Nokea
The client is hospitalized with a tentative diagnosis of Cushing's syndrome. Which laboratory findings should the nurse expect if the diagnosis of Cushing's syndrome is confirmed? Select all that apply.
- A. Hyperglycemia
- B. Eosinophilia
- C. Hypocalcemia
- D. Hypokalemia
- E. Thrombocytopenia
- F. Elevated serum cortisol
Correct Answer: A,D,F
Rationale: Cushing's syndrome causes hyperglycemia, hypokalemia, and elevated serum cortisol due to excessive adrenocortical activity.
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The nurse should assess for hypocalcemia based on which client statements after a subtotal thyroidectomy?
- A. I feel tingling in my hands and feet.
- B. I have a headache.
- C. I feel sleepy.
- D. I have a sore throat.
Correct Answer: A
Rationale: Tingling in the hands and feet indicates hypocalcemia, a potential complication due to parathyroid gland damage during thyroidectomy.
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 interviewing four clients. Which client is at the greatest risk for developing type 2 DM?
- A. 56-year-old Hispanic female
- B. 40-year-old Asian American female
- C. 25-year-old obese Caucasian male
- D. 38-year-old Native American male
Correct Answer: D
Rationale: Research has shown that the highest incidence of DM is among Native Americans.
The nurse is discussing the endocrine system with the client. Which endocrine gland secretes epinephrine and norepinephrine?
- A. The pancreas.
- B. The adrenal cortex.
- C. The adrenal medulla.
- D. The anterior pituitary gland.
Correct Answer: C
Rationale: The adrenal medulla secretes catecholamines (epinephrine and norepinephrine), which regulate the fight-or-flight response. The pancreas secretes insulin/glucagon, the adrenal cortex produces corticosteroids, and the anterior pituitary releases hormones like ACTH.
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.