A nurse should perform which intervention for a client with Cushing's syndrome?

Explain that the client’s physical changes are a result of excessive corticosteroids

Offer clothing or bedding that’s cool and comfortable

Explain the rationale for increasing salt and fluid intake in times of illness, increased stress, and very hot weather

Suggest a high-carbohydrate, low-protein diet

Answer and Explanation

The Correct Answer is A

Reasoning:

Choice A reason: Explaining that physical changes in Cushing’s syndrome, like moon face and weight gain, result from excessive corticosteroids helps the client understand their condition. Cortisol excess causes fat redistribution and metabolic changes, and education promotes adherence to treatment and coping with body image changes, improving psychological and physical management.

Choice B reason: Offering cool, comfortable clothing or bedding addresses symptoms like heat intolerance in Cushing’s syndrome due to cortisol’s metabolic effects. However, it is less critical than education about the condition, as it does not address the underlying cause or promote understanding and adherence to long-term management strategies.

Choice C reason: Increasing salt and fluid intake is appropriate for Addison’s disease, not Cushing’s syndrome, where cortisol’s mineralocorticoid effects cause fluid retention and hypertension. This intervention could worsen fluid overload and hyponatremia, making it inappropriate and potentially harmful for managing Cushing’s syndrome symptoms.

Choice D reason: A high-carbohydrate, low-protein diet is not recommended for Cushing’s syndrome. Cortisol excess causes protein catabolism and hyperglycemia, so a balanced diet with adequate protein supports muscle maintenance and glucose control. This dietary suggestion does not address the metabolic needs of the condition.

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Correct Answer is C

Explanation

Reasoning:

Choice A reason: Initiating thrombolytic therapy within 12 hours is too late for optimal ischemic stroke outcomes. Beyond 4.5 hours, the risk of hemorrhage outweighs benefits, as ischemic tissue becomes necrotic, reducing the effectiveness of thrombolytics like tPA in restoring blood flow and improving function.

Choice B reason: A 9-hour window for thrombolytic therapy exceeds the recommended time frame for ischemic stroke. After 4.5 hours, the risk of hemorrhagic transformation increases, and neuronal salvage is less likely due to prolonged ischemia, making this time frame ineffective for achieving optimal functional recovery.

Choice C reason: Thrombolytic therapy within 3 hours of ischemic stroke onset maximizes functional outcomes. Tissue plasminogen activator (tPA) dissolves clots, restoring blood flow to viable brain tissue. Early administration minimizes neuronal damage, reduces disability, and improves recovery, with guidelines supporting a 3–4.5-hour window for eligible patients.

Choice D reason: A 6-hour window for thrombolytics is beyond the optimal 3–4.5-hour period for ischemic stroke. While some patients may benefit up to 4.5 hours, delays increase hemorrhage risk and reduce the likelihood of salvaging ischemic tissue, leading to poorer functional outcomes compared to earlier intervention.

A. Decreased heart rate B. Alteration in level of consciousness (LOC) C. Slurred speech D. Bradycardia

Correct Answer is B

Explanation

Reasoning:

Choice A reason: Decreased heart rate is a late sign in subdural hematoma, occurring with increased intracranial pressure (ICP) causing Cushing’s triad (bradycardia, hypertension, irregular breathing). Early manifestations like altered LOC appear first due to hematoma compression, making heart rate changes a secondary concern.

Choice B reason: Alteration in level of consciousness is the earliest manifestation of subdural hematoma. As the hematoma expands, it compresses brain tissue, impairing cerebral function, leading to confusion, lethargy, or reduced responsiveness. This precedes other signs like motor deficits or vital sign changes, making it the first to monitor.

Choice C reason: Slurred speech may occur in subdural hematoma if motor or speech areas are affected, but it is not the earliest sign. Altered LOC typically precedes focal neurological deficits, as hematoma compression globally impacts brain function before specific areas, making speech changes secondary.

Choice D reason: Bradycardia, like decreased heart rate, is a late sign in subdural hematoma, part of Cushing’s triad from severe ICP elevation. Early signs like altered LOC occur first due to initial brain compression, making bradycardia a later manifestation requiring urgent intervention.

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A nurse should perform which intervention for a client with Cushing's syndrome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Thrombolytic therapy should be initiated within what time frame of an ischemic stroke to achieve the best functional outcome?

Correct Answer is C

Explanation

A client suffers a head injury. The nurse implements an assessment plan to monitor for potential subdural hematoma development. Which manifestation does the nurse anticipate seeing first?

Correct Answer is B

Explanation

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

Which endocrine disorder causes the client to have dilutional hyponatremia?

A nurse should perform which intervention for a client with Cushing's syndrome?

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