Nokea
A patient with Cushing syndrome has been hospitalized after a fall. The dietician consulted works with the patient to improve the patients nutritional intake. What foods should a patient with Cushing syndrome eat to optimize health? Select all that apply.
- A. Foods high in vitamin D
- B. Foods high in calories
- C. Foods high in protein
- D. Foods high in calcium
- E. Foods high in sodium
Correct Answer: A,C,D
Rationale: Foods high in vitamin D, protein, and calcium are recommended to minimize muscle wasting and osteoporosis. Referral to a dietitian may assist the patient in selecting appropriate foods that are also low in sodium and calories.
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A 30 year-old female patient has been diagnosed with Cushing syndrome. What psychosocial nursing diagnosis should the nurse most likely prioritize when planning the patients care?
- A. Decisional conflict related to treatment options
- B. Spiritual distress related to changes in cognitive function
- C. Disturbed body image related to changes in physical appearance
- D. Powerlessness related to disease progression
Correct Answer: C
Rationale: Cushing syndrome causes characteristic physical changes that are likely to result in disturbed body image. Decisional conflict and powerless may exist, but disturbed body image is more likely to be present. Cognitive changes take place in patients with Cushing syndrome, but these may or may not cause spiritual distress.
A patient has been taking prednisone for several weeks after experiencing a hypersensitivity reaction. To prevent adrenal insufficiency, the nurse should ensure that the patient knows to do which of the following?
- A. Take the drug concurrent with levothyroxine (Synthroid)
- B. Take each dose of prednisone with a dose of calcium chloride
- C. Gradually replace the prednisone with an OTC alternative
- D. Slowly taper down the dose of prednisone, as ordered
Correct Answer: D
Rationale: Corticosteroid dosages are reduced gradually (tapered) to allow normal adrenal function to return and to prevent steroid-induced adrenal insufficiency. There are no OTC substitutes for prednisone and neither calcium chloride nor levothyroxine addresses the risk of adrenal insufficiency.
A patient has been admitted to the critical care unit with a diagnosis of thyroid storm. What interventions should the nurse include in this patients immediate care? Select all that apply.
- A. Administering diuretics to prevent fluid overload
- B. Administering beta blockers to reduce heart rate
- C. Administering insulin to reduce blood glucose levels
- D. Applying interventions to reduce the patients temperature
- E. Administering corticosteroids
Correct Answer: B,D
Rationale: Thyroid storm necessitates interventions to reduce heart rate and temperature. Diuretics, insulin, and steroids are not indicated to address the manifestations of this health problem.
The nurse is assessing a patient diagnosed with Graves disease. What physical characteristics of Graves disease would the nurse expect to find?
- A. Hair loss
- B. Moon face
- C. Bulging eyes
- D. Fatigue
Correct Answer: C
Rationale: Clinical manifestations of the endocrine disorder Graves disease include exophthalmos (bulging eyes) and fine tremor in the hands. Graves disease is not associated with hair loss, a moon face, or fatigue.
A patient is undergoing testing for suspected adrenocortical insufficiency. The care team should ensure that the patient has been assessed for the most common cause of adrenocortical insufficiency. What is the most common cause of this health problem?
- A. Therapeutic use of corticosteroids
- B. Pheochromocytoma
- C. Inadequate secretion of ACTH
- D. Adrenal tumor
Correct Answer: A
Rationale: Therapeutic use of corticosteroids is the most common cause of adrenocortical insufficiency. The other options also cause adrenocortical insufficiency, but they are not the most common causes.