A nurse is caring for a client who has undergone a bilateral adrenalectomy. The nurse monitors for which of the following signs of Addisonian crisis?

Hypernatremia

Fluid volume overload

Hypokalemia

Hypoglycemia

Answer and Explanation

The Correct Answer is D

A.   Hypernatremia (elevated sodium levels) is not a common sign of Addisonian crisis. In Addisonian crisis, the lack of aldosterone leads to sodium loss, which often results in hyponatremia (low sodium levels) rather than hypernatremia. The patient might also experience dehydration and electrolyte imbalances, but hypernatremia is not typical in this scenario.
B.   Fluid volume overload is not characteristic of Addisonian crisis. Instead, Addisonian crisis often leads to fluid volume deficit due to the loss of aldosterone, which impairs sodium and water retention. This can result in dehydration and low blood volume rather than fluid overload.
C.   Hypokalemia (low potassium levels) is not typically associated with Addisonian crisis. In fact, the lack of aldosterone in Addisonian crisis leads to potassium retention, resulting in hyperkalemia (elevated potassium levels). Therefore, monitoring for hypokalemia is not relevant in the context of Addisonian crisis following a bilateral adrenalectomy.
D.   Hypoglycemia (low blood glucose levels) is a key sign of Addisonian crisis. Cortisol plays a crucial role in glucose metabolism and maintaining blood glucose levels. With the loss of cortisol production after a bilateral adrenalectomy, patients may experience hypoglycemia, which can be a critical indicator of Addisonian crisis.

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Correct Answer is C

Explanation

A. Casts in the urine are typically associated with kidney problems, such as glomerulonephritis or kidney infections, rather than biliary obstruction. Casts are formed from proteins or cells in the renal tubules and are not related to bile duct obstruction or cholelithiasis.
B. Dark, tarry stools are indicative of upper gastrointestinal bleeding and the presence of digested blood in the stool. This condition, known as melena, is not typically associated with obstruction of the common bile duct due to cholelithiasis.
C. Jaundice is a common and significant finding in cases of obstruction of the common bile duct due to cholelithiasis. When the bile duct is obstructed, bilirubin, which is a component of bile, accumulates in the bloodstream because it cannot be properly excreted into the intestine.
D. Pain from cholelithiasis (gallstones) typically occurs in the right upper quadrant, not the left. The right upper quadrant pain is often associated with gallbladder inflammation or bile duct obstruction.

A. The bleeding occurs from peptic ulcers in the stomach. B. This type of bleeding is treated by giving chewable aspirin. C. The bleeding occurs from tears in the lining of the duodenum. D. The bleeding occurs from a tear in the mucosal lining where the esophagus meets the stomach.

Correct Answer is D

Explanation

A. Peptic ulcers are sores that develop on the lining of the stomach, small intestine, or esophagus due to the erosion caused by stomach acid. A Mallory-Weiss tear is not related to peptic ulcers. Instead, it results from a different type of injury related to forceful vomiting or retching.
B. Chewable aspirin is not a treatment for Mallory-Weiss tears. In fact, aspirin can exacerbate bleeding and is typically avoided in situations where gastrointestinal bleeding is present. Mallory-Weiss tears are generally managed by supportive measures and sometimes endoscopic interventions, not with aspirin.
C. A Mallory-Weiss tear specifically affects the mucosal lining at the junction of the esophagus and the stomach, not the duodenum. The duodenum is part of the small intestine, and tears or bleeding here are not characteristic of Mallory-Weiss syndrome.

D. A Mallory-Weiss tear is a tear or laceration in the mucosal lining at the gastroesophageal junction (where the esophagus meets the stomach). It is typically caused by severe vomiting or retching, which can lead to the tear and subsequent upper gastrointestinal bleeding.

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A nurse is caring for a client who has undergone a bilateral adrenalectomy. The nurse monitors for which of the following signs of Addisonian crisis?

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Naxlex Comprehensive Predictor Exams

A client is admitted to the hospital with a diagnosis of obstruction of the common bile duct due to cholelithiasis. Which of the following assessment findings are consistent with this diagnosis?

Correct Answer is C

Explanation

The patient is admitted with upper GI bleeding following an episode of forceful vomiting due to excessive alcohol intake. The nurse suspects a Mallory-Weiss tear. Which of the following is true of a Mallory-Weiss tear?

Correct Answer is D

Explanation

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