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

Hypertensive crisis requires immediate treatment to prevent a stroke.

The drug may be needed to treat a sudden systemic allergic reaction.

Stress increases the body’s need for additional replacement hormone.

Hyperglycemia may require cortisol to lower the blood glucose level.

Answer and Explanation

The Correct Answer is C

Choice A reason: Hypertensive crisis is not a feature of Addison’s disease, which causes hypotension due to cortisol and aldosterone deficiency. Cortisol kits address adrenal insufficiency during stress, not hypertension. This choice is incorrect, as it misaligns with Addison’s pathophysiology and cortisol’s role.

Choice B reason: Cortisol is not used for systemic allergic reactions, which require antihistamines or epinephrine. Addison’s patients need cortisol for adrenal insufficiency during stress, as their bodies cannot produce it. This choice is incorrect, as cortisol kits address hypoadrenalism, not anaphylaxis.

Choice C reason: Addison’s disease involves adrenal insufficiency, impairing cortisol production. Stress increases cortisol demand, which the patient cannot meet, risking adrenal crisis. Carrying a cortisol kit allows rapid administration during stress, preventing life-threatening hypotension or shock, aligning with endocrinology evidence for Addison’s management.

Choice D reason: Hyperglycemia is unrelated to Addison’s disease, which does not typically affect glucose metabolism. Cortisol kits address adrenal insufficiency, not blood glucose. This choice is incorrect, as cortisol replacement is for stress-induced hypoadrenalism, not glycemic control, per Addison’s pathophysiological basis.

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Correct Answer is D

Explanation

Choice A reason: Inflammation may occur in prostatitis, not typically in BPH. BPH causes urinary retention via physical obstruction from gland enlargement, not spasms. Inflammation is not the primary mechanism, making this incorrect for explaining why BPH leads to retention in the client’s urinary symptoms.

Choice B reason: Abnormal growth in BPH does not cause loss of bladder muscle. The enlarged prostate compresses the urethra, obstructing urine flow. Bladder muscle may weaken over time from chronic obstruction, but this is secondary, making this incorrect for the primary cause of urinary retention.

Choice C reason: Nerve compression is not a primary BPH mechanism. BPH causes retention by mechanically obstructing the urethra, not by impairing bladder sensation. Sensory changes may occur in neurological conditions, but in BPH, physical compression is the cause, making this incorrect for the client’s retention.

Choice D reason: BPH causes the prostate to enlarge, compressing the urethra and obstructing urine flow, leading to urinary retention. This mechanical blockage is the primary pathophysiological mechanism, causing symptoms like hesitancy or incomplete voiding. This explanation aligns with urological evidence, accurately addressing the client’s condition.

A. Fibrosis and calcification of the pancreas tissue. B. Inflammation caused by obstructed pancreatic duct. C. Bleeding gastric ulcer. D. Spasms of the sphincter of Oddi blocking secretion. E. Autodigestion by pancreatic enzymes.

Correct Answer is ["B","D","E"]

Explanation

Choice A reason: Fibrosis and calcification occur in chronic pancreatitis, not acute pancreatitis, which is characterized by sudden inflammation. Alcohol-induced acute pancreatitis involves duct obstruction and enzyme autodigestion, causing pain. Fibrosis is a long-term consequence, not a primary driver of the acute pain in this client’s recent alcohol binge.

Choice B reason: Inflammation from an obstructed pancreatic duct is a key cause of acute pancreatitis pain. Alcohol can trigger duct blockage, leading to enzyme backup, inflammation, and tissue irritation. This process causes severe upper abdominal pain radiating to the back, aligning with the client’s symptoms and elevated amylase/lipase levels.

Choice C reason: Bleeding gastric ulcers cause epigastric pain but are unrelated to pancreatitis, which involves pancreatic inflammation. Elevated amylase and lipase confirm pancreatitis, not ulcer disease. Ulcers do not radiate pain to the back or stem from alcohol binges, making this incorrect for the client’s diagnosis.

Choice D reason: Spasms of the sphincter of Oddi, often alcohol-induced, block pancreatic secretions, causing enzyme backup and inflammation. This contributes to the severe pain of acute pancreatitis, as obstructed flow exacerbates tissue irritation. This process aligns with the client’s symptoms and laboratory findings, supporting its role in pain causation.

Choice E reason: Autodigestion by pancreatic enzymes, activated prematurely due to duct obstruction, causes tissue damage and severe pain in acute pancreatitis. Alcohol triggers this process, leading to inflammation and necrosis. This is a primary pathophysiological mechanism, explaining the client’s pain and elevated amylase/lipase, per evidence-based pancreatitis pathology.

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

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Naxlex Comprehensive Predictor Exams

When explanation should the nurse give to a male client on why benign prostatic hyperplasia (BPH) often causes urinary retention?

Correct Answer is D

Explanation

Correct Answer is ["B","D","E"]

Explanation

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