A nurse is providing education to a client who has a new diagnosis of Addison's disease. The nurse determines that additional teaching is needed when the client makes which of the following statements?

I will need to wear a medical alert bracelet at all times.

I will need to hold my hydrocortisone dose if I have an infection.

I will take my hydrocortisone tablets twice a day.

I will need to eat a high-sodium diet.

Answer and Explanation

The Correct Answer is B

A. I will need to wear a medical alert bracelet at all times: This statement is correct. Clients with Addison's disease should wear a medical alert bracelet to inform healthcare providers of their condition in case of an emergency, as it could impact treatment decisions.
B. I will need to hold my hydrocortisone dose if I have an infection: This statement indicates a need for additional teaching. Clients with Addison's disease should not hold their hydrocortisone dose if they have an infection. In fact, they may need to increase their dose during periods of stress or illness to manage their condition effectively.
C. I will take my hydrocortisone tablets twice a day: This statement is correct. Hydrocortisone is typically taken in divided doses to mimic the natural release of cortisol from the adrenal glands.
D. I will need to eat a high-sodium diet: This statement is correct. Clients with Addison's disease often need to increase their sodium intake, as they may have difficulties retaining sodium due to adrenal insufficiency.

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Correct Answer is B

Explanation

A. A 40-year-old patient with Cushing syndrome and gynecomastia: While Cushing syndrome requires ongoing management and monitoring, gynecomastia alone is not an urgent concern compared to the symptoms described in option B.
B. A 58-year-old patient with Addison's disease who is exhibiting confusion: Addison's disease can lead to adrenal insufficiency, and confusion could indicate an adrenal crisis or severe electrolyte imbalance. This is a critical situation requiring immediate assessment to prevent severe complications.
C. A 45-year-old patient with Graves' disease and exophthalmos: Graves' disease with exophthalmos is significant but does not typically represent an immediate life-threatening condition compared to the symptoms associated with Addison's disease.
D. A 47-year-old patient with hypothyroidism who is asking for a warm blanket: This patient’s request for a warm blanket suggests they might be experiencing symptoms related to hypothyroidism, such as feeling cold. However, this is less urgent compared to the confusion and potential crisis in option B.

A. Pain 7/10 at the surgical site B. Hyperglycemia C. Blood pressure 92/50 D. Sodium 152 mEq/L

Correct Answer is C

Explanation

A. Pain 7/10 at the surgical site: This level of pain is expected following major surgery, such as a bilateral adrenalectomy, and does not specifically indicate an Addisonian crisis.
B. Hyperglycemia: Although hyperglycemia can be associated with stress or corticosteroid treatment, it is not a hallmark of Addisonian crisis. Addisonian crisis is more related to adrenal insufficiency rather than hyperglycemia.
C. Blood pressure 92/50: Low blood pressure is a critical sign of an Addisonian crisis. This condition results from severe adrenal insufficiency where the body cannot maintain adequate blood pressure.
D. Sodium 152 mEq/L: High sodium levels are not characteristic of an Addisonian crisis. Addisonian crisis typically leads to hyponatremia (low sodium levels) due to inadequate aldosterone production.

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A nurse is providing education to a client who has a new diagnosis of Addison's disease. The nurse determines that additional teaching is needed when the client makes which of the following statements?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

At the beginning of the shift, a nurse receives report on the following four patients. Which patient should the nurse place priority on assessing first?

Correct Answer is B

Explanation

The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?

Correct Answer is C

Explanation

A client with a history of hypothyroidism has accidentally been taking double her prescribed dose of levothyroxine. Which assessment findings would the nurse expect due to an excess of this medication?

A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?

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A client who has hypothyroidism will be undergoing surgery for a total knee replacement. When planning care for this client, the nurse understands which of the following to be true for people who have hypothyroidism?

A nurse is caring for a client who has developed Cushing syndrome due to long-term corticosteroid therapy to treat multiple sclerosis. The nurse understands that Cushing syndrome puts the client at increased risk for which complication?

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