An adult client underwent a short plasma corticotropin (ACTH) stimulation test this morning. What subsequent assessment finding would rule out a diagnosis of adrenal insufficiency?

Static levels of serum cortisol

Blood glucose <70 mg/dL (3.80 mmol/L)

Decreased serum sodium levels

Elevated cortisol levels

Answer and Explanation

The Correct Answer is D

would rule out a diagnosis of adrenal insufficiency after a short plasma corticotropin (ACTH) stimulation test. In this test, a synthetic form of ACTH is given to stimulate the adrenal glands to produce cortisol. If the adrenal glands are functioning normally, they should produce an increased amount of cortisol in response to the ACTH. Therefore, if the client has elevated cortisol levels after the test, it would indicate that their adrenal glands are functioning properly and ruling out adrenal insufficiency.

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Correct Answer is A

Explanation

A. An increase in serum lactate – This is a critical laboratory value that can indicate lactic acidosis, a serious side effect associated with metformin, especially in older adults or those with renal impairment. An increase in serum lactate necessitates discontinuation of the medication.

B. A decrease in hemoglobin and hematocrit – While this change may indicate anemia, it is not directly associated with the need to discontinue metformin. Further evaluation of the cause of anemia would be necessary.

C. An increase in white blood cells – This could indicate an infection or inflammatory process but does not specifically necessitate the discontinuation of metformin.

D. A decrease in potassium accompanied by an increase in sodium – While electrolyte imbalances should be monitored, this change does not directly indicate that metformin should be discontinued.

A. Kidney failure B. Stroke with excessive doses C. Potential for abuse D. Unstable blood glucose levels

Correct Answer is C

Explanation

Dextroamphetamine is a central nervous system (CNS) stimulant that is used to treat ADHD and narcolepsy. The drug has a high potential for abuse and dependence, and therefore it carries a black box warning from the FDA. The black box warning is the strongest warning that the FDA requires, and it indicates that a drug has a significant risk of serious or life-threatening adverse effects.

The black box warning for dextroamphetamine relates to its potential for abuse, addiction, and misuse. The drug should only be used as directed by a healthcare provider, and clients should be advised not to share their medication with others or to take more than the prescribed dose. Excessive doses of dextroamphetamine can lead to serious adverse effects, including stroke and heart attack. Clients should also be advised to store their medication securely and to dispose of any unused medication properly.

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An adult client underwent a short plasma corticotropin (ACTH) stimulation test this morning. What subsequent assessment finding would rule out a diagnosis of adrenal insufficiency?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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