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 ["B","C","E"]

Explanation

Reasoning:

Choice A reason: Weight loss is not a typical side effect of corticosteroid therapy for Addison’s disease. Corticosteroids mimic cortisol, promoting weight gain through increased appetite and fat redistribution. Weight loss is more common in untreated Addison’s disease due to cortisol deficiency and reduced appetite.

Choice B reason: Poor wound healing is a side effect of corticosteroids, as they suppress immune responses and inhibit collagen synthesis. This impairs fibroblast activity and tissue repair, increasing infection risk and delaying wound closure, a significant concern for patients on long-term therapy for Addison’s disease.

Choice C reason: Hypertension is a common side effect of corticosteroids due to their mineralocorticoid effects, which increase sodium and water retention, elevating blood volume and pressure. This is particularly relevant in Addison’s disease treatment, where corticosteroids restore deficient aldosterone and cortisol, potentially causing fluid overload.

Choice D reason: Hypotension is not a side effect of corticosteroid therapy but a symptom of untreated Addison’s disease due to aldosterone deficiency, causing sodium loss and hypovolemia. Corticosteroid therapy corrects this, so hypotension is unlikely unless under-dosed or during acute crisis.

Choice E reason: Alterations in glucose metabolism are a side effect of corticosteroids, which induce insulin resistance and increase gluconeogenesis, leading to hyperglycemia. In Addison’s disease, corticosteroids replace deficient cortisol, but excess dosing can mimic Cushing’s syndrome, causing elevated blood glucose and requiring careful monitoring.

A. Radioimmunoassay B. Magnetic resonance imaging (MRI) C. Radioactive iodine uptake test D. Nuclear scan

Correct Answer is B

Explanation

Reasoning:

Choice A reason: Radioimmunoassay measures hormone levels, such as ADH, but is not the initial test for a suspected pituitary tumor. It may confirm hormonal deficiencies but cannot visualize structural abnormalities like tumors, which are better assessed by imaging techniques like MRI, making it a secondary diagnostic tool in this context.

Choice B reason: Magnetic resonance imaging (MRI) is the initial test for a suspected pituitary tumor. It provides detailed images of the pituitary gland, identifying structural abnormalities like tumors that may cause diabetes insipidus by disrupting ADH production. MRI is non-invasive and highly sensitive for detecting pituitary lesions, guiding further management.

Choice C reason: Radioactive iodine uptake tests assess thyroid function, not pituitary tumors. These tests are used for thyroid disorders like hyperthyroidism, which are unrelated to diabetes insipidus or pituitary pathology. They do not visualize the pituitary gland or confirm structural causes of ADH deficiency.

Choice D reason: A nuclear scan, such as a bone or thyroid scan, is not used to diagnose pituitary tumors. It assesses other conditions, like bone metastases or thyroid activity, but lacks specificity for pituitary imaging. MRI is the preferred modality for visualizing pituitary abnormalities causing diabetes insipidus.

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

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Naxlex Comprehensive Predictor Exams

A client has been placed on corticosteroid therapy for Addison's disease. The nurse should be aware of which of the following side effects associated with this type of therapy? (Select all that apply)

Correct Answer is ["B","C","E"]

Explanation

A client is suspected to have a pituitary tumor due to signs of diabetes insipidus. What initial test does the nurse help to prepare the client for?

Correct Answer is B

Explanation

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