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?

Excess mineralocorticoids

Excess adrenal androgens

Excess thyroid hormone

Excess glucocorticoids

Answer and Explanation

The Correct Answer is B

A. Excess mineralocorticoids: Mineralocorticoids primarily affect electrolyte and fluid balance. While excess mineralocorticoids can cause hypertension and fluid retention, they are not directly responsible for hirsutism or acne.
B. Excess adrenal androgens: Cushing syndrome can lead to elevated levels of adrenal androgens, which are responsible for hirsutism (excessive hair growth) and acne due to their androgenic effects.
C. Excess thyroid hormone: Thyroid hormone imbalances can affect various body systems, but they are not directly related to the development of hirsutism or acne seen in Cushing syndrome.
D. Excess glucocorticoids: While excess glucocorticoids are characteristic of Cushing syndrome and can cause a range of symptoms, hirsutism and acne are specifically due to excess adrenal androgens rather than glucocorticoids.

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Correct Answer is A

Explanation

A. IV hydrocortisone: In an Addisonian crisis, there is an acute adrenal insufficiency which requires immediate treatment with IV hydrocortisone to replace the deficient glucocorticoids. This helps to rapidly correct the hormone imbalance and stabilize the patient.
B. Ketoconazole and insulin: Ketoconazole is an antifungal medication used to treat Cushing syndrome, not Addisonian crisis. Insulin is used for managing blood glucose levels and is not directly related to the treatment of an Addisonian crisis.
C. Lactated Ringer's IV infusion: While fluid replacement may be necessary in an Addisonian crisis, the immediate priority is to address the adrenal insufficiency with hydrocortisone. Lactated Ringer's may be used to support fluid balance but is not a substitute for glucocorticoid therapy.
D. Furosemide slow IV push: Furosemide is a diuretic used to manage fluid retention and is not indicated for treating Addisonian crisis. The primary treatment for Addisonian crisis is to address the adrenal hormone deficiency with hydrocortisone.

A. Radioactive iodine therapy B. Levothyroxine C. Ketoconazole D. Propylthiouracil (PTU)

Correct Answer is D

Explanation

A. Radioactive iodine therapy: This is contraindicated during pregnancy as it can harm the fetus and affect thyroid function.
B. Levothyroxine: This is used for hypothyroidism, not hyperthyroidism. For hyperthyroidism, this medication would not be appropriate.
C. Ketoconazole: This is an antifungal and is not used to treat hyperthyroidism.
D. Propylthiouracil (PTU): PTU is the preferred treatment during the first trimester of pregnancy for hyperthyroidism. It inhibits thyroid hormone synthesis and is considered safer than methimazole during early pregnancy.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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