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?
Radioactive iodine uptake test
24-hour cortisol urine study
Adrenocorticotropic hormone (ACTH) stimulation test
Edrophonium (Tensilon) test
The Correct Answer is B
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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Related Questions
Correct Answer is B
Explanation
A. Hypercalcemia and hyperkalemia: These are not typical indicators of parathyroid damage. Hypercalcemia usually results from overactive parathyroid glands, while hyperkalemia is not a common result of parathyroid damage.
B. Muscle twitching and tingling around the mouth: These symptoms are indicative of hypoparathyroidism, a condition that can occur if the parathyroid glands are damaged during thyroid surgery. This results in hypocalcemia (low calcium levels), which causes neuromuscular symptoms like muscle twitching and tingling.
C. Harsh, vibratory breath sounds: These are not related to parathyroid damage. They may suggest respiratory issues, not problems with calcium regulation.
D. Hyperthermia and hypertension: These are not associated with parathyroid damage. They may be related to other post-surgical complications but not specifically to parathyroid gland injury.
Correct Answer is A
Explanation
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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