What is the priority of care for a patient with Cushing's syndrome?

Administering corticosteroid medications

Assessing for signs of infection

Providing emotional support

Monitoring blood glucose levels

Answer and Explanation

The Correct Answer is B

A. Administering corticosteroid medications is incorrect. In Cushing's syndrome, the body already has excess cortisol, either due to endogenous overproduction or prolonged corticosteroid use. The priority is to reduce cortisol levels, not increase them.
B. Assessing for signs of infection is correct. Excess cortisol suppresses the immune system, making patients with Cushing's syndrome highly susceptible to infections. These infections may not present with typical signs (e.g., fever) due to immune suppression, so vigilant assessment is a priority to prevent complications.
C. Providing emotional support is important, as patients may experience body image issues and mood changes, but it is not the immediate priority when life-threatening complications like infection are possible.
D. Monitoring blood glucose levels is also important, since hyperglycemia is common due to cortisol’s effects on glucose metabolism. However, infection risk poses a more immediate threat to patient safety, making infection assessment the top priority.

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Correct Answer is C

Explanation

A. Sensitivity to cold is not a typical manifestation of hyperthyroidism. Clients with hyperthyroidism generally experience an increase in metabolism, which can lead to symptoms such as heat intolerance and sweating. Sensitivity to cold is more commonly associated with hypothyroidism.
B. Constipation is also more commonly associated with hypothyroidism. Clients with hyperthyroidism tend to experience increased gastrointestinal motility, which can lead to more frequent bowel movements, rather than constipation.
C. Frequent mood changes are a common manifestation of hyperthyroidism. The overproduction of thyroid hormones can affect mood and cause symptoms like irritability, anxiety, and mood swings. This is often due to the increased metabolic rate and the effect thyroid hormones have on the nervous system.
D. Weight gain of 4.5 kg (10 lb) in 3 weeks is not typical in hyperthyroidism. In fact, hyperthyroidism often causes weight loss despite an increased appetite because of the elevated metabolic rate. Weight gain is more commonly seen in hypothyroidism, where metabolism slows down.

A. "You must be very upset about something." B. "Go back to your room, and I'll try to get in touch with your doctor." C. "You are being unreasonable, and I will not call your doctor at this hour." D. "I can't call a doctor in the middle of the night unless it's an emergency."

Correct Answer is A

Explanation

A. "You must be very upset about something." is the most appropriate response. This response acknowledges the client's emotional state without dismissing their feelings. It shows empathy and allows the nurse to validate the client's distress. In addition, it opens the door for further communication, where the nurse can explore the reasons behind the client's behavior and work with them to address their concerns. This approach promotes therapeutic communication and helps build trust with the client.
B. "Go back to your room, and I'll try to get in touch with your doctor." is not ideal. While it addresses the request, it could be seen as dismissive and doesn't validate the client's feelings or explain the situation in a way that helps calm the client.
C. "You are being unreasonable, and I will not call your doctor at this hour." is not appropriate. This response is judgmental and invalidates the client's feelings, which could escalate the situation.
D. "I can't call a doctor in the middle of the night unless it's an emergency." is not the best choice. This statement could come across as dismissive and doesn't address the underlying emotional distress of the client. Instead, it’s important to engage the client therapeutically before determining the necessity of contacting the provider.

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What is the priority of care for a patient with Cushing's syndrome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has hyperthyroidism. The nurse should expect the client to report which of the following manifestations?

Correct Answer is C

Explanation

A nurse who works in a psychiatric unit is caring for a client who has bipolar disorder. The client comes to the nurse's station at 0300 demanding that the nurse call the provider immediately. Which of the following responses by the nurse is appropriate?

Correct Answer is A

Explanation

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