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. A peak flow of more than 40% would indicate that the patient's asthma is not in an acute exacerbation. This patient's symptoms, such as confusion and inability to speak, suggest a severe asthma attack, and the peak flow would likely be much lower.
B. Bradycardia is not typically associated with severe asthma exacerbations. Tachycardia is more commonly observed as the body attempts to compensate for hypoxia.
C. Loud and prominent wheezing is usually seen in less severe cases of asthma. In this case, the inability to speak and confusion suggest severe respiratory distress, where wheezing might be diminished or absent due to poor air movement.
D. Deteriorating arterial blood gas (ABG) results, with low oxygen levels (hypoxemia) and elevated carbon dioxide levels (hypercapnia), would be expected in a patient with severe asthma exacerbation. These signs indicate respiratory failure and the need for urgent intervention.

A. Stop the infusion. B. Elevate the head of the bed. C. Auscultate the client's breath sounds. D. Call the client's provider.

Correct Answer is A

Explanation

A. The client is likely experiencing an allergic reaction to penicillin, such as anaphylaxis, which can cause symptoms like itching, dizziness, and difficulty breathing. The first step is to stop the infusion immediately to prevent further exposure to the allergen.
B. Elevating the head of the bed might be helpful if the client is experiencing respiratory distress, but stopping the infusion is the priority action.
C. Auscultating the client's breath sounds may be useful later to assess the severity of respiratory distress, but it is not the first action in an acute allergic reaction.
D. Calling the provider is important, but the immediate priority is stopping the infusion to prevent further harm from the allergic reaction.

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

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is A

Explanation

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