A client complaining of weight gain and acne undergoes laboratory testing, which reveals elevated cortisol levels and hyperglycemia. The client has no prior medical history, and does not take any medications. After further testing and imaging to determine the cause of the elevated cortisol levels, the client is diagnosed with Cushing disease caused by a pituitary adenoma. Which of the following statements should the nurse include when teaching the client about this diagnosis?

It is important that you taper off of the corticosteroids you are taking which have caused this disorder.

You will need to have your adrenal glands removed to reverse your symptoms.

You will need to begin taking hydrocortisone, and increase your dose during times of stress.

You will receive glucose checks and sliding-scale insulin until your hormone levels are corrected.

Answer and Explanation

The Correct Answer is B

A. It is important that you taper off of the corticosteroids you are taking which have caused this disorder: This statement is not applicable because the client has a pituitary adenoma causing Cushing disease, not iatrogenic Cushing syndrome from corticosteroid use.
B. You will need to have your adrenal glands removed to reverse your symptoms: For Cushing disease caused by a pituitary adenoma, treatment typically involves surgical removal of the pituitary tumor, not the adrenal glands.
C. You will need to begin taking hydrocortisone, and increase your dose during times of stress: This is incorrect as hydrocortisone replacement is used for Addison's disease, not for managing Cushing disease.
D. You will receive glucose checks and sliding-scale insulin until your hormone levels are corrected: While glucose monitoring might be necessary due to hyperglycemia, the primary treatment for Cushing disease involves addressing the source of excess cortisol, which is the pituitary adenoma.

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Correct Answer is B

Explanation

A. Hyperthermia: This is not commonly associated with hypothyroidism. Hypothyroidism is more likely to lead to a decreased metabolic rate and hypothermia rather than hyperthermia.
B. Hyperlipidemia: This is a common condition associated with hypothyroidism. Hypothyroidism can lead to increased levels of cholesterol and triglycerides due to decreased metabolism.
C. Agitation: Hypothyroidism typically presents with symptoms such as fatigue and depression rather than agitation. Agitation is more commonly associated with hyperthyroidism.
D. Insomnia: Insomnia is more often associated with hyperthyroidism. Hypothyroidism usually leads to symptoms like fatigue and sleepiness rather than insomnia.

A. B-type natriuretic peptide (BNP) B. Troponin I C. Blood urea nitrogen (BUN) D. Platelet levels

Correct Answer is A

Explanation

A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to the heart's response to increased pressure and volume overload. This biomarker is used specifically to diagnose and assess the severity of heart failure.
B. Troponin I: This is a marker for myocardial injury and is used to diagnose acute myocardial infarction rather than heart failure.
C. Blood urea nitrogen (BUN): While elevated BUN can be associated with renal dysfunction or fluid overload in heart failure, it is not specific to diagnosing heart failure.
D. Platelet levels: These are not directly related to diagnosing heart failure and do not provide information about cardiac function.

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Naxlex Comprehensive Predictor Exams

A client in a primary care provider's office has a new diagnosis of hypothyroidism. The nurse understands that the client should be screened for which of the following conditions common in people who have hypothyroidism?

Correct Answer is B

Explanation

A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be the most useful for diagnosing heart failure?

Correct Answer is A

Explanation

A client seen in the clinic with shortness of breath and fatigue is being evaluated for a possible diagnosis of heart failure. Which laboratory result will be the most useful for diagnosing heart failure?

A nurse is providing education to a client who has a new diagnosis of Addison's disease. The nurse determines that additional teaching is needed when the client makes which of the following statements?

A nurse is caring for a client who has hypokalemia, hyperglycemia, and hypertension. A diagnosis of Cushing syndrome is suspected. Which of the following tests would the nurse anticipate the health care provider will order to help confirm the diagnosis of Cushing syndrome?

A nurse is caring for a client who has developed Cushing syndrome due to long-term corticosteroid therapy to treat multiple sclerosis. The nurse understands that Cushing syndrome puts the client at increased risk for which complication?

The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?

A 28-year-old female client who is in the first trimester of pregnancy is diagnosed with hyperthyroidism. Which of the following would be the preferred treatment for this client?

At the beginning of the shift, a nurse receives report on the following four patients. Which patient should the nurse place priority on assessing first?

A client who takes daily hormone replacement therapy for Addison's disease is scheduled for an outpatient surgical procedure. Which of the following instructions should the nurse include when providing discharge education to the client?