A client with a history of Addison's disease and flu-like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by I.V. infusion?

Methylprednisolone (Solu-medrol)

Hypotonic saline

Potassium (K-dur)

Regular Insulin

Answer and Explanation

The Correct Answer is A

A. Methylprednisolone (Solu-medrol):
Explanation: Acute adrenal insufficiency is a life-threatening condition characterized by a sudden deficiency of adrenal hormones. In this situation, intravenous glucocorticoids such as methylprednisolone are administered to replace the deficient hormones and stabilize the patient. This is the appropriate intervention to address the acute adrenal crisis.

B. Hypotonic saline:
Explanation: Hypotonic saline is not the first-line treatment for acute adrenal insufficiency. The priority is to replace glucocorticoids to address the adrenal hormone deficiency.

C. Potassium (K-dur):
Explanation: While electrolyte imbalances can occur in adrenal insufficiency, potassium replacement alone does not address the primary issue of glucocorticoid deficiency in acute adrenal insufficiency.

D. Regular Insulin:
Explanation: Regular insulin is not the primary treatment for acute adrenal insufficiency. Glucocorticoid replacement, such as methylprednisolone, is the key intervention.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Avoid the use of moisturizing lotions.
This statement is not a priority instruction. Moisturizing lotions, especially those designed for diabetic foot care, can help prevent dry skin and complications. However, it's crucial to choose appropriate, diabetes-friendly moisturizers.

B. Examine feet weekly for redness, blisters, and abrasions.
This is an important and relevant instruction. Regular foot inspections help detect any signs of injury or infection early, preventing complications, especially for individuals with peripheral neuropathy.

C. Dry feet vigorously after each bath.
This statement is not advisable. Vigorous drying can potentially harm the skin, especially for individuals with diabetes. A gentle and thorough drying is recommended to prevent skin damage.

D. Avoid hot-water bottles and heating pads.
This is a priority instruction. Patients with peripheral neuropathy may have reduced sensation in their feet, making them more susceptible to burns. Avoiding sources of excessive heat helps prevent injuries.

A. Respiratory acidosis B. Hypokalemia C. Metabolic acidosis D. Respiratory alkalosis

Correct Answer is A

Explanation

A. Respiratory acidosis:
This occurs when there is inadequate removal of carbon dioxide (CO2) by the respiratory system. In the case of the patient post-op from knee surgery receiving Morphine, the opioid can cause respiratory depression, leading to the retention of CO2 and the development of respiratory acidosis. Signs include a decreased respiratory rate and drowsiness.

B. Hypokalemia:
This is a condition characterized by low levels of potassium in the blood. While opioids can cause constipation, they are not directly associated with hypokalemia.

C. Metabolic acidosis:
This occurs when there is an increase in acid production or a loss of bicarbonate, leading to an imbalance in the body's acid-base status. The symptoms of metabolic acidosis are not typically associated with opioid use.

D. Respiratory alkalosis:
This occurs when there is excessive elimination of CO2, leading to decreased carbon dioxide levels in the blood. Opioids, especially in higher doses, are more likely to cause respiratory depression and acidosis rather than alkalosis. The patient's low respiratory rate and drowsiness are indicative of respiratory acidosis rather than alkalosis.

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Naxlex Comprehensive Predictor Exams

A client with type 1 diabetes mellitus and peripheral neuropathy is seeing the nurse to review foot care. What would be a priority instruction for the nurse to give the client?

Correct Answer is D

Explanation

A patient is post-op from knee surgery. The patient has been receiving Morphine 4 mg IV every 2 hours. The nurse notices the patient is exhibiting a respiratory rate of 8 and is extremely drowsy. Which of the following conditions is the patient at risk for?

Correct Answer is A

Explanation

A nurse is caring for a patient with Addison's Disease. Which of the following clinical manifestations should the nurse expect to observe? (SELECT ALL THAT APPLY)

The nurse is monitoring a client who was diagnosed with Type 1 Diabetes Mellitus and is being treated with NPH and regular insulin. Which manifestations alert the nurse to the presence of a possible hypoglycemic reaction? (SELECT ALL THAT APPLY)

A client with diabetes mellitus is ordered to receive insulin for glucose correction (sliding scale coverage). The nurse knows the rapid acting insulin Insulin Lispro (Humalog) onset and peak action time are:

Which of the following should be included in the teaching plan for a patient receiving glargine (Lantus), "peakless" basal insulin?

A nurse is instructing a client with newly diagnosed hypo-parathyroidism about this disorder. The nurse explains to the patient that the physician has prescribed daily supplements of calcium and vitamin D. Which education by the nurse is appropriate for this patient?

A nurse is assessing a client who has diabetes for the presence of peripheral neuropathy. The nurse should question the client about what sign or symptom that would suggest the possible development of peripheral neuropathy?

A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this patient?