The nurse admits a client with sepsis and has developed cool ecchymotic fingertips and toes. The healthcare provider determines that the client has developed disseminated intravascular coagulation (DIC). Which findings support the pathophysiology of DIC?

Glucosuria and lethargy.

Frothy urine and anorexia.

Hematuria and hemoptysis.

Polyuria and productive cough.

Answer and Explanation

The Correct Answer is C

Disseminated intravascular coagulation (DIC) is a serious condition characterized by widespread activation of coagulation throughout the body, leading to both thrombosis and hemorrhage. Here's why option C is the correct choice:

A) Glucosuria and lethargy:

Glucosuria (presence of glucose in the urine) and lethargy are not typical findings associated with DIC. Glucosuria may indicate diabetes mellitus or renal dysfunction, while lethargy can result from various causes but is not specific to DIC.

B) Frothy urine and anorexia:

Frothy urine may indicate proteinuria, which can occur in conditions such as nephrotic syndrome, but it is not a characteristic finding of DIC. Anorexia (loss of appetite) is a nonspecific symptom that can occur in many conditions but is not directly related to DIC.

C) Hematuria and hemoptysis:

Correct. Hematuria (blood in the urine) and hemoptysis (coughing up blood) are common manifestations of DIC. In DIC, widespread activation of the coagulation cascade can lead to microthrombi formation in small blood vessels, resulting in tissue ischemia and bleeding. Hematuria and hemoptysis can occur due to bleeding from the urinary tract or respiratory system, respectively, as a result of DIC-induced coagulopathy.

D) Polyuria and productive cough:

Polyuria (excessive urination) and productive cough (cough with production of sputum) are not specific findings of DIC. Polyuria may occur in conditions such as diabetes mellitus or diuretic use, while productive cough can be seen in respiratory infections or chronic lung diseases but is not directly related to DIC.

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Correct Answer is D

Explanation

A) The drug may be needed to treat a sudden systemic allergic reaction:

While cortisol may play a role in managing allergic reactions by suppressing inflammation, the primary reason for carrying a cortisol kit in Addison's disease is not typically related to managing allergic reactions.

B) Hypertensive crisis requires immediate treatment to prevent a stroke:

Hypertensive crisis may occur in some individuals with Addison's disease due to adrenal insufficiency, but the immediate treatment for this would typically involve fluids and intravenous hydrocortisone rather than carrying a cortisol kit for self-administration.

C) Hyperglycemia may require cortisol to lower the blood glucose level:

Cortisol can indeed influence blood glucose levels, but the need to carry a cortisol kit is primarily related to the management of adrenal insufficiency rather than hyperglycemia alone.

D) Stress increases the body's need for additional replacement hormone:

Correct. Individuals with Addison's disease have insufficient production of cortisol and often also lack aldosterone. During times of stress, such as illness, trauma, or surgery, the body's demand for cortisol increases to help cope with the stress. Inadequate cortisol production during stress can lead to adrenal crisis, a life-threatening condition. Therefore, carrying a cortisol kit allows the individual to promptly administer additional replacement hormone (usually hydrocortisone) during times of stress to prevent adrenal crisis.

A. Small, skin-colored, pedunculated papules in areas of skin folds and on other areas as skin tags B. Hyperpigmented areas that vary in form and color and are slightly elevated from the skin. C. Hyperactive sebaceous areas forming comedones, papules, pustules on the face, neck, and upper back. D. Sharply demarcated silvery scaling plaques with underlying redness on the elbows and knees.

Correct Answer is C

Explanation

A) Small, skin-colored, pedunculated papules in areas of skin folds and on other areas as skin tags:

This description is more characteristic of acrochordons (skin tags), which are benign skin growths often found in skin folds. Skin tags are typically not associated with acne vulgaris.

B) Hyperpigmented areas that vary in form and color and are slightly elevated from the skin:

This description may be indicative of post-inflammatory hyperpigmentation, which can occur after resolution of acne lesions. However, it does not represent the primary pathological findings observed in acne vulgaris.

C) Hyperactive sebaceous areas forming comedones, papules, pustules on the face, neck, and upper back:

Correct. Acne vulgaris is characterized by hyperactive sebaceous glands, leading to the formation of comedones (blackheads and whiteheads), papules, and pustules. These lesions commonly occur on the face, neck, and upper back due to the high density of sebaceous glands in these areas.

D) Sharply demarcated silvery scaling plaques with underlying redness on the elbows and knees:

This description is more indicative of psoriasis, a chronic autoimmune skin condition characterized by silvery scaling plaques and inflammation. Psoriasis typically affects extensor surfaces such as the elbows and knees, rather than the areas commonly affected by acne vulgaris.

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The nurse admits a client with sepsis and has developed cool ecchymotic fingertips and toes. The healthcare provider determines that the client has developed disseminated intravascular coagulation (DIC). Which findings support the pathophysiology of DIC?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing a female client with Addison's disease for self-care afi.4 discharge. Which is the pathophysiological basis to support the need for the client to carry a cortisol kit at all times?

Correct Answer is D

Explanation

The nurse is caring for a young adult who reports uncontrolled acne vulgaris. Which pathological findings should the nurse observe on inspection of skin areas commonly affected in acne vulgaris?

Correct Answer is C

Explanation

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