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 B

Explanation

A. Weight gain and lethargy: These symptoms are more commonly associated with hypothyroidism or insufficient thyroid hormone levels, not with excess levothyroxine.
B. Nervousness and tachycardia: Excessive levothyroxine can lead to symptoms of hyperthyroidism, such as increased heart rate (tachycardia) and nervousness. These symptoms are consistent with an overdose of levothyroxine.
C. Facial puffiness and constipation: These symptoms are indicative of hypothyroidism, not hyperthyroidism. They would not be expected with an excess of levothyroxine.
D. Hypotension and intolerance to cold: These are symptoms of hypothyroidism and would not typically occur with an excess of levothyroxine. Excess levothyroxine usually causes symptoms of hyperthyroidism.

A. Radioactive iodine uptake test B. 24-hour cortisol urine study C. Adrenocorticotropic hormone (ACTH) stimulation test D. Edrophonium (Tensilon) test

Correct Answer is B

Explanation

A. Radioactive iodine uptake test: This test is used to assess thyroid function and diagnose thyroid disorders, such as hyperthyroidism. It is not used to diagnose Cushing syndrome.
B. 24-hour cortisol urine study: This test measures cortisol levels in the urine over a 24-hour period and is commonly used to diagnose Cushing syndrome by evaluating elevated cortisol production.
C. Adrenocorticotropic hormone (ACTH) stimulation test: This test evaluates adrenal function and is typically used to assess adrenal insufficiency rather than Cushing syndrome.
D. Edrophonium (Tensilon) test: This test is used to diagnose myasthenia gravis, not Cushing syndrome. It evaluates the effect of the medication on muscle strength.

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Naxlex Comprehensive Predictor Exams

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?

Correct Answer is B

Explanation

A nurse is caring for a client who has hypokalemia, hyperglycemia, and hypertension. A diagnosis of Cushing syndrome is suspected. Which of the following tests would the nurse anticipate the health care provider will order to help confirm the diagnosis of Cushing syndrome?

Correct Answer is B

Explanation

A client in a primary care provider's office has a new diagnosis of hypothyroidism. The nurse understands that the client should be screened for which of the following conditions common in people who have hypothyroidism?

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 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 who has hypothyroidism will be undergoing surgery for a total knee replacement. When planning care for this client, the nurse understands which of the following to be true for people who have hypothyroidism?

A nurse is caring for a client after a subtotal thyroidectomy. Which of the following manifestations would lead the nurse to suspect that the procedure caused damage to the client's parathyroid glands?