A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the health care provider immediately?

Frequent urination

An irregular apical pulse

Dry mucous membranes

Pitting edema of the legs

Answer and Explanation

The Correct Answer is B

Reasoning:

Choice A reason: Frequent urination may occur in Cushing’s syndrome due to hyperglycemia-induced osmotic diuresis, but it is not immediately life-threatening. It reflects chronic metabolic changes rather than an acute emergency, so it is less urgent than an irregular pulse, which could indicate a cardiovascular crisis.

Choice B reason: An irregular apical pulse is critical to report immediately in Cushing’s syndrome, as cortisol excess increases cardiovascular risk, including arrhythmias like atrial fibrillation. Irregular pulses may indicate acute cardiac instability, requiring urgent intervention to prevent complications like stroke or heart failure in this high-risk population.

Choice C reason: Dry mucous membranes may suggest dehydration but are not typical in Cushing’s syndrome, which causes fluid retention. Even if present, they are less urgent than an irregular pulse, as dehydration can be managed with fluids, whereas cardiac arrhythmias pose an immediate threat requiring prompt attention.

Choice D reason: Pitting edema in the legs is common in Cushing’s syndrome due to cortisol’s mineralocorticoid effects causing fluid retention. While important, it is a chronic issue manageable with diuretics and not as immediately life-threatening as an irregular pulse, which could indicate acute cardiac complications.

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Correct Answer is D

Explanation

Reasoning:

Choice A reason: A blood pressure reading of 120/85 mm Hg is normal but not specific to SIADH. While fluid overload in SIADH may elevate blood pressure, this reading is not diagnostic. Hypertension is possible but not a consistent finding, as fluid retention primarily causes hyponatremia and other symptoms.

Choice B reason: Pitting edema in the lower extremities is uncommon in SIADH, as fluid retention is primarily intravascular, leading to dilutional hyponatremia rather than extravascular edema. Edema is more typical in conditions like heart failure or nephrotic syndrome, not the water retention mechanism of SIADH.

Choice C reason: Normal skin turgor is not typical in SIADH, as water retention can cause slight fluid overload, potentially leading to subtle tissue swelling. While not as pronounced as edema, skin turgor may be slightly increased due to excess fluid, making “normal” less accurate than moist mucous membranes.

Choice D reason: Moist mucous membranes are expected in SIADH due to excessive water retention from ADH overactivity. This leads to fluid overload, keeping mucosal tissues hydrated and moist, unlike the dehydration seen in diabetes insipidus, which causes dry mucous membranes due to water loss.

A. Risk for injury B. Ineffective coping C. Noncompliance D. Diarrhea

Correct Answer is A

Explanation

Reasoning:

Choice A reason: Risk for injury is the priority for a client with left-sided hemiparesis post-stroke. Weakness on one side impairs mobility and balance, increasing fall risk. Home environment assessment ensures removal of hazards like rugs or clutter, promoting safety and preventing injuries, critical for stroke recovery.

Choice B reason: Ineffective coping may occur post-stroke due to emotional or functional challenges, but it is not the primary focus during home environment assessment. Physical safety from falls due to hemiparesis is more immediate, as coping issues are addressed through counseling, not environmental modifications.

Choice C reason: Noncompliance with treatment may affect stroke recovery but is not directly addressed by home environment assessment. Ensuring a safe environment to prevent falls due to hemiparesis takes precedence, as physical safety is critical before addressing behavioral or adherence issues in discharge planning.

Choice D reason: Diarrhea is unrelated to hemiparesis or home environment assessment post-stroke. It may occur from medications or other causes but does not pose an immediate risk like falls. The focus is on preventing injuries due to mobility issues, not gastrointestinal symptoms, in this context.

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A nurse is assessing a client with Cushing's syndrome. Which observation should the nurse report to the health care provider immediately?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client admitted with SIADH. What finding would the nurse expect to assess in a client with SIADH?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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