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The nurse is performing a physical assessment on a client with Cushing's disease. Which assessment findings should the nurse expect?
- A. Hypotension
- B. Acne
- C. Hirsutism
- D. Buffalo hump
- E. Truncal obesity
Correct Answer: B, C, D, E
Rationale: Cushing's disease from excess cortisol causes acne, hirsutism (excess hair), buffalo hump, and truncal obesity due to fat redistribution. Hypertension, not hypotension, is typical.
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The nurse is planning a staff education program about conditions that increase cortisol levels. Which of the following conditions should the nurse include?
- A. Addison's disease
- B. Congestive heart failure (CHF)
- C. Renal failure
- D. Cushing's disease
Correct Answer: D
Rationale: Cushing's disease increases cortisol due to excess ACTH. Addison's reduces cortisol, and CHF and renal failure do not directly elevate cortisol levels.
This nurse is caring for a client who is receiving prescribed sitagliptin. Which assessment findings indicate the client is experiencing a severe adverse effect?
- A. Nasal stuffiness
- B. Abdominal pain
- C. Headache
- D. Occasional dry cough
Correct Answer: B
Rationale: Abdominal pain may indicate pancreatitis, a rare but severe sitagliptin adverse effect, requiring immediate attention. Nasal stuffiness, headache, and dry cough are less severe.
The nurse is caring for a client diagnosed with hyperparathyroidism. Which laboratory data would support this diagnosis?
- A. Potassium 4.1 mEq/L (mmol/L) [3.5-5 mEq/L, mmol/L]
- B. Phosphorus 4.9 mEq/L (mmol/L) [2-4.5 mEq/L, 0.81-1.58 mmol/L]
- C. Calcium 11.2 mg/dL (2.8 mmol/L) [9-10.5 mg/dL, 2.12-2.52 mmol/L]
- D. Sodium 132 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]
Correct Answer: C
Rationale: Hyperparathyroidism increases PTH, raising blood calcium (11.2 mg/dL is elevated) and often lowering phosphorus. Potassium and sodium are not directly affected.
The nurse administers a combination of regular insulin and NPH insulin subcutaneously to a client at 0800. At which time should the nurse initially assess the client for hypoglycemia based on the peaks of the medications?
- A. 830
- B. 1000
- C. 1200
- D. 1400
Correct Answer: B
Rationale: Regular insulin peaks at 2-4 hours (1000-1200), and NPH peaks at 4-12 hours. Initial hypoglycemia risk is highest around 1000 due to regular insulin's peak effect.
The nurse is developing a plan of care for a client with hypothyroidism that is not controlled with medication. The nurse should recommend
- A. applying lotion after a warm bath.
- B. high-fiber snacks.
- C. caffeinated beverages to promote energy.
- D. physical activities with frequent rest breaks.
- E. adding fans to the room to keep it cool.
Correct Answer: A, B, D
Rationale: Hypothyroidism causes dry skin, constipation, and fatigue. Lotion hydrates skin, high-fiber snacks aid bowel movements, and rest breaks accommodate low energy. Caffeine may overstimulate, and fans are unhelpful as clients feel cold, not hot.