The nurse assesses a client who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease?

Sodium of 140 mEq/L (range 135-145 mEq/L)

Glucose of 100 mg/dL (range 60-100 mg/dL)

A blood pressure reading of 135/90 mm Hg

Potassium of 6.0 mEq/L (range 3.5-5 mEq/L)

Answer and Explanation

The Correct Answer is D

Reasoning:

Choice A reason: A sodium level of 140 mEq/L is within the normal range and not diagnostic of Addison’s disease. This condition, caused by adrenal insufficiency, typically leads to hyponatremia due to reduced aldosterone, which decreases sodium reabsorption, making a normal sodium level uncharacteristic of the disease.

Choice B reason: A glucose level of 100 mg/dL is normal and not specific to Addison’s disease. Hypoglycemia is more common due to cortisol deficiency, which impairs gluconeogenesis. A normal glucose level does not support the diagnosis, as it does not reflect the metabolic disruptions of adrenal insufficiency.

Choice C reason: A blood pressure of 135/90 mm Hg is elevated but not diagnostic of Addison’s disease. The condition typically causes hypotension due to reduced aldosterone and cortisol, leading to low blood volume and vascular tone. Hypertension suggests another etiology, not adrenal insufficiency.

Choice D reason: A potassium level of 6.0 mEq/L indicates hyperkalemia, a diagnostic sign of Addison’s disease. Aldosterone deficiency reduces potassium excretion in the kidneys, leading to elevated serum potassium. This, combined with hyponatremia and hypotension, is a hallmark of adrenal insufficiency, making hyperkalemia a key diagnostic finding.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: An occluded urinary catheter is the most likely trigger for autonomic dysreflexia in spinal cord injury above T6. Bladder distension stimulates sympathetic overactivity, causing hypertension and bradycardia. This noxious stimulus below the injury level disrupts autonomic regulation, making catheter occlusion a common precipitant of this condition.

Choice B reason: A changed analgesia regimen is unlikely to cause autonomic dysreflexia. Pain may contribute to discomfort, but dysreflexia typically results from visceral stimuli like bladder or bowel distension. Analgesia changes do not directly trigger the sympathetic overresponse characteristic of this life-threatening condition.

Choice C reason: Failure to reposition may cause pressure injuries but is less likely to precipitate autonomic dysreflexia. While discomfort from immobility can contribute, visceral stimuli like catheter occlusion are more direct triggers, as they strongly activate the sympathetic nervous system below the spinal injury level.

Choice D reason: A blood transfusion is not a common cause of autonomic dysreflexia. Transfusions may cause reactions like fever, but dysreflexia results from stimuli like bladder distension. Transfusion-related complications do not typically trigger the autonomic overresponse seen in spinal cord injury patients with dysreflexia.

A. Above-normal urine osmolality level, below-normal serum osmolality level B. Above-normal urine and serum osmolality levels C. Below-normal urine osmolality level, above-normal serum osmolality level D. Below-normal urine and serum osmolality levels

Correct Answer is C

Explanation

Reasoning:

Choice A reason: Above-normal urine osmolality and below-normal serum osmolality are not consistent with diabetes insipidus. High urine osmolality suggests concentrated urine, typical in syndrome of inappropriate antidiuretic hormone (SIADH), where ADH is excessive. Low serum osmolality also aligns with SIADH due to water retention, not the water loss seen in diabetes insipidus.

Choice B reason: Above-normal urine and serum osmolality levels do not reflect diabetes insipidus. High urine osmolality indicates concentrated urine, which contradicts the dilute urine output of diabetes insipidus. High serum osmolality could occur with dehydration, but the combination with high urine osmolality suggests another condition, not ADH deficiency.

Choice C reason: Below-normal urine osmolality and above-normal serum osmolality are classic findings in diabetes insipidus. Arginine vasopressin (ADH) deficiency impairs water reabsorption, leading to dilute urine (low osmolality). The resulting water loss increases serum osmolality as the body becomes dehydrated, supporting the diagnosis of diabetes insipidus.

Choice D reason: Below-normal urine and serum osmolality levels are inconsistent with diabetes insipidus. Low urine osmolality occurs due to ADH deficiency, but low serum osmolality suggests water retention, as in SIADH. Diabetes insipidus causes dehydration, elevating serum osmolality, not lowering it, making this combination unlikely in this condition.

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The nurse assesses a client who has been diagnosed with Addison's disease. Which of the following is a diagnostic sign of this disease?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is C

Explanation

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