A client experiencing exophthalmos is seen in a primary care provider's clinic. The nurse understands that the most likely endocrine disorder which would cause this symptom is which of the following?

Cushing syndrome

Hashimoto's disease

Addison's disease

Graves' disease

Answer and Explanation

The Correct Answer is D

A.   Cushing syndrome is characterized by excessive levels of cortisol in the body, often due to an adrenal gland tumor or prolonged use of corticosteroid medications. The primary symptoms include weight gain, hypertension, and changes in skin appearance. Exophthalmos is not typically associated with Cushing syndrome.
B.   Hashimoto's disease is an autoimmune thyroid disorder that leads to hypothyroidism (underactive thyroid). The condition is characterized by symptoms such as fatigue, weight gain, cold intolerance, and dry skin. Exophthalmos is not a feature of Hashimoto's disease. Instead, it is more commonly associated with hyperthyroidism.
C.   Addison's disease is a condition caused by inadequate production of cortisol and aldosterone by the adrenal glands. Symptoms include fatigue, weight loss, hyperpigmentation of the skin, and low blood pressure. Exophthalmos is not related to Addison's disease.
D.   Graves' disease is an autoimmune hyperthyroid condition that leads to an overproduction of thyroid hormones. One of the hallmark symptoms of Graves' disease is exophthalmos or protruding eyes, caused by inflammation and swelling of the tissues around the eyes. This condition is directly associated with exophthalmos.

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Correct Answer is C

Explanation

A. Methylprednisolone is a corticosteroid used to reduce inflammation and suppress the immune system. While corticosteroids are sometimes used in critical care settings, they are not specifically used to prevent stress ulcers. In fact, corticosteroids can increase the risk of gastrointestinal bleeding and may require additional measures to protect the stomach lining.
B. Enoxaparin is a low molecular weight heparin (LMWH) used primarily for the prevention of deep vein thrombosis (DVT) and pulmonary embolism (PE). It works as an anticoagulant, preventing blood clots. While enoxaparin is important for preventing thromboembolic events in critically ill patients, it does not specifically address the prevention of stress ulcers.
C. Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid production by inhibiting the proton pumps in the stomach lining. PPIs are commonly used to prevent and treat stress ulcers because they help decrease gastric acid secretion, thereby reducing the risk of ulcer formation and bleeding. This makes pantoprazole the appropriate medication to administer to prevent physiologic stress ulcers in a patient with sepsis on a ventilator.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is used for pain relief and inflammation. NSAIDs can actually increase the risk of gastrointestinal bleeding and ulceration, especially in critically ill patients.

A. Thirty seconds after administration, the facial weakness and ptosis will be relieved for approximately 5 minutes. B. After administration, the client will experience worsening facial weakness and ptosis. C. After administration of the medication, there will be no change in the status of the ptosis or facial weakness. D. The client will have elimination of symptoms lasting at least 24 hours after the administration of the medication.

Correct Answer is A

Explanation

This is the correct expected outcome if the test is positive for myasthenia gravis. Edrophonium works quickly to increase acetylcholine levels, leading to temporary improvement in muscle strength. In a patient with myasthenia gravis, administration of edrophonium typically results in a rapid improvement in symptoms like facial weakness and ptosis within 30 to 60 seconds, with the effects lasting for a few minutes. This brief improvement is indicative of a positive result for myasthenia gravis.
B.A Worsening symptoms after administration of edrophonium are not expected and could indicate an adverse reaction or incorrect diagnosis. In myasthenia gravis, edrophonium typically improves symptoms rather than worsening them.
C. No change in symptoms would be unexpected in the case of myasthenia gravis. If edrophonium is effective, there should be a noticeable improvement in symptoms. If there is no change, it might suggest a diagnosis other than myasthenia gravis or that the test is inconclusive.
D. This outcome is not expected. Edrophonium has a very short duration of action, typically relieving symptoms for only a few minutes. The effects do not last for 24 hours. A longer-lasting improvement might be observed with other treatments for myasthenia gravis, such as anticholinesterase medications like pyridostigmine, but not with edrophonium.

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A client experiencing exophthalmos is seen in a primary care provider's clinic. The nurse understands that the most likely endocrine disorder which would cause this symptom is which of the following?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient with a diagnosis of sepsis who is on a ventilator in the intensive care unit. To reduce the risk of developing a physiologic stress ulcer, the nurse should anticipate an order to administer which medication?

Correct Answer is C

Explanation

The nurse is assisting while a neurologist administers an edrophonium (Tensilon) test to a client with facial weakness and ptosis. If the test is positive for myasthenia gravis, which outcome would the nurse observe?

Correct Answer is A

Explanation

A client experiencing exophthalmos is seen in a primary care provider's clinic. The nurse understands that the most likely endocrine disorder which would cause this symptom is which of the following?

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