A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect?

Increased body hair

Decreased blood urea nitrogen level

Hyperpigmentation of the skin

Hypocalcemia

Answer and Explanation

The Correct Answer is C

A. Increased body hair: Adrenal insufficiency leads to decreased androgen production, which may cause hair thinning rather than increased body hair. Hypertrichosis (excessive hair growth) is not a typical finding in adrenal insufficiency.

B. Decreased blood urea nitrogen level: Adrenal insufficiency is often associated with dehydration due to aldosterone deficiency, leading to reduced sodium retention and increased fluid loss. This can result in elevated blood urea nitrogen (BUN) levels rather than a decrease.

C. Hyperpigmentation of the skin: Increased melanocyte-stimulating hormone (MSH) activity, triggered by elevated adrenocorticotropic hormone (ACTH) levels, causes darkening of the skin, especially in sun-exposed areas, skin folds, and mucous membranes. This is a hallmark feature of primary adrenal insufficiency (Addison’s disease).

D. Hypocalcemia: Adrenal insufficiency is more commonly associated with hypercalcemia rather than hypocalcemia. Decreased cortisol levels can lead to reduced renal calcium excretion, contributing to elevated serum calcium levels.

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Correct Answer is B

Explanation

A. Contact your pharmacy to inquire about a different medication: Pharmacies may offer generic alternatives, but they cannot change a prescription without provider authorization. A social worker can explore financial assistance programs, which is a more comprehensive solution.

B. I can arrange for a social worker to talk with you before you leave: Social workers assist clients in finding resources such as medication assistance programs, prescription discount plans, or community aid. This ensures the client can access their medication without financial strain.

C. You should ask your provider to prescribe a cheaper medication: While discussing cost-effective alternatives with the provider is an option, it does not directly address the client’s financial concerns. A social worker can provide broader support beyond just switching medications.

D. I can contact the occupational therapist to schedule a home visit: Occupational therapy focuses on improving daily function and independence. It does not address financial concerns related to medication affordability, making this option inappropriate for the situation.

A. Insulin aspart and NPH insulin B. Insulin degludec and NPH insulin. C. Insulin glargine and insulin detemir D. Insulin lispro and regular insulin

Correct Answer is A

Explanation

A. Insulin aspart and NPH insulin: Insulin aspart is a rapid-acting insulin, and NPH is an intermediate-acting insulin. These can be mixed in the same syringe to provide both immediate and prolonged glucose control, with aspart covering postprandial spikes and NPH maintaining basal levels.

B. Insulin degludec and NPH insulin: Insulin degludec is an ultra-long-acting insulin and should not be mixed with any other insulin, as mixing can alter its absorption and effectiveness.

C. Insulin glargine and insulin detemir: Both glargine and detemir are long-acting insulins and should not be mixed with any other insulin, as this can interfere with their mechanism of providing a steady release.

D. Insulin lispro and regular insulin: Insulin lispro is a rapid-acting insulin, and regular insulin is short-acting. These insulins should not be mixed because they have different onset and peak times, which can lead to unpredictable glucose control.

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A nurse is assessing a client who has adrenal insufficiency. Which of the following findings should the nurse expect?

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