A nurse is collecting data from a client who has Cushing’s syndrome. Which of the following findings should the nurse expect?

Weight loss

Diaphoresis

Hyperpigmentation

Hypotension

Answer and Explanation

The Correct Answer is C

Choice A reason: Weight loss is not a symptom of Cushing’s syndrome. On the contrary, weight gain and obesity are common signs of this condition, especially in the trunk, face and upper back1.

Choice B reason: Diaphoresis, or excessive sweating, is not a symptom of Cushing’s syndrome. It can be caused by other conditions, such as hyperthyroidism, menopause or anxiety.

Choice C reason: Hyperpigmentation, or darkening of the skin, is a symptom of Cushing’s syndrome. It occurs due to increased production of melanin, the pigment that gives color to the skin. Hyperpigmentation can aﬀect any part of the body, but it is more noticeable in areas exposed to friction or pressure, such as the elbows, knees, knuckles and armpits.

Choice D reason: Hypotension, or low blood pressure, is not a symptom of Cushing’s syndrome. In fact, high blood pressure (hypertension) is one of the common symptoms of this condition, due to the eﬀects of cortisol on the cardiovascular system.

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Correct Answer is A

Explanation

Choice A reason: A fruity odor in the breath is a symptom of hyperglycemia, especially when it is severe and causes ketoacidosis. Ketoacidosis is a condition where the body produces ketones, which are acidic substances that result from the breakdown of fat for energy when there is not enough insulin or glucose available. Ketones can make the breath smell fruity or like nail polish remover.

Choice B reason: A decreased appetite is not a symptom of hyperglycemia. On the contrary, an increased appetite or hunger is a symptom of hyperglycemia, as the body tries to compensate for the lack of glucose in the cells by stimulating the hunger center in the brain.

Choice C reason: An increased thirst is a symptom of hyperglycemia, as the body tries to ﬂush out the excess glucose and ketones in the blood through urine. This leads to dehydration and thirst signals in the brain.

Choice D reason: A blurry vision at times is a symptom of hyperglycemia, as high blood glucose levels can cause swelling and damage to the lens of the eye, aﬀecting its ability to focus light properly. This can lead to temporary or permanent vision problems.

A. Phosphate 5.7 mg/dL B. Vitamin D 25 ng/mL C. Calcium 9.8 mg/dL D. Magnesium 1.8 mEq/L

Correct Answer is A

Explanation

Choice A reason: Phosphate 5.7 mg/dL is an elevated value, as the normal range is 2.5 to 4.5 mg/dL. Hypoparathyroidism causes low levels of parathyroid hormone (PTH), which regulates calcium and phosphorus balance in the body. Low PTH leads to low calcium and high phosphorus levels in the blood.

Choice B reason: Vitamin D 25 ng/mL is a normal value, as the normal range is 20 to 50 ng/mL. Hypoparathyroidism does not directly aﬀect vitamin D levels, but vitamin D supplements may be given to help increase calcium absorption and lower phosphorus levels in the blood.

Choice C reason: Calcium 9.8 mg/dL is a normal value, as the normal range is 8.6 to 10.2 mg/dL. Hypoparathyroidism causes low levels of parathyroid hormone (PTH), which regulates calcium and phosphorus balance in the body. Low PTH leads to low calcium and high phosphorus levels in the blood. However, calcium levels may be normal or near- normal in some cases of hypoparathyroidism, especially if the condition is mild or well-controlled with treatment.

Choice D reason: Magnesium 1.8 mEq/L is a normal value, as the normal range is 1.5 to 2.5 mEq/L. Hypoparathyroidism does not directly aﬀect magnesium levels, but magnesium deficiency can cause or worsen hypoparathyroidism, as magnesium is needed for PTH secretion and action. Magnesium supplements may be given to correct magnesium deficiency and improve PTH function.

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A nurse is collecting data from a client who has Cushing’s syndrome. Which of the following findings should the nurse expect?

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