The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up?

Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg

Serum phosphorus 3 mg/dL and hirsutism

Serum calcium 10 mg/dl, and reports of feelings of depression

Serum sodium 145 mEq/L and reports of muscle weakness

Answer and Explanation

The Correct Answer is A

A. Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg - This combination of severe hypokalemia (low potassium) and elevated blood pressure is a concerning finding. It can lead to serious cardiac complications and requires immediate attention.

B. Serum phosphorus 3 mg/dL and hirsutism - While low serum phosphorus may be seen in Cushing syndrome, it is not an immediate concern. Hirsutism (excessive hair growth) is a characteristic feature of Cushing syndrome.

C. Serum calcium 10 mg/dL, and reports of feelings of depression - Although an elevated serum calcium level is not typical in Cushing syndrome, it is not an immediate concern. Reports of depression should be addressed but do not require immediate follow-up.

D. Serum sodium 145 mEq/L and reports of muscle weakness - These findings are not indicative of immediate danger. Elevated serum sodium and muscle weakness can occur in Cushing syndrome, but they do not warrant immediate attention compared to the potassium level and blood pressure in option A.

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Correct Answer is A

Explanation

A. Correct. Chvostek's sign is a clinical sign of hypocalcemia. It is elicited by tapping on the facial nerve, just anterior to the ear, and observing for facial twitching or spasm.

B. Incorrect. Kernig's sign is a test for assessing meningitis and involves flexing the hip and knee at 90-degree angles and then extending the knee. This test is not relevant to the client's reported symptoms.

C. Incorrect. Brudzinski's sign is another test for assessing meningitis. It involves flexing the neck forward and observing for involuntary flexion of the hips and knees. This test is not relevant to the client's reported symptoms.

D. Incorrect. Babinski's sign is used to assess upper motor neuron lesions. It involves stimulating the sole of the foot, and in a positive response, the big toe extends upward. This test is not relevant to the client's reported symptoms.

A. NPH insulin may be mixed with pens B. insulin detemir is administered to taking meals C. insulin glargine may be used to treat gestational diabetes D. Regular insulin can be administered intravenously E. Lispro is a rapid acting insulin

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

Explanation

A. NPH insulin may be mixed with pens. This statement is correct. NPH insulin can be mixed with other insulins, and it is available in pens for ease of administration.

B. Insulin detemir is administered once or twice daily, not necessarily with meals. Detemir is a long-acting insulin and can be taken once or twice daily, depending on the individual's specific treatment plan. It does not need to be strictly timed with meals.

C. Insulin glargine is a long-acting insulin and is generally not used as a first-line treatment for gestational diabetes. Short-acting insulins are typically recommended. Gestational diabetes is usually managed with short-acting insulins (like regular insulin) due to their faster onset and shorter duration of action. Long-acting insulins like glargine are not typically used in this context.

D. Regular insulin can be administered intravenously. This is a correct statement. Regular insulin can indeed be given intravenously in a hospital setting for precise control of blood glucose levels.

E. Lispro is a rapid-acting insulin. This statement is accurate. Lispro is a rapid-acting insulin analog used to control high blood sugar levels during and after meals. It has a fast onset of action.

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The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up?

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