Nokea
The client is admitted to rule out Cushing's syndrome. Which laboratory tests should the nurse anticipate being ordered?
- A. Plasma drug levels of quinidine, digoxin, and hydralazine.
- B. Plasma levels of ACTH and cortisol.
- C. A 24-hour urine for metanephrine and catecholamine.
- D. Spot urine for creatinine and white blood cells (WBCs).
Correct Answer: B
Rationale: ACTH and cortisol levels diagnose Cushing’s by confirming hypercortisolism. Other tests assess unrelated conditions (e.g., pheochromocytoma, renal function).
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The nurse reviews the HCP's orders for the newly admitted client diagnosed with DKA. Which order should the nurse question?
- A. Administer D5W intravenously (IV) at 125 mL per hour
- B. Administer KCL 10 mEq in 100 mL NaCl IV now
- C. Give sodium bicarbonate IV per pharmacy dosing if arterial pH is less than 7.0
- D. Start regular insulin infusion per protocol; titrate based on hourly glucose level
Correct Answer: A
Rationale: In DKA, the blood glucose level is above 300 mg/dL. Additional glucose will increase the glucose level further. Initially 0.45% or 0.9% sodium chloride (NaCl) is administered for fluid resuscitation.
Which client statement indicates a correct understanding of corticosteroid therapy for Addison's disease?
- A. I can stop the medication if I feel better.
- B. I need to take this medication daily.
- C. I should take it only during stress.
- D. I can double the dose if I'm sick.
Correct Answer: B
Rationale: Corticosteroid therapy for Addison's disease requires daily administration to replace deficient hormones and maintain physiological balance.
The nurse is admitting the client tentatively diagnosed with possible hyperaldosteronism. What should be the nurse's priority?
- A. Prepare for a computed tomography (CT) scan
- B. Give prn prescribed analgesic to treat headache
- C. Obtain an ECG to evaluate for dysrhythmias
- D. Assess for generalized weakness and fatigue
Correct Answer: C
Rationale: Obtaining an ECG is priority to detect dysrhythmias from hypokalemia caused by potassium wasting in hyperaldosteronism.
Based on the client's blood glucose measurement, the nurse immediately reevaluates the client. Which physician orders should the nurse anticipate? Select all that apply.
- A. STAT serum blood glucose
- B. Intravenous regular insulin
- C. Vital signs every 2 hours
- D. A diet of six small, frequent meals
- E. Electronic glucometer measurements before meals and at bedtime
- F. Continuous cardiac monitoring
Correct Answer: A,B,E,F
Rationale: DKA with a glucose of 498 mg/dL requires STAT serum glucose, IV insulin, frequent glucometer checks, and cardiac monitoring.
Which of the following provides the best evidence that the dietary measures to control functional hypoglycemia are therapeutic?
- A. The client experiences fewer incidences of weakness and tremors.
- B. The client experiences fewer incidences of thirst and dry mouth.
- C. The client experiences fewer incidences of muscle spasms and fatigue.
- D. The client experiences fewer incidences of hunger and abdominal cramps.
Correct Answer: A
Rationale: Reduced weakness and tremors indicate stabilized blood glucose levels in functional hypoglycemia.