The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?

Pain 7/10 at the surgical site

Hyperglycemia

Blood pressure 92/50

Sodium 152 mEq/L

Answer and Explanation

The Correct Answer is C

A. Pain 7/10 at the surgical site: This level of pain is expected following major surgery, such as a bilateral adrenalectomy, and does not specifically indicate an Addisonian crisis.
B. Hyperglycemia: Although hyperglycemia can be associated with stress or corticosteroid treatment, it is not a hallmark of Addisonian crisis. Addisonian crisis is more related to adrenal insufficiency rather than hyperglycemia.
C. Blood pressure 92/50: Low blood pressure is a critical sign of an Addisonian crisis. This condition results from severe adrenal insufficiency where the body cannot maintain adequate blood pressure.
D. Sodium 152 mEq/L: High sodium levels are not characteristic of an Addisonian crisis. Addisonian crisis typically leads to hyponatremia (low sodium levels) due to inadequate aldosterone production.

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Correct Answer is B

Explanation

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.

A. B-type natriuretic peptide (BNP) B. Troponin I C. Blood urea nitrogen (BUN) D. Platelet levels

Correct Answer is A

Explanation

A. B-type natriuretic peptide (BNP): BNP levels are elevated in heart failure due to increased pressure and stretch in the heart's chambers. It is a key marker used to diagnose and assess the severity of heart failure.
B. Troponin I: This marker is used to diagnose myocardial infarction (heart attack) rather than heart failure. Elevated troponin levels indicate damage to the heart muscle.
C. Blood urea nitrogen (BUN): BUN levels can be elevated in heart failure due to decreased renal perfusion, but it is not as specific for diagnosing heart failure as BNP.
D. Platelet levels: Platelet levels are not directly related to the diagnosis of heart failure. They are more relevant for assessing clotting disorders and other conditions.

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The patient is returning to the unit after undergoing a bilateral adrenalectomy. Which clinical manifestation would indicate that the client is experiencing an Addisonian crisis?

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Naxlex Comprehensive Predictor Exams

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