Which admission assessment findings should the nurse document related to a client who has been diagnosed with Cushing’s syndrome?
Husky voice and complaints of hoarseness.
Warm, soft, moist, salmon-colored skin.
Visible swelling of the neck, with no pain.
Central-type obesity, with thin extremities.
The Correct Answer is D
Choice A reason: A husky voice and complaints of hoarseness are not related to Cushing's syndrome, but may indicate a thyroid disorder or vocal cord damage.
Choice B reason: Warm, soft, moist, salmon-colored skin is not a characteristic of Cushing's syndrome, but may be seen in hyperthyroidism or infection.
Choice C reason: Visible swelling of the neck, with no pain, is not a sign of Cushing's syndrome, but may indicate a goiter or thyroid enlargement.
Choice D reason: Central-type obesity, with thin extremities, is a common feature of Cushing's syndrome, which is caused by excess cortisol production or exposure. Cortisol causes fat redistribution to the trunk, face, and back of the neck, while causing muscle wasting and weakness in the arms and legs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Overall fluid intake should not be limited, but rather increased, for a client with urinary tract calculi. Increasing fluid intake can help flush out the stones and prevent new ones from forming.
Choice B reason: Tea and hot chocolate should be limited, because they contain oxalates, which can increase the risk of calcium oxalate stones, the most common type of urinary tract calculi. Other foods high in oxalates include spinach, rhubarb, nuts, and chocolate.
Choice C reason: Low-sodium soups are not a problem for a client with urinary tract calculi, unless they have other conditions that require sodium restriction, such as hypertension or heart failure. Sodium intake does not directly affect the formation of stones, but it can increase calcium excretion in the urine, which can contribute to calcium oxalate stones.
Choice D reason: Citrus fruit juices are beneficial for a client with urinary tract calculi, because they contain citrate, which can prevent the crystallization of calcium and oxalate in the urine. Citrate can also help dissolve existing stones and prevent new ones from forming.
Correct Answer is C
Explanation
Choice A reason: Swabbing the throat for a rapid strep test is not a priority action that the nurse should implement, because it is not relevant to the client's current condition. A rapid strep test is a diagnostic tool that can detect the presence of Streptococcus bacteria in the throat, which can cause strep throat, a common bacterial infection. However, the client has already been diagnosed with strep throat and has been taking antibiotics for three days, so the test result may not be accurate or useful.
Choice B reason: Providing a mask for the client to wear is not a necessary action that the nurse should implement, because it is not related to the client's problem. A mask is a protective device that can prevent the transmission of respiratory infections, such as COVID-19, influenza, or tuberculosis, by blocking the droplets or aerosols that contain the pathogens. However, the client's symptoms are not caused by a respiratory infection, but by an allergic reaction to the antibiotics, which is not contagious.
Choice C reason: Instructing the client to stop taking the antibiotics is the most important action that the nurse should implement, because it can prevent further exposure to the allergen and reduce the severity of the reaction. The client's symptoms, such as rash, wheezing, and tachycardia, indicate that the client is having an allergic reaction to the antibiotics, which can be a serious and potentially life-threatening condition, especially if it progresses to anaphylaxis, a severe systemic reaction that can cause shock, airway obstruction, and organ failure. The nurse should instruct the client to stop taking the antibiotics immediately and notify the doctor.
Choice D reason: Applying a hypoallergenic cream to the rash is not a sufficient action that the nurse should implement, because it can only provide temporary relief and not address the underlying cause of the rash. A hypoallergenic cream is a topical product that can moisturize, soothe, and protect the skin, and it does not contain any ingredients that can cause allergic reactions. However, the rash is not caused by a skin irritant, but by a systemic reaction to the antibiotics, which requires more than a cream to treat.
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