines, leading to symptoms such as hypertension, palpitations, and headaches. It does not cause high levels of ACTH or the physical manifestations described in the patient, such as facial rounding and purple striae.

Choice C Reason:

Cushing Disease is caused by a pituitary adenoma that secretes excess adrenocorticotropic hormone (ACTH), leading to overproduction of cortisol by the adrenal glands. This results in symptoms such as facial rounding (moon face), central obesity, purple striae on the abdomen, and high levels of ACTH. These clinical features align with the patient’s presentation, making Cushing Disease the most likely underlying cause.

Choice D Reason:

Hyperthyroidism is characterized by excessive production of thyroid hormones, leading to symptoms such as weight loss, heat intolerance, palpitations, and tremors. It does not cause high levels of ACTH or the specific physical changes seen in Cushing Disease.

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Correct Answer is A

Explanation

Choice A Reason:

Implementing strict hand hygiene protocols is the most critical intervention to prevent infection in patients with acute lymphoblastic leukemia (ALL). Patients with ALL are highly susceptible to infections due to their compromised immune systems, which result from both the disease and the chemotherapy treatment. Hand hygiene is a fundamental practice in infection control, significantly reducing the transmission of pathogens. Ensuring that all healthcare providers, patients, and visitors adhere to strict hand hygiene protocols can greatly minimize the risk of infections.

Choice B Reason:

Administering prophylactic antibiotics regularly can help prevent infections, but it is not the most critical intervention. Overuse of antibiotics can lead to antibiotic resistance and other complications. While antibiotics are important in managing infections, they should be used judiciously and in conjunction with other infection control measures, such as hand hygiene.

Choice C Reason:

Encouraging the patient to eat a high-protein diet is beneficial for overall health and recovery, but it does not directly prevent infections. A high-protein diet can help maintain muscle mass and support the immune system, but it is not a primary infection control measure.

Choice D Reason:

Limiting the patient’s fluid intake is not relevant to preventing infections in patients with ALL. Adequate hydration is important for overall health and helps in the management of side effects from chemotherapy. Fluid restriction is not a standard intervention for infection prevention in this context.

A. Night blindness B. Central vision loss C. Peripheral vision loss D. Double vision

Correct Answer is B

Explanation

Choice A Reason:

Night blindness, or difficulty seeing in low light, is not a primary symptom of macular degeneration. This condition primarily affects the macula, the central part of the retina responsible for sharp, central vision. Night blindness is more commonly associated with conditions like retinitis pigmentosa or vitamin A deficiency.

Choice B Reason:

Central vision loss is the hallmark of macular degeneration. This condition leads to the deterioration of the macula, causing blurred or lost central vision while peripheral vision remains intact. Patients often report difficulty reading, recognizing faces, and performing tasks that require fine visual detail3.

Choice C Reason:

Peripheral vision loss is not typically associated with macular degeneration. This condition affects the central part of the retina, leaving peripheral vision largely unaffected. Peripheral vision loss is more commonly seen in conditions like glaucoma.

Choice D Reason:

Double vision, or diplopia, is not a characteristic symptom of macular degeneration. This condition affects the clarity of central vision but does not typically cause double vision. Double vision can result from issues with the eye muscles or nerves, such as in cases of strabismus or cranial nerve palsies.

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A 50-year-old male patient presents with facial rounding, central obesity, and purple striae on the abdomen. Laboratory results show high levels of ACTH. What is the most likely underlying cause of his condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient with acute lymphoblastic leukemia (ALL) is admitted for chemotherapy treatment. As part of the nursing management, which of the following interventions is most critical to prevent infection in this patient?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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