A client with Addison’s disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

Platelets

Albumin

Glucose

Serum electrolytes

Answer and Explanation

The Correct Answer is C

Choice A reason: Platelets are unaffected by hydrocortisone in Addison’s disease. Hydrocortisone replaces cortisol, regulating metabolism, not coagulation. Platelet monitoring is relevant for bleeding disorders, not adrenal insufficiency, making this value less critical than glucose, which is directly impacted by cortisol’s gluconeogenic effects.

Choice B reason: Albumin reflects nutritional status but is not directly altered by hydrocortisone. Addison’s disease and hydrocortisone affect glucose and electrolytes via cortisol’s metabolic roles, not protein synthesis. Albumin is secondary, as glucose monitoring addresses immediate metabolic complications of corticosteroid therapy.

Choice C reason: Glucose is critical to monitor, as hydrocortisone increases gluconeogenesis and insulin resistance in Addison’s disease, risking hyperglycemia. Elevated glucose can cause osmotic diuresis or ketoacidosis, requiring dose adjustments or insulin therapy, making this the most important value to ensure safe corticosteroid management.

Choice D reason: Serum electrolytes, like sodium and potassium, are affected by Addison’s, but hydrocortisone primarily corrects hyponatremia and hyperkalemia. Glucose is more critical, as hydrocortisone’s glucocorticoid effects directly raise blood sugar, posing immediate metabolic risks, making this value secondary to glucose monitoring.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason: Measuring intake and output monitors fluid balance but does not address blood clots obstructing TURP drainage. Clots risk bladder distension or hemorrhage, and increasing irrigation flow directly clears the tubing, making this action secondary to preventing immediate complications in post-prostate surgery.

Choice B reason: Increasing bladder irrigation flow is the best initial action, as blood clots in TURP drainage indicate clot formation, risking obstruction. Faster irrigation flushes clots, preventing bladder distension or bleeding, maintaining catheter patency, and ensuring postoperative stability, making it the priority intervention.

Choice C reason: Providing oral fluids increases urine output but does not directly clear blood clots in TURP drainage. Clots require irrigation adjustment to prevent obstruction, and oral hydration is secondary, as it does not address the immediate risk of catheter blockage or bladder complications.

Choice D reason: Administering an antispasmodic addresses bladder spasms but not blood clots in TURP drainage. Clots cause obstruction, not spasms, and increasing irrigation flow directly resolves the issue, making antispasmodics irrelevant for the immediate problem of maintaining catheter patency.

A. The stoma mucosa is purple in color B. The fecal matter is brown and has a solid consistency C. The stoma has streaks of bright red blood D. There are no bowel sounds in the left lower quadrant

Correct Answer is A

Explanation

Choice A reason: A purple stoma mucosa indicates ischemia or necrosis, a surgical emergency post-colostomy. Poor blood supply risks stoma failure, infection, or perforation, requiring immediate surgical evaluation. This finding is critical, as it threatens the colostomy’s viability, making it the priority to report.

Choice B reason: Brown, solid fecal matter is normal 24 hours post-colostomy, indicating bowel function. This does not suggest complications like ischemia or obstruction, requiring no immediate reporting, as it aligns with expected postoperative outcomes, making this finding benign.

Choice C reason: Streaks of bright red blood from the stoma suggest minor trauma or irritation, common post-colostomy. This is less urgent than purple mucosa, which indicates ischemia, a life-threatening issue, making bleeding a secondary concern requiring monitoring but not immediate surgical intervention.

Choice D reason: Absent bowel sounds in the left lower quadrant are expected post-bowel surgery due to ileus. This is less urgent than purple stoma mucosa, which signals necrosis, requiring immediate action, making bowel sounds a normal postoperative finding not warranting urgent reporting.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client with Addison’s disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse observes an increased number of blood clots in the drainage tubing of a client with continuous bladder irrigation following a transurethral resection of the prostate (TURP). Which is the best initial nursing action?

Correct Answer is B

Explanation

The nurse assesses an adult client 24 hours after a bowel exploration and formation of a sigmoid colostomy. Which assessment finding should be reported to the surgeon immediately?

Correct Answer is A

Explanation

Which instruction should the nurse include in the discharge teaching for a client who has gastroesophageal reflux?

A client who is experiencing a first gouty arthritis attack reports excruciating pain in the right great toe. The nurse inspects the inflamed joint and administers ibuprofen 800 mg PO as prescribed. Which instruction should the nurse include in the discharge teaching?

Four days following an abdominal aortic aneurysm (AAA) repair, the client is exhibiting edema of both lower extremities, and pedal pulses are not palpable. Which action should the nurse implement first?

A client with Addison’s disease started taking hydrocortisone in a divided daily dose last week. It is most important for the nurse to monitor which serum laboratory value?

A postoperative client reports incisional pain. The client has two prescriptions for PRN analgesia that accompanied the client from the postanesthesia unit. Before selecting which medication to administer, which action should the nurse implement?

A female client reports that pain from carpal tunnel syndrome is beginning to affect her job performance. Which instruction should the nurse provide this client?

The nurse reports that a client is at risk for a stroke based on which assessment finding?