The nurse notes that which disorder places the patient at greatest risk for hypertensive crisis?

Pheochromocytoma

Adrenal insufficiency

Hypothyroidism

Diabetes insipidus

Answer and Explanation

The Correct Answer is A

A. Pheochromocytoma is a tumor of the adrenal glands that can cause excessive production of catecholamines (such as norepinephrine and epinephrine), leading to a hypertensive crisis. This condition can cause severe hypertension, headaches, palpitations, and sweating.
B. Adrenal insufficiency is typically associated with low blood pressure, not hypertension. It is characterized by symptoms like weakness, fatigue, and hypotension, which are not linked to hypertensive crises.
C. Hypothyroidism is associated with low blood pressure and bradycardia, not an increased risk of hypertensive crisis. It typically leads to symptoms like weight gain, fatigue, and cold intolerance.
D. Diabetes insipidus is a condition that leads to excessive urination and thirst due to a lack of antidiuretic hormone, but it does not directly lead to a hypertensive crisis. It is primarily concerned with electrolyte imbalance and dehydration.

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Correct Answer is D

Explanation

A. Glucocorticoid medications are not used to treat DKA. In fact, glucocorticoids can increase blood glucose levels and exacerbate hyperglycemia.
B. Dextrose 5% in 0.45% sodium chloride is not appropriate for the initial treatment of DKA. Initially, IV fluids containing normal saline (0.9% sodium chloride) are used to correct dehydration and restore electrolyte balance.
C. Oral hypoglycemic medications are not effective in DKA, as it is a serious acute complication of diabetes that requires insulin therapy and IV fluids, not oral medications.
D. 0.9% sodium chloride IV bolus is the first-line treatment for DKA to rehydrate the patient, correct electrolyte imbalances, and dilute the high blood glucose level. After stabilization, insulin therapy is also introduced.

A. Restrict fluid intake. B. Administer oral corticosteroids. C. Provide a low-carbohydrate diet. D. Weigh the client daily.

Correct Answer is B

Explanation

A. Restrict fluid intake: This is incorrect. Clients with Addison’s disease are at risk for dehydration, especially during an Addisonian crisis. Fluids should be encouraged to help maintain blood pressure and fluid balance, rather than restricting fluid intake.
B. Administer oral corticosteroids: This is the correct action. Clients with Addison's disease have insufficient cortisol production, especially during times of stress or illness. Oral corticosteroids, such as hydrocortisone, are given to replace the deficient hormones and prevent or manage an Addisonian crisis.
C. Provide a low-carbohydrate diet: This is incorrect. Clients with Addison’s disease should have a balanced diet that includes adequate carbohydrates to support energy needs, especially during stress or illness. A low-carbohydrate diet could lead to further complications like hypoglycemia.
D. Weigh the client daily: While daily weight measurements can be helpful in monitoring for fluid retention or loss, it is not a primary intervention for preventing or managing Addisonian crisis. The most critical action is providing the necessary corticosteroid replacement therapy.

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The nurse notes that which disorder places the patient at greatest risk for hypertensive crisis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?

Correct Answer is D

Explanation

A nurse is caring for a client who has Addison's disease and is at risk for Addisonian crisis. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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