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)
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Reasoning:
Choice A reason: Decreased pain tolerance may occur in chronic conditions, but it is not the primary mechanism of pain in a sickle cell crisis. Pain results from vaso-occlusion by sickled red blood cells, causing tissue ischemia, not a psychological or tolerance issue, making this explanation incorrect.
Choice B reason: Overhydration does not enlarge red blood cells or cause sickle cell crises. Dehydration can trigger sickling by increasing blood viscosity, but overhydration dilutes plasma, potentially reducing sickling. Pain in crises stems from vaso-occlusion, not cell size changes due to fluid status.
Choice C reason: Bone marrow in sickle cell anemia increases, not decreases, erythrocyte production to compensate for chronic hemolysis. Hypoxia results from vaso-occlusion, not reduced production, as sickled cells block vessels, impairing oxygen delivery, making this an incorrect explanation for crisis-related pain.
Choice D reason: Vascular occlusion in small vessels by sickled red blood cells is the primary mechanism of sickle cell crisis pain. Sickled cells obstruct microvasculature, reducing blood flow and oxygen delivery, causing tissue ischemia and severe pain, accurately explaining the client’s symptoms in the emergency department.
Correct Answer is C
Explanation
Reasoning:
Choice A reason: Thiazide diuretics reduce urine output in nephrogenic diabetes insipidus by increasing sodium excretion, which enhances water reabsorption indirectly. However, they are not the primary treatment for central diabetes insipidus, where ADH deficiency is the issue. Desmopressin, an ADH analog, directly addresses the hormonal deficiency, making thiazides less effective.
Choice B reason: Diabinese (chlorpropamide) is a sulfonylurea used for type 2 diabetes mellitus, not diabetes insipidus. It lowers blood glucose by stimulating insulin release, which is irrelevant to the water balance issue in diabetes insipidus caused by ADH deficiency. It does not address the underlying hormonal imbalance.
Choice C reason: Desmopressin (DDAVP) is a synthetic ADH analog used to treat central diabetes insipidus. It mimics ADH, promoting water reabsorption in the kidneys’ collecting ducts, reducing polyuria and thirst. This directly corrects the fluid imbalance caused by ADH deficiency, making it the primary and most effective treatment.
Choice D reason: Ibuprofen, a nonsteroidal anti-inflammatory drug, is used for pain and inflammation, not for fluid balance in diabetes insipidus. It has no effect on ADH or renal water reabsorption, making it irrelevant for treating the excessive urine output and dehydration associated with this condition.
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