Nokea
The client has developed iatrogenic Cushing's disease. Which statement is the scientific rationale for the development of this diagnosis?
- A. The client has an autoimmune problem causing the destruction of the adrenal cortex.
- B. The client has been taking steroid medications for an extended period for another disease process.
- C. The client has a pituitary gland tumor causing the adrenal glands to produce too much cortisol.
- D. The client has developed an adrenal gland problem for which the health-care provider does not have an explanation.
Correct Answer: B
Rationale: Iatrogenic Cushing’s results from prolonged exogenous steroid use, mimicking endogenous hypercortisolism. Autoimmune issues, pituitary tumors, and idiopathic causes are incorrect.
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When the nurse conducts an admission history, which subjective symptom is the client likely to describe?
- A. Difficulty urinating
- B. Intolerance to cold
- C. Profuse perspiration
- D. Excessive appetite
Correct Answer: B
Rationale: Intolerance to cold is a common symptom of myxedema due to decreased metabolic rate.
Which medication order should the nurse question in the client diagnosed with untreated hypothyroidism?
- A. Thyroid hormones.
- B. Oxygen.
- C. Sedatives.
- D. Laxatives.
Correct Answer: C
Rationale: Sedatives risk respiratory depression in untreated hypothyroidism due to slowed metabolism. Thyroid hormones, oxygen, and laxatives are appropriate.
Which laboratory data indicate to the nurse the client’s pancreatitis is improving?
- A. The amylase and lipase serum levels are decreased.
- B. The white blood cell (WBC) count is decreased.
- C. The conjugated and unconjugated bilirubin levels are decreased.
- D. The blood urea nitrogen (BUN) serum level is decreased.
Correct Answer: A
Rationale: Acute pancreatitis is characterized by elevated serum amylase and lipase levels due to pancreatic inflammation. A decrease in these levels indicates reduced pancreatic injury and improvement in the condition. While a decreased WBC count may suggest resolving infection, it is less specific. Bilirubin levels are relevant for biliary obstruction, not pancreatitis improvement, and BUN reflects renal function, not pancreatic status.
The nurse obtains a fingerstick blood glucose reading of 48 mg/dL for the client with type 1 DM. The client is to receive 6 units of regular and 10 units of NPH insulin now. Which is the nurse's best immediate intervention?
- A. Administer the insulin that is due now.
- B. Call the lab for a STAT serum glucose level.
- C. Have the client choose foods for a meal now.
- D. Provide juice with 15 grams of carbohydrates.
Correct Answer: D
Rationale: Hypoglycemia is treated with 15 to 20 g of a simple (fast-acting) carbohydrate, such as 4 to 6 oz of fruit juice or 8 oz of low-fat milk.
Which nursing care measure is essential because a client has exophthalmos?
- A. Administer artificial tears.
- B. Encourage the client to wear her glasses.
- C. Promote bed rest.
- D. Monitor her pulse rate every four hours.
Correct Answer: A
Rationale: Exophthalmos (bulging eyes) in hyperthyroidism causes dry eyes, requiring artificial tears to prevent corneal damage.