Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is assessing four clients on a medical unit. The nurse should identify which of the following clients as exhibiting positive manifestations of hypercortisolism?
A. A client who has muscle hypertrophy.
Muscle hypertrophy is not a typical manifestation of hypercortisolism; rather, muscle weakness and wasting may occur.
B. Moon face
Moon face, or rounded facial appearance with prominent cheeks, is a characteristic manifestation of hypercortisolism (Cushing's syndrome).
C. A client who has a butterfly rash on his face.
A butterfly rash on the face is not specific to hypercortisolism; it may suggest other conditions such as systemic lupus erythematosus.
D. A client who has a positive Chvostek's sign.
Chvostek's sign is associated with hypocalcemia, not hypercortisolism.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Med Surg Proctored Exam 8. Take the full exam now
Full Explanation
A. Muscle hypertrophy is not a typical manifestation of hypercortisolism; rather, muscle weakness and wasting may occur.
B. Moon face, or rounded facial appearance with prominent cheeks, is a characteristic manifestation of hypercortisolism (Cushing's syndrome).
C. A butterfly rash on the face is not specific to hypercortisolism; it may suggest other conditions such as systemic lupus erythematosus.
D. Chvostek's sign is associated with hypocalcemia, not hypercortisolism.
Similar Questions
A nurse is caring for a client who has hypernatremia and requires IV fluid therapy due to his NPO status. Which of the following solutions should the nurse prepare to infuse for this client?
A. 0.45% sodium chloride
0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution with a lower concentration of sodium than normal serum levels. It can help to lower the sodium levels in a client with hypernatremia by diluting the excess sodium in the body.
B. Dextrose 10% in water
Dextrose 10% in water is hypertonic and not appropriate for a client with hypernatremia, as it could exacerbate the imbalance.
C. Lactated Ringer's
Lactated Ringer's is isotonic and contains sodium in a similar concentration to serum levels, hence it could further increase the sodium levels.
D. Dextrose 5% in 0.9% sodium chloride
Dextrose 5% in 0.9% sodium chloride (also known as D5NS) is a hypertonic solution that contains both dextrose and sodium. It would not be appropriate for a client with hypernatremia, as it could exacerbate the condition.
Full Explanation
A. 0.45% sodium chloride, also known as half-normal saline, is a hypotonic solution with a lower concentration of sodium than normal serum levels. It can help to lower the sodium levels in a client with hypernatremia by diluting the excess sodium in the body.
B. Dextrose 10% in water is hypertonic and not appropriate for a client with hypernatremia, as it could exacerbate the imbalance.
C. Lactated Ringer's is isotonic and contains sodium in a similar concentration to serum levels, hence it could further increase the sodium levels.
D. Dextrose 5% in 0.9% sodium chloride (also known as D5NS) is a hypertonic solution that contains both dextrose and sodium. It would not be appropriate for a client with hypernatremia, as it could exacerbate the condition.
A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?
A. Hyperkalemia
Hyperkalemia is a common finding in the oliguric phase of acute kidney injury due to impaired renal function, leading to decreased potassium excretion.
B. Hypomagnesaemia
Hypomagnesemia is not typically associated with the oliguric phase of acute kidney injury.
C. Increased glomerular filtration rate (GFR)
In the oliguric phase, the glomerular filtration rate is typically decreased, not increased.
D. Decreased creatinine level
In acute kidney injury, creatinine levels typically rise due to decreased renal function, rather than decrease.
Full Explanation
A. Hyperkalemia is a common finding in the oliguric phase of acute kidney injury due to impaired renal function, leading to decreased potassium excretion.
B. Hypomagnesemia is not typically associated with the oliguric phase of acute kidney injury.
C. In the oliguric phase, the glomerular filtration rate is typically decreased, not increased.
D. In acute kidney injury, creatinine levels typically rise due to decreased renal function, rather than decrease.
George Kent is a 54-year-old widower with a history of chronic obstructive pulmonary disease and was rushed to the emergency department with increasing shortness of breath, pyrexia, and a productive cough with yellow-green sputum. He has difficulty communicating because of his inability to complete a sentence. One of his sons, Jacob, says he has been unwell for three days. Upon examination, crackles and wheezes can be heard in the lower lobes; he has tachycardia and a bounding pulse. Measurement of arterial blood gas shows pH 7.3, PaCO2 68 mm Hg, HCO3 28 mmol/L and Pa02 60 mm Hg.
How would you interpret this?
A. Metabolic Acidosis. Partially Compensated
Metabolic acidosis would involve a low pH and low bicarbonate level, which is not evident in the given arterial blood gas results.
B. Respiratory Acidosis, Uncompensated
The low pH (acidosis) and high PaCO2 (respiratory component) indicate respiratory acidosis. The increased HCO3 (normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
C. Respiratory Acidosis, Partially Compensated
George Kent's arterial blood gas values indicate a lower pH and an elevated PaCO2, which are consistent with respiratory acidosis. The increased HCO3 ((normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
D. Metabolic Alkalosis Uncompensated
Metabolic alkalosis is not supported by the given arterial blood gas results.
Full Explanation
A. Metabolic acidosis would involve a low pH and low bicarbonate level, which is not evident in the given arterial blood gas results.
B. The low pH (acidosis) and high PaCO2 (respiratory component) indicate respiratory acidosis. The increased HCO3 (normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
C. George Kent's arterial blood gas values indicate a lower pH and an elevated PaCO2, which are consistent with respiratory acidosis. The increased HCO3 ((normal range of 22-26 mEq/L), suggests a renal compensatory mechanism attempting to normalize the pH.
D. Metabolic alkalosis is not supported by the given arterial blood gas results.