Which safety measure is most important for the nurse to institute for a patient who has Cushing Syndrome?

Using a lift sheet to change the patient's position

Assisting the patient to change positions slowly

Padding the siderails of the patient's bed

Keeping suctioning equipment at the patient's bedside

Answer and Explanation

The Correct Answer is B

A. Using a lift sheet is helpful for preventing injury and ensuring safe handling of the patient, but it is not the most critical safety measure for a patient with Cushing’s syndrome.
B. Assisting the patient to change positions slowly is the most important safety measure for a patient with Cushing’s syndrome. Patients with Cushing’s syndrome often have osteoporosis and a risk of fractures due to prolonged exposure to high cortisol levels, which can lead to weakened bones. Orthostatic hypotension may also occur, so changing positions slowly can prevent falls.
C. Padding the siderails of the bed is typically done for patients at risk of seizures or those with neurological issues, not as a primary concern for patients with Cushing’s syndrome.
D. While keeping suction equipment at the bedside is important for patients at risk of aspiration or respiratory issues, it is not the most critical measure for a patient with Cushing’s syndrome. The most significant concern is the risk of falls and fractures due to bone weakening and potential hypotension.

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Correct Answer is B

Explanation

A. HCO3 (bicarbonate) levels above 26 mEq/L indicate alkalosis, not acidosis. In metabolic acidosis, the HCO3 levels would be low as the body attempts to neutralize excess acid.
B. In metabolic acidosis, the pH is expected to be below 7.35 because metabolic acidosis indicates an accumulation of acid or loss of bicarbonate, which lowers the blood pH.
C. PaO2 (partial pressure of oxygen) below 70 mm Hg typically indicates hypoxemia, not necessarily metabolic acidosis. The primary concern with metabolic acidosis is the balance of acid-base status, not oxygenation.
D. PaCO2 above 45 mm Hg would suggest respiratory acidosis rather than metabolic acidosis. In metabolic acidosis, the body compensates by hyperventilating to blow off CO2 and raise the pH, resulting in a normal or low PaCO2.

A. Hirsutism B. Hyperpigmentation C. Purple striations D. Intention tremors

Correct Answer is B

Explanation

A. Hirsutism, or excessive hair growth, is more commonly associated with conditions such as polycystic ovary syndrome (PCOS) or Cushing’s syndrome, rather than Addison’s disease.
B. Hyperpigmentation is a characteristic sign of Addison’s disease. Due to insufficient cortisol production in the adrenal glands, there is an increase in melanocyte-stimulating hormone (MSH), which leads to darkening of the skin, particularly in areas exposed to friction like elbows, knees, and the face.
C. Purple striations are a common finding in Cushing’s syndrome, which results from excessive cortisol production. They are not typically seen in Addison's disease.
D. Intention tremors are more commonly associated with neurological conditions, such as Parkinson’s disease, rather than Addison’s disease, which primarily affects the adrenal glands.

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Which safety measure is most important for the nurse to institute for a patient who has Cushing Syndrome?

Nursing Test Bank

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