A nurse is caring for a client who has Cushing’s syndrome. Which of the following clinical manifestations should the nurse expect to observe? (Select all that apply.)

Purple striations

Tremors

Buﬀalo hump

Obese extremities

Moon face

Answer and Explanation

Correct Answer : A,C,E

Choice A: Purple striations. These are also known as striae, and they are caused by the thinning and weakening of the skin and underlying connective tissue due to cortisol. They appear as purple or red lines on the abdomen, thighs, breasts, or arms.

Choice C: Buﬀalo hump. This is a term used to describe the accumulation of fat on the upper back and neck due to cortisol. It gives the appearance of a hump or a rounded shape.

Choice E: Moon face. This is a term used to describe the rounding and fullness of the face due to cortisol. It gives the

appearance of a moon-like shape.

Choice B: Tremors. These are not a clinical manifestation of Cushing’s syndrome, but rather a sign of hyperthyroidism, which is a condition caused by excess thyroid hormone production or exposure. Thyroid hormone aﬀects the nervous system and causes increased muscle activity and tremors.

Choice D: Obese extremities. These are not a clinical manifestation of Cushing’s syndrome, but rather a sign of hypothyroidism, which is a condition caused by low thyroid hormone production or exposure. Thyroid hormone aﬀects the metabolism of carbohydrates, proteins, and fats, and causes decreased energy expenditure and weight gain.

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Correct Answer is D

Explanation

Choice A: Peri-umbilical area. This is not an area that the nurse should inspect to monitor for the presence of jaundice in a client who is African American and has cholecystitis. The peri-umbilical area is the area around the navel, which is part of the skin. The skin can show jaundice, but it may be difficult to detect in clients with dark skin tones.

Choice B: Nail beds. This is not an area that the nurse should inspect to monitor for the presence of jaundice in a client who is African American and has cholecystitis. The nail beds are part of the skin that can show jaundice, but they may also be aﬀected by other factors such as anemia, cyanosis, or nail polish.

Choice C: Webbed areas of the fingers. This is not an area that the nurse should inspect to monitor for the presence of jaundice in a client who is African American and has cholecystitis. The webbed areas of the fingers are part of the skin that can show jaundice, but they may also be inﬂuenced by other factors such as temperature, circulation, or pressure.

Choice D: Hard palate. This is an area that the nurse should inspect to monitor for the presence of jaundice in a client who is African American and has cholecystitis, which is an inﬂammation of the gallbladder. Jaundice is a yellowish discoloration of the skin and mucous membranes due to elevated bilirubin levels in the blood. Bilirubin is a pigment that is produced from the breakdown of red blood cells and is normally excreted in bile. If the gallbladder or bile ducts are inﬂamed or obstructed, bile cannot ﬂow into the duodenum and bilirubin accumulates in the blood and tissues. The hard palate is a part of the oral mucosa that can show jaundice, especially in clients with dark skin tones.

A. Faty stools B. Ecchymosis of the extremities C. Straw-colored urine D. Tenderness in the left upper abdomen

Correct Answer is A

Explanation

Choice A: Faty stools. This is a finding that is expected for a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis, which is the presence of gallstones in the gallbladder or bile ducts. The common bile duct carries bile from the liver and gallbladder to the duodenum, where it helps digest fats. If the common bile duct is obstructed by a gallstone, bile cannot reach the duodenum and fats cannot be properly absorbed. This results in fatty stools, which are also known as steatorrhea. Fatty stools are pale, bulky, greasy, and foul-smelling.

Choice B: Ecchymosis of the extremities. This is not a finding that is expected for a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis. Ecchymosis of the extremities is a sign of bleeding under the skin, which can be caused by trauma, coagulation disorders, or medications. It is not related to bile duct obstruction or gallstones.

Choice C: Straw-colored urine. This is not a finding that is expected for a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis. Straw-coloured urine is a normal colour of urine, which indicates adequate hydration and kidney function. It is not aﬀected by bile duct obstruction or gallstones.

Choice D: Tenderness in the left upper abdomen. This is not a finding that is expected for a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis. Tenderness in the left upper abdomen is a sign of splenomegaly, which is an enlargement of the spleen due to infection, inﬂammation, or cancer. It is not related to bile duct obstruction or gallstones.

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A nurse is caring for a client who has Cushing’s syndrome. Which of the following clinical manifestations should the nurse expect to observe? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is African American and has cholecystitis. Which of the following areas should the nurse inspect to monitor for the presence of jaundice?

Correct Answer is D

Explanation

A nurse is collecting data from a client who has obstruction and inﬂammation of the common bile duct due to cholelithiasis. Which of the following findings is expected for this condition?

Correct Answer is A

Explanation

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