NR 507 Final Study Guide
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1. Acid base imbalance
While checking arterial blood gas results, a nurse finds respiratory acidosis. What does
the nurse suspect is occurring in the patient?
reduced tidal volumes
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon
dioxide (CO2 ) levels. Which of the following does the nurse suspect is the most likely
cause?
Hyperventilation
The nurse is assessing a client with suspected respiratory acidosis. Which assessment
items are priority for the nurse to collect?
Rate and depth of respirations, Skin color and temperature, Appearance of the optic
nerve
o The nurse is administering sodium bicarbonate to the client with respiratory
acidosis. The nurse understands that which is the primary goal of treatment for
this client?
Removing excess acids in blood
The student nurse is assisting in the care for a client with acute respiratory acidosis. The
nurse explains to the student nurse that the client's blood pH initially falls in the
development of acute respiratory acidosis because of which process?
Hypoventilation
1
, 2. ACTH
The nurse is preparing a client for testing to determine if the client has Cushing
syndrome. What tests are included in the screening process
24-hour urine secretion of cortisol
Dexamethasone suppression test
Plasma levels of ACTH
A client comes to the clinic with fatigue and muscle weakness. The client also states she
has been having diarrhea. The nurse observes the skin of the client has a bronze tone and
when asked, the client says she has not had any sun exposure. The mucous membranes of
the gums are bluish-black. When reviewing laboratory results from this client, what does
the nurse anticipate seeing?
Increased levels of ACTH
A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to
begin replacement therapy. Regarding which type of replacement will the nurse educate
the client?
Cortisol replacement therapy
Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to
stimulate the adrenal glands, the adrenals' production of cortisol drops. This is an
example of which type of endocrine disorder?
Secondary
2
, The nurse is preparing a client for a test that will measure negative feedback suppression
of ACTH. Which medication will the nurse administer in conjunction for this test?
Dexamethasone
ACTH deficiency results in secondary hypocortisolism
ACTH deficiency is most commonly caused by?
glucocorticoid withdrawal
6 symptoms of an ACTH deficiency
tiredness
weakness
anorexia
N/V
hypoglycemia
orthostatic hypotension
interpretation of ACTH levels requires simultaneous assessment of plasma cortisol
levels
ACTH levels are normal to high in primary adrenal insufficiency
ACTH levels are low to absent in secondary adrenal insufficiency
The client has been taking an oral cortisol preparation for 2 years to manage an
autoimmune disease. What effects does the nurse expect this therapy to have on this
client's circulating levels of ACTH and aldosterone?
Decreased ACTH, decreased aldosterone
A nurse checks lab results as both Cushing syndrome and Addison disease can manifest
with elevated levels of:
3
_____________________________________________________________________________
1. Acid base imbalance
While checking arterial blood gas results, a nurse finds respiratory acidosis. What does
the nurse suspect is occurring in the patient?
reduced tidal volumes
A 20-year-old male is in acute pain. An arterial blood gas reveals decreased carbon
dioxide (CO2 ) levels. Which of the following does the nurse suspect is the most likely
cause?
Hyperventilation
The nurse is assessing a client with suspected respiratory acidosis. Which assessment
items are priority for the nurse to collect?
Rate and depth of respirations, Skin color and temperature, Appearance of the optic
nerve
o The nurse is administering sodium bicarbonate to the client with respiratory
acidosis. The nurse understands that which is the primary goal of treatment for
this client?
Removing excess acids in blood
The student nurse is assisting in the care for a client with acute respiratory acidosis. The
nurse explains to the student nurse that the client's blood pH initially falls in the
development of acute respiratory acidosis because of which process?
Hypoventilation
1
, 2. ACTH
The nurse is preparing a client for testing to determine if the client has Cushing
syndrome. What tests are included in the screening process
24-hour urine secretion of cortisol
Dexamethasone suppression test
Plasma levels of ACTH
A client comes to the clinic with fatigue and muscle weakness. The client also states she
has been having diarrhea. The nurse observes the skin of the client has a bronze tone and
when asked, the client says she has not had any sun exposure. The mucous membranes of
the gums are bluish-black. When reviewing laboratory results from this client, what does
the nurse anticipate seeing?
Increased levels of ACTH
A client is diagnosed with adrenocorticotropic hormone deficiency (ACTH) and is to
begin replacement therapy. Regarding which type of replacement will the nurse educate
the client?
Cortisol replacement therapy
Following destruction of the pituitary gland, ACTH stimulation stops. Without ACTH to
stimulate the adrenal glands, the adrenals' production of cortisol drops. This is an
example of which type of endocrine disorder?
Secondary
2
, The nurse is preparing a client for a test that will measure negative feedback suppression
of ACTH. Which medication will the nurse administer in conjunction for this test?
Dexamethasone
ACTH deficiency results in secondary hypocortisolism
ACTH deficiency is most commonly caused by?
glucocorticoid withdrawal
6 symptoms of an ACTH deficiency
tiredness
weakness
anorexia
N/V
hypoglycemia
orthostatic hypotension
interpretation of ACTH levels requires simultaneous assessment of plasma cortisol
levels
ACTH levels are normal to high in primary adrenal insufficiency
ACTH levels are low to absent in secondary adrenal insufficiency
The client has been taking an oral cortisol preparation for 2 years to manage an
autoimmune disease. What effects does the nurse expect this therapy to have on this
client's circulating levels of ACTH and aldosterone?
Decreased ACTH, decreased aldosterone
A nurse checks lab results as both Cushing syndrome and Addison disease can manifest
with elevated levels of:
3
