A patient is hospitalized with acute adrenal insufficiency. The nurse determines that the patient is responding favorably to treatment on finding:

Decreasing serum sodium

Decreasing blood glucose

Decreasing serum potassium

Increasing urinary output

Answer and Explanation

The Correct Answer is D

One of the hallmarks of adrenal insufficiency is dehydration and decreased urinary output, which can lead to electrolyte imbalances such as hyperkalemia and hyponatremia. As treatment begins to take eﬀect, the patient's ﬂuid and electrolyte balance should improve, leading to an increase in urinary output. Acute adrenal insufficiency, also known as the Addisonian crisis, is a life-threatening condition caused by a sudden decrease in cortisol and aldosterone hormones. Treatment usually involves the administration of intravenous glucocorticoids and mineralocorticoids to replace the deficient hormones.
Decreasing serum sodium (a) and decreasing blood glucose (b) are not signs of improvement but rather indicative of continued adrenal insufficiency. Decreasing serum potassium (c) is also not a sign of improvement as it could indicate that the patient is developing hyperkalemia, which is a potential complication of adrenal crisis.

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Correct Answer is B

Explanation

Sudden discontinuation of prednisone can result in adrenal insufficiency and can lead to life-threatening complications. The nurse should also instruct the patient to report any symptoms of an infection, such as fever, to the doctor promptly, as prednisone can mask signs of an infection.

Monitoring for mood alterations and daily weight measurement are also important aspects of care, but they are not as crucial as the need to gradually taper oﬀ the medication.

A. The patient’s voice is weak and hoarse sounding. B. The patient is complaining of a 7/10 incisional pain. C. The patient’s cardiac monitor shows a heart rate of 112. D. The patient is increasingly swelling at the neck.

Correct Answer is D

Explanation

This is a critical finding that could indicate bleeding or compromised airway, both of which are potentially life-threatening complications following a thyroidectomy. Immediate intervention may be necessary to prevent further harm to the patient. The other options are important to note and should be addressed, but they do not require immediate intervention as the swelling in the neck does.

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A patient is hospitalized with acute adrenal insufficiency. The nurse determines that the patient is responding favorably to treatment on finding:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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