A nurse is caring for a client who has a diagnosis of Cushing syndrome. After performing magnetic resonance imaging (MRI), the underlying cause of the condition is found to be an ectopic ACTH-secreting tumor on the liver. Which of the following lab results would the nurse anticipate with this condition?

Elevated adrenocorticotropic hormone (ACTH) and elevated cortisol

Elevated adrenocorticotropic hormone (ACTH) and low cortisol

Low adrenocorticotropic hormone (ACTH) and elevated cortisol

Low adrenocorticotropic hormone (ACTH) and low cortisol

Answer and Explanation

The Correct Answer is A

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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Correct Answer is A

Explanation

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.

A. Pain 7/10 at the surgical site B. Hyperglycemia C. Blood pressure 92/50 D. Sodium 152 mEq/L

Correct Answer is C

Explanation

A. Pain 7/10 at the surgical site: This level of pain is expected following major surgery, such as a bilateral adrenalectomy, and does not specifically indicate an Addisonian crisis.
B. Hyperglycemia: Although hyperglycemia can be associated with stress or corticosteroid treatment, it is not a hallmark of Addisonian crisis. Addisonian crisis is more related to adrenal insufficiency rather than hyperglycemia.
C. Blood pressure 92/50: Low blood pressure is a critical sign of an Addisonian crisis. This condition results from severe adrenal insufficiency where the body cannot maintain adequate blood pressure.
D. Sodium 152 mEq/L: High sodium levels are not characteristic of an Addisonian crisis. Addisonian crisis typically leads to hyponatremia (low sodium levels) due to inadequate aldosterone production.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is A

Explanation

The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?

Correct Answer is C

Explanation

A 28-year-old female client who is in the first trimester of pregnancy is diagnosed with hyperthyroidism. Which of the following would be the preferred treatment for this client?

A nurse is caring for a client who has developed Cushing syndrome due to long-term corticosteroid therapy to treat multiple sclerosis. The nurse understands that Cushing syndrome puts the client at increased risk for which complication?

A client is experiencing tachycardia and tremors. Lab values show elevated Free T4 and low thyroid stimulating hormone (TSH). Which diagnostic study will help the practitioner differentiate Graves' disease from other forms of hyperthyroidism?

A nurse is providing dietary teaching for a client who has Graves' disease. Which of the following statements made by the client indicates a need for further teaching by the nurse?

A client with a history of hypothyroidism has accidentally been taking double her prescribed dose of levothyroxine. Which assessment findings would the nurse expect due to an excess of this medication?

A nurse is caring for a female client who has a diagnosis of Cushing syndrome. The client is embarrassed that she is experiencing hirsutism and severe acne. The nurse understands that these manifestations are caused by which of the following?

A nurse is caring for a client Exhibits Select the 3 interventions that the nurse should anticipate for this client.