A client complaining of weight gain and acne undergoes laboratory testing, which reveals elevated cortisol levels and hyperglycemia. The client has no prior medical history, and does not take any medications. After further testing and imaging to determine the cause of the elevated cortisol levels, the client is diagnosed with Cushing disease caused by a pituitary adenoma. Which of the following statements should the nurse include when teaching the client about this diagnosis?
It is important that you taper off of the corticosteroids you are taking which have caused this disorder.
You will need to have your adrenal glands removed to reverse your symptoms.
You will need to begin taking hydrocortisone, and increase your dose during times of stress.
You will receive glucose checks and sliding-scale insulin until your hormone levels are corrected.
The Correct Answer is B
A. It is important that you taper off of the corticosteroids you are taking which have caused this disorder: This statement is not applicable because the client has a pituitary adenoma causing Cushing disease, not iatrogenic Cushing syndrome from corticosteroid use.
B. You will need to have your adrenal glands removed to reverse your symptoms: For Cushing disease caused by a pituitary adenoma, treatment typically involves surgical removal of the pituitary tumor, not the adrenal glands.
C. You will need to begin taking hydrocortisone, and increase your dose during times of stress: This is incorrect as hydrocortisone replacement is used for Addison's disease, not for managing Cushing disease.
D. You will receive glucose checks and sliding-scale insulin until your hormone levels are corrected: While glucose monitoring might be necessary due to hyperglycemia, the primary treatment for Cushing disease involves addressing the source of excess cortisol, which is the pituitary adenoma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Levothyroxine replacement test: This test is used to assess the thyroid's response to synthetic thyroid hormone and is not used to differentiate types of hyperthyroidism.
B. Radioactive iodine uptake (RAIU) test: This test measures the thyroid gland's ability to absorb iodine, which helps differentiate Graves' disease (characterized by increased uptake) from other forms of hyperthyroidism, such as thyroiditis (which may show decreased uptake).
C. Adrenocorticotropic hormone (ACTH) stimulation test: This test is used to evaluate adrenal function and is not relevant for diagnosing or differentiating forms of hyperthyroidism.
D. Subtotal thyroidectomy: This is a surgical procedure rather than a diagnostic test and would not be used to differentiate between types of hyperthyroidism.
Correct Answer is A
Explanation
A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to the heart's response to increased pressure and volume overload. This biomarker is used specifically to diagnose and assess the severity of heart failure.
B. Troponin I: This is a marker for myocardial injury and is used to diagnose acute myocardial infarction rather than heart failure.
C. Blood urea nitrogen (BUN): While elevated BUN can be associated with renal dysfunction or fluid overload in heart failure, it is not specific to diagnosing heart failure.
D. Platelet levels: These are not directly related to diagnosing heart failure and do not provide information about cardiac function.
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