Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a client with Cushing's syndrome?

Monitor bowel patterns

Observe urine output

Observe the color of stool

Monitor vital signs every 4 hours

Answer and Explanation

The Correct Answer is C

Reasoning:

Choice A reason: Monitoring bowel patterns can detect changes in frequency or consistency but is not specific for peptic ulcers. Cushing’s syndrome increases gastric acid production due to cortisol, but altered bowel patterns are more indicative of other gastrointestinal issues, not directly linked to ulcer detection.

Choice B reason: Observing urine output is unrelated to peptic ulcer assessment in Cushing’s syndrome. Urine output reflects renal function or fluid status, not gastrointestinal pathology. Peptic ulcers, caused by cortisol-induced gastric acid hypersecretion, manifest as bleeding or pain, not changes in urine production.

Choice C reason: Observing stool color is critical for detecting peptic ulcers, as cortisol in Cushing’s syndrome increases gastric acid, leading to ulcer formation. Black, tarry stools (melena) indicate gastrointestinal bleeding, a common complication of peptic ulcers, making this the most specific assessment for early detection.

Choice D reason: Monitoring vital signs every 4 hours is routine but not specific for peptic ulcers. While tachycardia or hypotension may indicate severe bleeding, these are late signs. Stool color changes (melena) are earlier and more specific indicators of ulcer-related gastrointestinal bleeding in Cushing’s syndrome.

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Correct Answer is A

Explanation

Reasoning:

Choice A reason: An occluded urinary catheter is the most likely trigger for autonomic dysreflexia in spinal cord injury above T6. Bladder distension stimulates sympathetic overactivity, causing hypertension and bradycardia. This noxious stimulus below the injury level disrupts autonomic regulation, making catheter occlusion a common precipitant of this condition.

Choice B reason: A changed analgesia regimen is unlikely to cause autonomic dysreflexia. Pain may contribute to discomfort, but dysreflexia typically results from visceral stimuli like bladder or bowel distension. Analgesia changes do not directly trigger the sympathetic overresponse characteristic of this life-threatening condition.

Choice C reason: Failure to reposition may cause pressure injuries but is less likely to precipitate autonomic dysreflexia. While discomfort from immobility can contribute, visceral stimuli like catheter occlusion are more direct triggers, as they strongly activate the sympathetic nervous system below the spinal injury level.

Choice D reason: A blood transfusion is not a common cause of autonomic dysreflexia. Transfusions may cause reactions like fever, but dysreflexia results from stimuli like bladder distension. Transfusion-related complications do not typically trigger the autonomic overresponse seen in spinal cord injury patients with dysreflexia.

A. Color, warmth, movement, and sensation of extremities B. Breath sounds and bowel sounds C. Heart rate and blood pressure D. Temperature and oxygen saturation

Correct Answer is C

Explanation

Choice A reason: Assessing color, warmth, movement, and sensation of extremities is relevant for neurological or vascular conditions, not a fluid deprivation test. This test induces dehydration to evaluate ADH function, which primarily affects fluid status and cardiovascular parameters, not peripheral limb function, making these assessments less critical for monitoring during the test.

Choice B reason: Breath and bowel sounds are not prioritized during a fluid deprivation test. The test assesses the body’s ability to concentrate urine under dehydration stress, primarily impacting fluid and cardiovascular status. Respiratory and gastrointestinal functions are not directly affected by short-term fluid restriction in diagnosing diabetes insipidus.

Choice C reason: Heart rate and blood pressure are critical during a fluid deprivation test, as dehydration from fluid restriction can cause hypovolemia, leading to tachycardia and hypotension. Monitoring these parameters ensures patient safety and detects cardiovascular responses to fluid loss, which are key to evaluating the severity of diabetes insipidus.

Choice D reason: Temperature and oxygen saturation are secondary in a fluid deprivation test. Dehydration may cause slight temperature changes, but these are not primary indicators. Oxygen saturation remains stable unless severe hypovolemia leads to shock, which is rare in a controlled setting, making these assessments less critical than cardiovascular monitoring.

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Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a client with Cushing's syndrome?

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Naxlex Comprehensive Predictor Exams

A client who suffered a spinal cord injury is experiencing an exaggerated autonomic response. What aspect of the client’s current health status is most likely to have precipitated this event?

Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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