The nurse notes that which disorder places the patient at greatest risk for hypertensive crisis?

Pheochromocytoma

Adrenal insufficiency

Hypothyroidism

Diabetes insipidus

Answer and Explanation

The Correct Answer is A

A. Pheochromocytoma is a tumor of the adrenal glands that can cause excessive production of catecholamines (such as norepinephrine and epinephrine), leading to a hypertensive crisis. This condition can cause severe hypertension, headaches, palpitations, and sweating.
B. Adrenal insufficiency is typically associated with low blood pressure, not hypertension. It is characterized by symptoms like weakness, fatigue, and hypotension, which are not linked to hypertensive crises.
C. Hypothyroidism is associated with low blood pressure and bradycardia, not an increased risk of hypertensive crisis. It typically leads to symptoms like weight gain, fatigue, and cold intolerance.
D. Diabetes insipidus is a condition that leads to excessive urination and thirst due to a lack of antidiuretic hormone, but it does not directly lead to a hypertensive crisis. It is primarily concerned with electrolyte imbalance and dehydration.

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Correct Answer is C

Explanation

A. "It is caused by the lack of production of insulin by the pancreas.": This is incorrect. The lack of insulin production causes diabetes mellitus, not Addison’s disease. Addison’s disease results from insufficient production of adrenal hormones, particularly aldosterone and cortisol.
B. "It is caused by the overproduction of parathormone by the parathyroid gland.": This is incorrect. Parathormone is produced by the parathyroid glands and regulates calcium balance, but overproduction of parathormone leads to conditions such as hyperparathyroidism, not Addison’s disease.
C. "It is caused by the lack of production of aldosterone by the adrenal gland.": This is correct. Addison’s disease, also known as primary adrenal insufficiency, is caused by the inability of the adrenal glands to produce sufficient aldosterone and cortisol, two critical hormones. Aldosterone helps regulate sodium and potassium balance, and cortisol helps the body respond to stress.
D. "It is caused by the overproduction of growth hormone by the pituitary gland.": This is incorrect. Overproduction of growth hormone causes acromegaly or gigantism, not Addison’s disease. Addison’s disease results from adrenal insufficiency, not pituitary gland dysfunction.

A. Take the medication with meals. B. Rinse the mouth after administration. C. Check the pulse after medication administration. D. Limit caffeine intake.

Correct Answer is B

Explanation

A. Taking inhaled beclomethasone with meals is not necessary, as this medication works locally in the lungs and does not require food to be absorbed or tolerated.
B. Rinsing the mouth after using inhaled corticosteroids like beclomethasone is important to prevent the development of oral thrush (a fungal infection) and reduce the risk of other side effects, such as hoarseness.
C. Checking the pulse after medication administration is not required for beclomethasone. While some medications affect heart rate, inhaled corticosteroids like beclomethasone are not typically associated with this effect.
D. Limiting caffeine intake is not necessary when using beclomethasone. Caffeine is a stimulant that may interact with some medications, but it does not typically interfere with corticosteroids used in asthma treatment.

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The nurse notes that which disorder places the patient at greatest risk for hypertensive crisis?

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Correct Answer is B

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