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?

B-type natriuretic peptide (BNP)

Troponin I

Blood urea nitrogen (BUN)

Platelet levels

Answer and Explanation

The Correct Answer is A

A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to increased pressure and stretch in the heart's chambers. It is a key marker used to diagnose and assess the severity of heart failure.
B. Troponin I: This marker is used to diagnose myocardial infarction (heart attack) rather than heart failure. Elevated troponin levels indicate damage to the heart muscle.
C. Blood urea nitrogen (BUN): BUN levels can be elevated in heart failure due to decreased renal perfusion, but it is not as specific for diagnosing heart failure as BNP.
D. Platelet levels: Platelet levels are not directly related to the diagnosis of heart failure. They are more relevant for assessing clotting disorders and other conditions.

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Correct Answer is A

Explanation

A. IV hydrocortisone: In an Addisonian crisis, there is an acute adrenal insufficiency which requires immediate treatment with IV hydrocortisone to replace the deficient glucocorticoids. This helps to rapidly correct the hormone imbalance and stabilize the patient.
B. Ketoconazole and insulin: Ketoconazole is an antifungal medication used to treat Cushing syndrome, not Addisonian crisis. Insulin is used for managing blood glucose levels and is not directly related to the treatment of an Addisonian crisis.
C. Lactated Ringer's IV infusion: While fluid replacement may be necessary in an Addisonian crisis, the immediate priority is to address the adrenal insufficiency with hydrocortisone. Lactated Ringer's may be used to support fluid balance but is not a substitute for glucocorticoid therapy.
D. Furosemide slow IV push: Furosemide is a diuretic used to manage fluid retention and is not indicated for treating Addisonian crisis. The primary treatment for Addisonian crisis is to address the adrenal hormone deficiency with hydrocortisone.

A. Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol B. Elevated adrenocorticotropic hormone (ACTH) and low cortisol C. Low adrenocorticotropic hormone (ACTH) and elevated cortisol D. Low adrenocorticotropic hormone (ACTH) and low cortisol

Correct Answer is A

Explanation

A. Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol: In cases of ectopic ACTH syndrome, the tumor produces ACTH, which stimulates the adrenal glands to produce excess cortisol. Therefore, both ACTH and cortisol levels are elevated.
B. Elevated adrenocorticotropic hormone (ACTH) and low cortisol: This scenario is less likely as elevated ACTH typically results in increased cortisol production, not decreased.
C. Low adrenocorticotropic hormone (ACTH) and elevated cortisol: This is characteristic of primary adrenal insufficiency, not ectopic ACTH syndrome, where ACTH levels are usually high.
D. Low adrenocorticotropic hormone (ACTH) and low cortisol: This pattern is inconsistent with Cushing syndrome, especially due to ectopic ACTH-secreting tumors, which typically result in elevated ACTH and cortisol.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who is experiencing an Addisonian crisis. Which of the following should the nurse anticipate an order for?

Correct Answer is A

Explanation

Correct Answer is A

Explanation

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