A client is being successfully treated for Cushing's syndrome. The nurse should expect a decline in:

Hair loss

Serum glucose level

Bone demineralization

Menstrual flow

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Hair loss may not significantly decline with successful Cushing’s syndrome treatment. Excess cortisol causes hirsutism or hair thinning due to androgen excess or protein catabolism. Treatment reduces cortisol, but hair changes may persist due to slow hair growth cycles or irreversible follicular damage.

Choice B reason: Successful treatment of Cushing’s syndrome lowers serum glucose levels. Excess cortisol induces insulin resistance and gluconeogenesis, causing hyperglycemia. Reducing cortisol through treatment (e.g., surgery or medication) restores insulin sensitivity and reduces glucose production, normalizing blood sugar levels, a key indicator of effective management.

Choice C reason: Bone demineralization may not decline quickly with treatment. Chronic cortisol excess inhibits osteoblast activity and calcium absorption, causing osteoporosis. While treatment halts further bone loss, reversal is slow due to the time required for bone remodeling, making this less immediate than glucose normalization.

Choice D reason: Menstrual flow may not immediately increase with treatment. Cortisol excess disrupts gonadotropin release, causing amenorrhea. Restoring normal cortisol levels may improve menstrual cycles, but hormonal recovery is gradual, and changes in flow are less immediate or reliable than glucose level declines as a treatment outcome.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Above-normal urine osmolality and below-normal serum osmolality are not consistent with diabetes insipidus. High urine osmolality suggests concentrated urine, typical in syndrome of inappropriate antidiuretic hormone (SIADH), where ADH is excessive. Low serum osmolality also aligns with SIADH due to water retention, not the water loss seen in diabetes insipidus.

Choice B reason: Above-normal urine and serum osmolality levels do not reflect diabetes insipidus. High urine osmolality indicates concentrated urine, which contradicts the dilute urine output of diabetes insipidus. High serum osmolality could occur with dehydration, but the combination with high urine osmolality suggests another condition, not ADH deficiency.

Choice C reason: Below-normal urine osmolality and above-normal serum osmolality are classic findings in diabetes insipidus. Arginine vasopressin (ADH) deficiency impairs water reabsorption, leading to dilute urine (low osmolality). The resulting water loss increases serum osmolality as the body becomes dehydrated, supporting the diagnosis of diabetes insipidus.

Choice D reason: Below-normal urine and serum osmolality levels are inconsistent with diabetes insipidus. Low urine osmolality occurs due to ADH deficiency, but low serum osmolality suggests water retention, as in SIADH. Diabetes insipidus causes dehydration, elevating serum osmolality, not lowering it, making this combination unlikely in this condition.

A. Diabetes insipidus (DI) B. Pituitary tumor C. Hypothyroidism D. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Correct Answer is A

Explanation

Reasoning:

Choice A reason: Diabetes insipidus is likely due to the client’s symptoms of polyuria, thirst, and weight loss following a head injury. Trauma can disrupt the posterior pituitary, reducing ADH secretion, leading to excessive dilute urine output, dehydration, and subsequent thirst and weight loss from fluid depletion, consistent with central DI.

Choice B reason: A pituitary tumor may cause diabetes insipidus but is not the condition itself. Tumors can disrupt ADH production, but the symptoms described—polyuria, thirst, and weight loss—point directly to diabetes insipidus as the primary condition, with a tumor being a potential underlying cause requiring further investigation.

Choice C reason: Hypothyroidism, caused by thyroid hormone deficiency, leads to symptoms like fatigue and weight gain, not polyuria or weight loss. It is unrelated to head injury or ADH dysfunction, making it an unlikely diagnosis for the client’s symptoms of excessive urine output and dehydration.

Choice D reason: SIADH causes water retention, leading to concentrated urine, hyponatremia, and potential weight gain, opposite to the client’s symptoms of dilute urine, weight loss, and thirst. Head injury may cause SIADH, but the clinical presentation aligns with diabetes insipidus, not water retention.

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A client is being successfully treated for Cushing's syndrome. The nurse should expect a decline in:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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