A client with a history of a bilateral adrenalectomy is admitted with a weak, irregular pulse, and hypotension. Which assessment finding warrants immediate intervention by the nurse?

Decreased urinary output.

Profound weight gain.

Low blood glucose levels.

Ventricular arrhythmias.

Answer and Explanation

The Correct Answer is D

Rationale:
A. Decreased urinary output: While decreased output may signal fluid imbalance or poor perfusion, it is not as immediately life-threatening as a cardiac arrhythmia. It should be monitored, but other findings take precedence in an acute setting.

B. Profound weight gain: Rapid weight gain suggests fluid retention, possibly from corticosteroid imbalance, but it does not pose an immediate danger compared to cardiac instability. It requires intervention but is not emergent.

C. Low blood glucose levels: Hypoglycemia is common after adrenalectomy due to cortisol deficiency and must be treated, but symptoms often develop gradually and are managed with glucose replacement. It is serious but not as acutely life-threatening as arrhythmias.

D. Ventricular arrhythmias: This finding indicates severe electrolyte disturbances—especially hyperkalemia, which can occur after adrenalectomy due to aldosterone deficiency. It poses an immediate threat to cardiac function and requires urgent intervention.

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Correct Answer is ["A","C","D"]

Explanation

Rationale:
A. Both the sun and radiation can damage the skin because it has a rapid renewal rate:
The skin’s high cellular turnover makes it vulnerable to damage from both UV radiation and radiation therapy. Clients with fair skin are especially prone to radiation dermatitis due to lower melanin protection.

B. Ionizing energy of RT penetrates to the target tumor and does not affect the skin like sun rays: Although radiation targets deeper tissues, the skin at the entry site can still be affected. Radiation can cause localized skin damage, including dryness, erythema, or peeling.

C. Shielding helps to localize the entrance of RT and protects other sensitive areas:
Radiation therapy uses shielding and precise targeting to minimize exposure to surrounding tissues. However, the entry site of the beam still receives some exposure, making localized protection and care essential.

D. Special gels can be prescribed for local application to promote healing and comfort:
Topical agents like hydrophilic creams or corticosteroid gels may be recommended to soothe irritated skin and promote healing during radiation therapy. These help manage symptoms like dryness and inflammation.

E. Application of cold compresses after treatment decreases the skin's sensitivity: Cold compresses are not typically recommended after radiation, as they may constrict blood flow and delay healing. Instead, gentle skincare routines and prescribed topical treatments are preferred.

A. Full volume of pedal pulses. B. Reduced level of pain. C. Granulating tissue in foot ulcer. D. Improved visual acuity.

Correct Answer is B

Explanation

Rationale:
A. Full volume of pedal pulses: Pedal pulses reflect peripheral arterial circulation, not neuropathic pain. Pregabalin does not affect vascular flow, so this finding is unrelated to the medication’s intended effect.

B. Reduced level of pain: Pregabalin is an anticonvulsant used to treat neuropathic pain by modulating nerve signals. A reduction in reported pain confirms that the medication is helping manage the client’s diabetic nerve pain.

C. Granulating tissue in foot ulcer: Wound healing is influenced by infection control, circulation, and blood glucose management—not directly by pregabalin. While important, this finding does not measure the drug’s effectiveness for neuropathy.

D. Improved visual acuity: Visual changes are not treated with pregabalin and may be associated with diabetic retinopathy. Pregabalin does not improve vision and is not indicated for ocular complications of diabetes.

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Body system	Findings
Cardiovascular	Blood pressure of 120/74 mm Hg Capillary refill of 4 seconds in lower extremities Pedal pulse of 2+ or better
Neurovascular	Pupils equal and nonresponsive to light Absence of numbness or tingling in feet Skin that is pale, cool to touch
Renal Perfusion	Client has urine output of 1,600 mL in 24 hours Creatinine of 1.2 mg/dL (106 mmol/L)

A client with a history of a bilateral adrenalectomy is admitted with a weak, irregular pulse, and hypotension. Which assessment finding warrants immediate intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C","D"]

Explanation

A client with diabetic peripheral neuropathy has been taking pregabalin for 4 days. Which finding indicates to the nurse that the medication is effective?

Correct Answer is B

Explanation

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