What are the expected findings during assessment of a client with Cushing's disease?
weight loss-muscle wasting
truncal obesity-moon face
pallor - swollen tongue
depigmented skin- eyelid lag
The Correct Answer is B
A. Weight loss–muscle wasting: Muscle wasting can occur in Cushing’s disease due to protein catabolism, but it is usually accompanied by weight gain rather than weight loss. Clients typically experience redistribution of fat rather than overall loss of body mass. Weight loss is more characteristic of conditions such as Addison’s disease or hyperthyroidism.
B. Truncal obesity–moon face: Excess cortisol leads to abnormal fat redistribution, resulting in central (truncal) obesity and a rounded “moon face.” These are classic physical assessment findings in clients with Cushing’s disease. The pattern reflects prolonged exposure to high cortisol levels.
C. Pallor–swollen tongue: Pallor and a swollen tongue are more suggestive of anemia or vitamin B12 deficiency. These findings are not associated with the hormonal and metabolic effects of excess cortisol. They do not reflect the typical physical changes seen in Cushing’s disease.
D. Depigmented skin–eyelid lag: Depigmented skin is commonly associated with autoimmune conditions, while eyelid lag is a hallmark of hyperthyroidism. These findings are unrelated to cortisol excess and do not align with the expected assessment findings in Cushing’s disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Iron deficiency: Iron deficiency anemia results from inadequate iron for hemoglobin synthesis, leading to small, pale red blood cells. The bone marrow itself is usually functioning normally, but the substrate for RBC production is insufficient.
B. Pernicious: Pernicious anemia is caused by vitamin B12 deficiency, often due to intrinsic factor deficiency. While red blood cell production is affected, the underlying problem is nutritional and not a direct malfunction of the bone marrow.
C. Sickle cell: Sickle cell anemia is a genetic disorder causing abnormal hemoglobin formation, leading to sickle-shaped red blood cells. The bone marrow can produce red blood cells, but they are structurally defective and have a shortened lifespan.
D. Aplastic: Aplastic anemia occurs when the bone marrow fails to produce sufficient red blood cells, white blood cells, and platelets. This primary marrow dysfunction leads to pancytopenia and is directly related to impaired hematopoiesis.
E. Hemolytic: Hemolytic anemia results from premature destruction of red blood cells, either inherited or acquired. The bone marrow may respond by increasing RBC production, so the marrow itself is not the primary site of dysfunction.
Correct Answer is B
Explanation
A. Curable with antivirals: Rheumatoid arthritis is not caused by a viral infection, so antiviral medications have no curative effect. Treatment focuses on managing inflammation and preventing joint damage rather than eradicating a pathogen.
B. An autoimmune disease: Rheumatoid arthritis is a chronic autoimmune disorder in which the immune system mistakenly attacks the synovial membranes of joints. This leads to inflammation, pain, stiffness, and progressive joint deformity over time.
C. A complication of rheumatic fever: Rheumatic fever can cause rheumatic heart disease, but it is distinct from rheumatoid arthritis. Rheumatoid arthritis is not a sequela of streptococcal infection.
D. Related to repetitive movements: Conditions caused by repetitive movements, such as osteoarthritis or tendonitis, are mechanical rather than autoimmune. Rheumatoid arthritis arises from immune system dysfunction rather than repetitive stress on joints.
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