A child weighs 36 kg. What is the child's weight in pounds? (Round to the tenth place)

Choice A rationale

While clients with Cushing's syndrome may experience fatigue due to elevated cortisol levels affecting sleep patterns and muscle catabolism, clustering activities only in the morning may not adequately address the fluctuating energy levels or provide sufficient rest periods throughout the day. A more balanced approach involving rest periods and activity modification throughout the day is generally more beneficial.

Choice B rationale

Clients with Cushing's syndrome often experience fluid retention and edema due to the mineralocorticoid effects of excess cortisol. Therefore, increasing fluid intake would exacerbate fluid overload rather than alleviate symptoms. Fluid restriction and diuretic therapy may be necessary to manage fluid balance and prevent complications like hypertension and heart failure.

Choice C rationale

Cushing's syndrome is characterized by endogenous overproduction of cortisol, meaning the body already produces too much. Requesting a medical prescription for cortisol would further elevate cortisol levels, worsening the client's symptoms and potentially leading to adrenal crisis if exogenous cortisol is administered in addition to already elevated endogenous levels. Management focuses on reducing cortisol.

Choice D rationale

Assessing daily weights is crucial for clients with Cushing's syndrome due to the propensity for fluid retention and weight gain caused by increased mineralocorticoid activity of cortisol. Daily weights provide an objective measure of fluid balance and can indicate exacerbation or improvement of edema, helping guide interventions and monitor treatment effectiveness. Normal weight fluctuation should be within 1-2 kg in 24 hours.

Choice A rationale

The statement "I can change who I designate as my health care proxy at any time" indicates a correct understanding. A health care proxy designation is a revocable document, meaning the individual can modify or revoke their chosen proxy at any point, provided they have the decisional capacity to do so, reflecting their evolving wishes.

Choice B rationale

The statement "The health care proxy does not go into effect until I am incapable of making decisions" indicates a correct understanding. A health care proxy's authority is activated only when the principal is deemed medically incapacitated and unable to communicate their own healthcare decisions, preserving patient autonomy while capable.

Choice C rationale

The statement "If I become incapacitated, end-of-life choices will be made by my proxy" indicates a correct understanding. The designated health care proxy is legally empowered to make medical decisions, including end-of-life choices, on behalf of the incapacitated individual, aligning with the patient's previously expressed wishes or acting in their best interest.

Choice D rationale

The statement "I have to choose a family member as my health care proxy" indicates a need for clarification. While many individuals choose a family member, the law does not restrict the choice of a health care proxy to family members only. A person can designate any trusted adult, such as a friend, as their proxy, as long as they are competent and willing to serve. .