The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up?

Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg

Serum phosphorus 3 mg/dL and hirsutism

Serum calcium 10 mg/dl, and reports of feelings of depression

Serum sodium 145 mEq/L and reports of muscle weakness

Answer and Explanation

The Correct Answer is A

A. Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg - This combination of severe hypokalemia (low potassium) and elevated blood pressure is a concerning finding. It can lead to serious cardiac complications and requires immediate attention.

B. Serum phosphorus 3 mg/dL and hirsutism - While low serum phosphorus may be seen in Cushing syndrome, it is not an immediate concern. Hirsutism (excessive hair growth) is a characteristic feature of Cushing syndrome.

C. Serum calcium 10 mg/dL, and reports of feelings of depression - Although an elevated serum calcium level is not typical in Cushing syndrome, it is not an immediate concern. Reports of depression should be addressed but do not require immediate follow-up.

D. Serum sodium 145 mEq/L and reports of muscle weakness - These findings are not indicative of immediate danger. Elevated serum sodium and muscle weakness can occur in Cushing syndrome, but they do not warrant immediate attention compared to the potassium level and blood pressure in option A.

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Correct Answer is D

Explanation

A. Incorrect. Withholding insulin during illness is not recommended. Clients with type 1 diabetes should continue to take their prescribed insulin even when they are ill. Insulin is necessary to regulate blood glucose levels, and illness can increase the body's demand for insulin.

B. Incorrect. Drinking calorie-free liquids is important to prevent dehydration during illness, but specific fluid amounts should be individualized based on the client's needs and healthcare provider's recommendations. The given volume is not a universally applicable guideline.

C. Incorrect. Testing blood glucose levels every 8 hours may not be frequent enough during illness. Blood glucose should be monitored more frequently to closely track changes in response to illness and adjust insulin doses accordingly.

D. Correct. Checking urine for ketones when blood glucose levels exceed 240 mg/dL is an important guideline during illness. Elevated blood glucose levels can lead to the production of ketones, and checking for ketones in the urine helps identify the early signs of diabetic ketoacidosis (DKA). If ketones are present, the client should follow a specific plan of action as outlined by their healthcare provider, which may include adjusting insulin doses or seeking medical attention.

A. in the morning with breakfast B. in the morning on an empty stomach with other daily meds C. in the evening with a snack D. the morning before breakfast and without any other medications

Correct Answer is B

Explanation

A. This option is not ideal for levothyroxine (Synthroid) because it should be taken on an empty stomach for optimal absorption. Taking it with food, especially a meal like breakfast, can interfere with its absorption.

B. This is the correct option. Levothyroxine should be taken in the morning, at least 30 minutes before breakfast, or any other medications. Taking it on an empty stomach ensures the best absorption of the medication.

C. Taking levothyroxine in the evening is not recommended. It should be taken in the morning to coincide with the body's natural circadian rhythm and to avoid potential interactions with food or other medications.

D. While it's important to take levothyroxine in the morning before breakfast, it is not necessary to take it without any other medications. It can be taken alongside other daily medications as long as there are no interactions that would affect its absorption.

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The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

Correct Answer is D

Explanation

When preparing to provide morning medications, the nurse would give levothyroxine (Synthroid) ordered daily in which of the following ways?

Correct Answer is B

Explanation

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