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

Answer and Explanation

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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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. It is important that you taper off of the corticosteroids you are taking which have caused this disorder. B. You will need to have your adrenal glands removed to reverse your symptoms. C. You will need to begin taking hydrocortisone, and increase your dose during times of stress. D. You will receive glucose checks and sliding-scale insulin until your hormone levels are corrected.

Correct Answer is B

Explanation

A. It is important that you taper off of the corticosteroids you are taking which have caused this disorder: This statement is not applicable because the client has a pituitary adenoma causing Cushing disease, not iatrogenic Cushing syndrome from corticosteroid use.
B. You will need to have your adrenal glands removed to reverse your symptoms: For Cushing disease caused by a pituitary adenoma, treatment typically involves surgical removal of the pituitary tumor, not the adrenal glands.
C. You will need to begin taking hydrocortisone, and increase your dose during times of stress: This is incorrect as hydrocortisone replacement is used for Addison's disease, not for managing Cushing disease.
D. You will receive glucose checks and sliding-scale insulin until your hormone levels are corrected: While glucose monitoring might be necessary due to hyperglycemia, the primary treatment for Cushing disease involves addressing the source of excess cortisol, which is the pituitary adenoma.

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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?

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Explanation

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