Test bank nsdwqrty
The nurse is caring for a patient with a diagnosis of Addison's disease. What sign or
symptom is most closely associated with this health problem?
A) Truncal obesity
B) Hypertension
C) Muscle weakness
D) Moon face - answers Ans: C
Feedback:
Patients with Addison's disease demonstrate muscular weakness, anorexia,
gastrointestinal symptoms, fatigue, emaciation, dark pigmentation of the skin, and
hypotension. Patients with Cushing syndrome demonstrate truncal obesity, moon face,
acne, abdominal striae, and hypertension.
The nurse is caring for a patient with Addison's disease who is scheduled for discharge.
When teaching the patient about hormone replacement therapy, the nurse should
address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement
C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function - answers Ans: B
Feedback:
Because of the need for lifelong replacement of adrenal cortex hormones to prevent
addisonian crises, the patient and family members receive explicit education about the
rationale for replacement therapy and proper dosage. Doses are not adjusted on a
short-term basis. Weight gain and hepatotoxicity are not common adverse effects.
A patient is prescribed corticosteroid therapy. What would be priority information for the
nurse to give the patient who is prescribed long-term corticosteroid therapy?
A) The patient's diet should be low protein with ample fat.
,B) The patient may experience short-term changes in cognition.
C) The patient is at an increased risk for developing infection.
D) The patient is at a decreased risk for development of thrombophlebitis and
thromboembolism. - answers Ans: C
Feedback:
The patient is at increased risk of infection and masking of signs of infection. The
cardiovascular effects of corticosteroid therapy may result in development of
thrombophlebitis or thromboembolism. Diet should be high in protein with limited fat.
Changes in appearance usually disappear when therapy is no longer necessary.
Cognitive changes are not common adverse effects.
A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What
is an expected urinalysis finding?
A) Glucose in the urine
B) Albumin in the urine
C) Highly dilute urine
D) Leukocytes in the urine - answers Ans: C
Feedback:
Patients with diabetes insipidus produce an enormous daily output of very dilute, water-
like urine with a specific gravity of 1.001 to 1.005. The urine contains no abnormal
substances such as glucose or albumin. Leukocytes in the urine are not related to the
condition of diabetes insipidus, but would indicate a urinary tract infection, if present in
the urine.
The nurse caring for a patient with Cushing syndrome is describing the dexamethasone
suppression test scheduled for tomorrow. What does the nurse explain that this test will
involve?
A) Administration of dexamethasone orally, followed by a plasma cortisol level every
hour for 3 hours
B) Administration of dexamethasone IV, followed by an x-ray of the adrenal glands
C) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8
AM the next morning
,D) Administration of dexamethasone intravenously, followed by a plasma cortisol level 3
hours after the drug is administered - answers Ans: C
Feedback:
Dexamethasone (1 mg) is administered orally at 11 PM, and a plasma cortisol level is
obtained at 8 AM the next morning. This test can be performed on an outpatient basis
and is the most widely used and sensitive screening test for diagnosis of pituitary and
adrenal causes of Cushing syndrome.
You are developing a care plan for a patient with Cushing syndrome. What nursing
diagnosis would have the highest priority in this care plan?
A) Risk for injury related to weakness
B) Ineffective breathing pattern related to muscle weakness
C) Risk for loneliness related to disturbed body image
D) Autonomic dysreflexia related to neurologic changes - answers Ans: A
Feedback:
The nursing priority is to decrease the risk of injury by establishing a protective
environment. The patient who is weak may require assistance from the nurse in
ambulating to prevent falls or bumping corners or furniture. The patient's breathing will
not be affected and autonomic dysreflexia is not a plausible risk. Loneliness may or may
not be an issue for the patient, but safety is a priority.
The nurse is performing a shift assessment of a patient with aldosteronism. What
assessments should the nurse include? Select all that apply.
A) Urine output
B) Signs or symptoms of venous thromboembolism
C) Peripheral pulses
D) Blood pressure
E) Skin integrity - answers Ans: A, D
Feedback:
, The principal action of aldosterone is to conserve body sodium. Alterations in
aldosterone levels consequently affect urine output and BP. The patient's peripheral
pulses, risk of VTE, and skin integrity are not typically affected by aldosteronism.
The home care nurse is conducting patient teaching with a patient on corticosteroid
therapy. To achieve consistency with the body's natural secretion of cortisol, when
would the home care nurse instruct the patient to take his or her corticosteroids?
A) In the evening between 4 PM and 6 PM
B) Prior to going to sleep at night
C) At noon every day
D) In the morning between 7 AM and 8 AM - answers Ans: D
Feedback:
In keeping with the natural secretion of cortisol, the best time of day for the total
corticosteroid dose is in the morning from 7 to 8 AM. Large-dose therapy at 8 AM, when
the adrenal gland is most active, produces maximal suppression of the gland. Also, a
large 8 AM dose is more physiologic because it allows the body to escape effects of the
steroids from 4 PM to 6 AM, when serum levels are normally low, thus minimizing
cushingoid effects
A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient
has a documented history of adrenal insufficiency. Considering the patient's history and
current symptoms, the nurse should anticipate that the patient will be instructed to do
which of the following?
A) Increase his intake of sodium until the GI symptoms improve.
B) Increase his intake of potassium until the GI symptoms improve.
C) Increase his intake of glucose until the GI symptoms improve.
D) Increase his intake of calcium until the GI symptoms improve. - answers Ans: A
Feedback:
The patient will need to supplement dietary intake with added salt during episodes of GI
losses of fluid through vomiting and diarrhea to prevent the onset of addisonian crisis.
While the patient may experience the loss of other electrolytes, the major concern is the
replacement of lost sodium.
The nurse is caring for a patient with a diagnosis of Addison's disease. What sign or
symptom is most closely associated with this health problem?
A) Truncal obesity
B) Hypertension
C) Muscle weakness
D) Moon face - answers Ans: C
Feedback:
Patients with Addison's disease demonstrate muscular weakness, anorexia,
gastrointestinal symptoms, fatigue, emaciation, dark pigmentation of the skin, and
hypotension. Patients with Cushing syndrome demonstrate truncal obesity, moon face,
acne, abdominal striae, and hypertension.
The nurse is caring for a patient with Addison's disease who is scheduled for discharge.
When teaching the patient about hormone replacement therapy, the nurse should
address what topic?
A) The possibility of precipitous weight gain
B) The need for lifelong steroid replacement
C) The need to match the daily steroid dose to immediate symptoms
D) The importance of monitoring liver function - answers Ans: B
Feedback:
Because of the need for lifelong replacement of adrenal cortex hormones to prevent
addisonian crises, the patient and family members receive explicit education about the
rationale for replacement therapy and proper dosage. Doses are not adjusted on a
short-term basis. Weight gain and hepatotoxicity are not common adverse effects.
A patient is prescribed corticosteroid therapy. What would be priority information for the
nurse to give the patient who is prescribed long-term corticosteroid therapy?
A) The patient's diet should be low protein with ample fat.
,B) The patient may experience short-term changes in cognition.
C) The patient is at an increased risk for developing infection.
D) The patient is at a decreased risk for development of thrombophlebitis and
thromboembolism. - answers Ans: C
Feedback:
The patient is at increased risk of infection and masking of signs of infection. The
cardiovascular effects of corticosteroid therapy may result in development of
thrombophlebitis or thromboembolism. Diet should be high in protein with limited fat.
Changes in appearance usually disappear when therapy is no longer necessary.
Cognitive changes are not common adverse effects.
A nurse caring for a patient with diabetes insipidus is reviewing laboratory results. What
is an expected urinalysis finding?
A) Glucose in the urine
B) Albumin in the urine
C) Highly dilute urine
D) Leukocytes in the urine - answers Ans: C
Feedback:
Patients with diabetes insipidus produce an enormous daily output of very dilute, water-
like urine with a specific gravity of 1.001 to 1.005. The urine contains no abnormal
substances such as glucose or albumin. Leukocytes in the urine are not related to the
condition of diabetes insipidus, but would indicate a urinary tract infection, if present in
the urine.
The nurse caring for a patient with Cushing syndrome is describing the dexamethasone
suppression test scheduled for tomorrow. What does the nurse explain that this test will
involve?
A) Administration of dexamethasone orally, followed by a plasma cortisol level every
hour for 3 hours
B) Administration of dexamethasone IV, followed by an x-ray of the adrenal glands
C) Administration of dexamethasone orally at 11 PM, and a plasma cortisol level at 8
AM the next morning
,D) Administration of dexamethasone intravenously, followed by a plasma cortisol level 3
hours after the drug is administered - answers Ans: C
Feedback:
Dexamethasone (1 mg) is administered orally at 11 PM, and a plasma cortisol level is
obtained at 8 AM the next morning. This test can be performed on an outpatient basis
and is the most widely used and sensitive screening test for diagnosis of pituitary and
adrenal causes of Cushing syndrome.
You are developing a care plan for a patient with Cushing syndrome. What nursing
diagnosis would have the highest priority in this care plan?
A) Risk for injury related to weakness
B) Ineffective breathing pattern related to muscle weakness
C) Risk for loneliness related to disturbed body image
D) Autonomic dysreflexia related to neurologic changes - answers Ans: A
Feedback:
The nursing priority is to decrease the risk of injury by establishing a protective
environment. The patient who is weak may require assistance from the nurse in
ambulating to prevent falls or bumping corners or furniture. The patient's breathing will
not be affected and autonomic dysreflexia is not a plausible risk. Loneliness may or may
not be an issue for the patient, but safety is a priority.
The nurse is performing a shift assessment of a patient with aldosteronism. What
assessments should the nurse include? Select all that apply.
A) Urine output
B) Signs or symptoms of venous thromboembolism
C) Peripheral pulses
D) Blood pressure
E) Skin integrity - answers Ans: A, D
Feedback:
, The principal action of aldosterone is to conserve body sodium. Alterations in
aldosterone levels consequently affect urine output and BP. The patient's peripheral
pulses, risk of VTE, and skin integrity are not typically affected by aldosteronism.
The home care nurse is conducting patient teaching with a patient on corticosteroid
therapy. To achieve consistency with the body's natural secretion of cortisol, when
would the home care nurse instruct the patient to take his or her corticosteroids?
A) In the evening between 4 PM and 6 PM
B) Prior to going to sleep at night
C) At noon every day
D) In the morning between 7 AM and 8 AM - answers Ans: D
Feedback:
In keeping with the natural secretion of cortisol, the best time of day for the total
corticosteroid dose is in the morning from 7 to 8 AM. Large-dose therapy at 8 AM, when
the adrenal gland is most active, produces maximal suppression of the gland. Also, a
large 8 AM dose is more physiologic because it allows the body to escape effects of the
steroids from 4 PM to 6 AM, when serum levels are normally low, thus minimizing
cushingoid effects
A patient presents at the walk-in clinic complaining of diarrhea and vomiting. The patient
has a documented history of adrenal insufficiency. Considering the patient's history and
current symptoms, the nurse should anticipate that the patient will be instructed to do
which of the following?
A) Increase his intake of sodium until the GI symptoms improve.
B) Increase his intake of potassium until the GI symptoms improve.
C) Increase his intake of glucose until the GI symptoms improve.
D) Increase his intake of calcium until the GI symptoms improve. - answers Ans: A
Feedback:
The patient will need to supplement dietary intake with added salt during episodes of GI
losses of fluid through vomiting and diarrhea to prevent the onset of addisonian crisis.
While the patient may experience the loss of other electrolytes, the major concern is the
replacement of lost sodium.
