A nurse in the emergency department is assessing an older adult client who has community-acquired pneumonia. Which of the following findings should the nurse expect?

Hypertension

Unequal pupils

Confusion

Tympany upon chest percussion

Answer and Explanation

The Correct Answer is C

A. Hypertension is not typically associated with pneumonia, especially in older adults. Pneumonia can lead to hypotension or sepsis, but not usually hypertension.
B. Unequal pupils are not a typical finding associated with pneumonia. This could suggest a neurological issue or a possible eye problem, not a respiratory infection.
C. Confusion is a common sign of pneumonia in older adults, especially in the elderly, who may present with altered mental status due to hypoxia, infection, or dehydration. Delirium or confusion is a common manifestation of pneumonia in this population.
D. Tympany on chest percussion suggests air in the abdominal cavity, not in the lungs, and is not typically associated with pneumonia. Pneumonia is more likely to present with dullness upon percussion due to consolidation in the lungs.

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Correct Answer is C

Explanation

A. Increase carbohydrate intake.: This is incorrect. Cushing’s disease is characterized by excessive cortisol, which can lead to increased blood glucose levels, making carbohydrate intake less desirable. Clients with Cushing's disease often need to manage their blood sugar levels, so they should not increase carbohydrates indiscriminately.
B. Limit intake of potassium-rich foods.: This is incorrect. In Cushing’s disease, elevated cortisol levels can lead to potassium depletion, so clients should actually increase their intake of potassium-rich foods to help counteract the effects of low potassium, not limit them.
C. Restrict sodium intake.: This is correct. Cushing’s disease often results in fluid retention and hypertension due to increased cortisol and aldosterone levels. Restricting sodium helps manage these symptoms and reduces the risk of complications such as edema and high blood pressure.
D. Decrease protein intake.: This is incorrect. While protein breakdown is a feature of Cushing's disease, protein intake should not necessarily be decreased. Adequate protein intake is important to prevent muscle wasting, a common issue in clients with Cushing’s disease.

A. Hirsutism B. Hyperpigmentation C. Purple striations D. Intention tremors

Correct Answer is B

Explanation

A. Hirsutism, or excessive hair growth, is more commonly associated with conditions such as polycystic ovary syndrome (PCOS) or Cushing’s syndrome, rather than Addison’s disease.
B. Hyperpigmentation is a characteristic sign of Addison’s disease. Due to insufficient cortisol production in the adrenal glands, there is an increase in melanocyte-stimulating hormone (MSH), which leads to darkening of the skin, particularly in areas exposed to friction like elbows, knees, and the face.
C. Purple striations are a common finding in Cushing’s syndrome, which results from excessive cortisol production. They are not typically seen in Addison's disease.
D. Intention tremors are more commonly associated with neurological conditions, such as Parkinson’s disease, rather than Addison’s disease, which primarily affects the adrenal glands.

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A nurse in the emergency department is assessing an older adult client who has community-acquired pneumonia. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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