A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:

Sodium and potassium abnormalities

Calcium and phosphorus abnormalities

Sodium and chloride abnormalities

Chloride and magnesium abnormalities

Answer and Explanation

The Correct Answer is A

Reasoning:

Choice A reason: Addison’s disease, due to adrenal insufficiency, reduces aldosterone and cortisol production, leading to sodium loss (hyponatremia) and potassium retention (hyperkalemia). These electrolyte abnormalities result from impaired renal sodium reabsorption and potassium excretion, making sodium and potassium monitoring critical for managing complications like hypotension and arrhythmias.

Choice B reason: Calcium and phosphorus abnormalities are not primary concerns in Addison’s disease. These electrolytes are more affected by parathyroid or renal disorders. Addison’s disease primarily disrupts sodium and potassium balance due to aldosterone deficiency, with calcium and phosphorus typically remaining within normal ranges unless other conditions coexist.

Choice C reason: Sodium abnormalities occur in Addison’s disease due to aldosterone deficiency, causing hyponatremia. However, chloride levels are not significantly altered, as chloride follows sodium passively. Potassium imbalances (hyperkalemia) are more critical alongside sodium, making this combination less comprehensive than sodium and potassium monitoring.

Choice D reason: Chloride and magnesium abnormalities are not hallmark features of Addison’s disease. While mild chloride changes may occur with sodium loss, magnesium is typically unaffected. The primary electrolyte disturbances involve sodium (hyponatremia) and potassium (hyperkalemia), making these the focus of monitoring in adrenal insufficiency.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: Sickle cell anemia is an inherited disorder caused by a genetic mutation in the hemoglobin gene, leading to abnormal hemoglobin (HbS). This causes red blood cells to sickle under stress, triggering hemolysis. The autosomal recessive inheritance pattern makes it a classic example of an inherited hemolytic anemia with chronic hemolysis.

Choice B reason: Hypersplenism is not an inherited disorder but a condition where an enlarged spleen sequesters and destroys red blood cells, causing anemia. It results from secondary causes like liver disease or portal hypertension, not genetic mutations, making it an acquired cause of hemolytic anemia.

Choice C reason: Cold agglutinin disease is typically acquired, often due to infections or autoimmune disorders, causing antibodies to agglutinate red blood cells at low temperatures, leading to hemolysis. While rare congenital forms exist, it is not primarily inherited, unlike sickle cell anemia’s genetic basis.

Choice D reason: Autoimmune hemolytic anemia is usually acquired, caused by autoantibodies attacking red blood cells, leading to hemolysis. It is associated with conditions like lupus or infections, not genetic mutations. Unlike sickle cell anemia, it lacks an inherited genetic component as its primary etiology.

A. The client has a decreased tolerance of pain related to the chronic nature of the illness B. Overhydration enlarges the red blood cells C. Bone marrow decreases the erythrocyte production causing decrease in hypoxia D. Vascular occlusion in small vessels decreasing blood and oxygen to the tissues

Correct Answer is D

Explanation

Reasoning:

Choice A reason: Decreased pain tolerance may occur in chronic conditions, but it is not the primary mechanism of pain in a sickle cell crisis. Pain results from vaso-occlusion by sickled red blood cells, causing tissue ischemia, not a psychological or tolerance issue, making this explanation incorrect.

Choice B reason: Overhydration does not enlarge red blood cells or cause sickle cell crises. Dehydration can trigger sickling by increasing blood viscosity, but overhydration dilutes plasma, potentially reducing sickling. Pain in crises stems from vaso-occlusion, not cell size changes due to fluid status.

Choice C reason: Bone marrow in sickle cell anemia increases, not decreases, erythrocyte production to compensate for chronic hemolysis. Hypoxia results from vaso-occlusion, not reduced production, as sickled cells block vessels, impairing oxygen delivery, making this an incorrect explanation for crisis-related pain.

Choice D reason: Vascular occlusion in small vessels by sickled red blood cells is the primary mechanism of sickle cell crisis pain. Sickled cells obstruct microvasculature, reducing blood flow and oxygen delivery, causing tissue ischemia and severe pain, accurately explaining the client’s symptoms in the emergency department.

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A client with Addison's disease comes to the clinic for a follow-up visit. When assessing this client, the nurse should stay alert for signs and symptoms of:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which type of hemolytic anemia is categorized as an inherited disorder?

Correct Answer is A

Explanation

A client is seen in the emergency department with severe pain related to a sickle cell crisis. What does the nurse understand is occurring with this client?

Correct Answer is D

Explanation

A client with a history of diabetes insipidus seeks medical attention for an exacerbation of symptoms. Which laboratory finding indicates to the nurse that the client has been restricting fluids in an attempt to control the symptoms?

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A preceptor discussing stroke with a new nurse on the unit would tell the new nurse that which cardiac dysrhythmia is associated with cardiogenic embolic strokes?

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A client receiving long-term treatment with high-dose corticosteroids is expected to exhibit which of the following?

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