NUR1211 E MEDICAL SURGICAL NURSING I
EXAM STUDY GUIDE WITH FULL SOLUTIONS
2026
◉ Cushing's Syndrome Clinical Manifestations. Answer: Women
Mostly
"Moon-faced" and increased oiliness of skin
The classic picture of Cushing syndrome in the adult is that of
central-type obesity, with a fatty "buffalo hump" in the neck and
supraclavicular areas, a heavy trunk, and relatively thin extremities.
The skin is thin, fragile, and easily traumatized; ecchymoses
(bruises) and striae develop. The patient complains of weakness and
lassitude. Sleep is disturbed because of altered diurnal secretion of
cortisol.
Excessive protein catabolism occurs, producing muscle wasting and
osteoporosis. Kyphosis, backache, and compression fractures of the
vertebrae may result. Retention of sodium and water occurs as a
result of increased mineralocorticoid activity, producing
hypertension and heart failure
Moon Face
Buffalo Hump
Central Obesity (thin extremities)
Thin Fragile Skin, Easily Bruised, Abdominal Stretch Marks
,Acne
Hirsutism
Hypertension & Hyperglycemia
Infertility
◉ Cushing's Syndrome- Excess. Answer: Adredncortical Activity
◉ Cushing's Syndrome Dietary Considerations. Answer: Foods high
in protein, calcium, and vitamin D 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.
Weight gain and edema may be modified by a low-carbohydrate,
low-sodium diet, and a high-protein intake may reduce some of the
other bothersome symptoms.
◉ Pediatric Acromegaly. Answer: Gigantism (child)
Kids can grow to 7-8ft tall
Although rare, oversecretion of GH in children before the fusion of
epiphyseal growth plates results in pituitary gigantism; a person
may grow to be seven or even eight feet tall. Conversely, insufficient
secretion of GH during childhood can result in generalized limited
growth and pituitary dwarfism
, ◉ Adult Acromegaly. Answer: Acromegaly, a disorder caused by an
excess of GH in adults, results in enlargement of peripheral body
parts and soft tissue, after the fusion of the epiphyseal plates has
occurred, without an increase in height
Adults: Hands, Feet, Nose, Above Eyebrows (super-ciliary ridge),
Chin
◉ Diabetes Insipidus Clinical Manifestations. Answer: Without the
action of ADH on the distal nephron of the kidney, an enormous daily
output (greater than 250 mL per hour) of very dilute urine with a
specific gravity of 1.001 to 1.005 occurs. The urine contains no
abnormal substances such as glucose or albumin. Because of the
intense thirst, the patient tends to drink 2 to 20 L of fluid daily and
craves cold water. In adults, the onset of DI may be insidious or
abrupt. The disease cannot be controlled by limiting fluid intake,
because the high-volume loss of urine continues even without fluid
replacement. Attempts to restrict fluids cause the patient to
experience an insatiable craving for fluid and to develop
hypernatremia and severe dehydration.
Peeing non-stop, crystal clear, cannot have concentrated urine
Low urine osmolarity (concentration)
Serum Osmolality High
Hypokalemia & Hypernatremia
Polyuria & Polydipsia
EXAM STUDY GUIDE WITH FULL SOLUTIONS
2026
◉ Cushing's Syndrome Clinical Manifestations. Answer: Women
Mostly
"Moon-faced" and increased oiliness of skin
The classic picture of Cushing syndrome in the adult is that of
central-type obesity, with a fatty "buffalo hump" in the neck and
supraclavicular areas, a heavy trunk, and relatively thin extremities.
The skin is thin, fragile, and easily traumatized; ecchymoses
(bruises) and striae develop. The patient complains of weakness and
lassitude. Sleep is disturbed because of altered diurnal secretion of
cortisol.
Excessive protein catabolism occurs, producing muscle wasting and
osteoporosis. Kyphosis, backache, and compression fractures of the
vertebrae may result. Retention of sodium and water occurs as a
result of increased mineralocorticoid activity, producing
hypertension and heart failure
Moon Face
Buffalo Hump
Central Obesity (thin extremities)
Thin Fragile Skin, Easily Bruised, Abdominal Stretch Marks
,Acne
Hirsutism
Hypertension & Hyperglycemia
Infertility
◉ Cushing's Syndrome- Excess. Answer: Adredncortical Activity
◉ Cushing's Syndrome Dietary Considerations. Answer: Foods high
in protein, calcium, and vitamin D 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.
Weight gain and edema may be modified by a low-carbohydrate,
low-sodium diet, and a high-protein intake may reduce some of the
other bothersome symptoms.
◉ Pediatric Acromegaly. Answer: Gigantism (child)
Kids can grow to 7-8ft tall
Although rare, oversecretion of GH in children before the fusion of
epiphyseal growth plates results in pituitary gigantism; a person
may grow to be seven or even eight feet tall. Conversely, insufficient
secretion of GH during childhood can result in generalized limited
growth and pituitary dwarfism
, ◉ Adult Acromegaly. Answer: Acromegaly, a disorder caused by an
excess of GH in adults, results in enlargement of peripheral body
parts and soft tissue, after the fusion of the epiphyseal plates has
occurred, without an increase in height
Adults: Hands, Feet, Nose, Above Eyebrows (super-ciliary ridge),
Chin
◉ Diabetes Insipidus Clinical Manifestations. Answer: Without the
action of ADH on the distal nephron of the kidney, an enormous daily
output (greater than 250 mL per hour) of very dilute urine with a
specific gravity of 1.001 to 1.005 occurs. The urine contains no
abnormal substances such as glucose or albumin. Because of the
intense thirst, the patient tends to drink 2 to 20 L of fluid daily and
craves cold water. In adults, the onset of DI may be insidious or
abrupt. The disease cannot be controlled by limiting fluid intake,
because the high-volume loss of urine continues even without fluid
replacement. Attempts to restrict fluids cause the patient to
experience an insatiable craving for fluid and to develop
hypernatremia and severe dehydration.
Peeing non-stop, crystal clear, cannot have concentrated urine
Low urine osmolarity (concentration)
Serum Osmolality High
Hypokalemia & Hypernatremia
Polyuria & Polydipsia
