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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Reasoning:
Choice A reason: Addison’s disease, due to adrenal insufficiency, reduces aldosterone and cortisol production, leading to sodium loss (hyponatremia) and potassium retention (hyperkalemia). These electrolyte abnormalities result from impaired renal sodium reabsorption and potassium excretion, making sodium and potassium monitoring critical for managing complications like hypotension and arrhythmias.
Choice B reason: Calcium and phosphorus abnormalities are not primary concerns in Addison’s disease. These electrolytes are more affected by parathyroid or renal disorders. Addison’s disease primarily disrupts sodium and potassium balance due to aldosterone deficiency, with calcium and phosphorus typically remaining within normal ranges unless other conditions coexist.
Choice C reason: Sodium abnormalities occur in Addison’s disease due to aldosterone deficiency, causing hyponatremia. However, chloride levels are not significantly altered, as chloride follows sodium passively. Potassium imbalances (hyperkalemia) are more critical alongside sodium, making this combination less comprehensive than sodium and potassium monitoring.
Choice D reason: Chloride and magnesium abnormalities are not hallmark features of Addison’s disease. While mild chloride changes may occur with sodium loss, magnesium is typically unaffected. The primary electrolyte disturbances involve sodium (hyponatremia) and potassium (hyperkalemia), making these the focus of monitoring in adrenal insufficiency.
Correct Answer is C
Explanation
Reasoning:
Choice A reason: Thiazide diuretics reduce urine output in nephrogenic diabetes insipidus by increasing sodium excretion, which enhances water reabsorption indirectly. However, they are not the primary treatment for central diabetes insipidus, where ADH deficiency is the issue. Desmopressin, an ADH analog, directly addresses the hormonal deficiency, making thiazides less effective.
Choice B reason: Diabinese (chlorpropamide) is a sulfonylurea used for type 2 diabetes mellitus, not diabetes insipidus. It lowers blood glucose by stimulating insulin release, which is irrelevant to the water balance issue in diabetes insipidus caused by ADH deficiency. It does not address the underlying hormonal imbalance.
Choice C reason: Desmopressin (DDAVP) is a synthetic ADH analog used to treat central diabetes insipidus. It mimics ADH, promoting water reabsorption in the kidneys’ collecting ducts, reducing polyuria and thirst. This directly corrects the fluid imbalance caused by ADH deficiency, making it the primary and most effective treatment.
Choice D reason: Ibuprofen, a nonsteroidal anti-inflammatory drug, is used for pain and inflammation, not for fluid balance in diabetes insipidus. It has no effect on ADH or renal water reabsorption, making it irrelevant for treating the excessive urine output and dehydration associated with this condition.
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