Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up?
A. Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg
Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg - This combination of severe hypokalemia (low potassium) and elevated blood pressure is a concerning finding. It can lead to serious cardiac complications and requires immediate attention.
B. Serum phosphorus 3 mg/dL and hirsutism
Serum phosphorus 3 mg/dL and hirsutism - While low serum phosphorus may be seen in Cushing syndrome, it is not an immediate concern. Hirsutism (excessive hair growth) is a characteristic feature of Cushing syndrome.
C. Serum calcium 10 mg/dl, and reports of feelings of depression
Serum calcium 10 mg/dL, and reports of feelings of depression - Although an elevated serum calcium level is not typical in Cushing syndrome, it is not an immediate concern. Reports of depression should be addressed but do not require immediate follow-up.
D. Serum sodium 145 mEq/L and reports of muscle weakness
Serum sodium 145 mEq/L and reports of muscle weakness - These findings are not indicative of immediate danger. Elevated serum sodium and muscle weakness can occur in Cushing syndrome, but they do not warrant immediate attention compared to the potassium level and blood pressure in option A.
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Full Explanation
A. Serum potassium 2.5 mEq/L and blood pressure 150/90 mmHg - This combination of severe hypokalemia (low potassium) and elevated blood pressure is a concerning finding. It can lead to serious cardiac complications and requires immediate attention.
B. Serum phosphorus 3 mg/dL and hirsutism - While low serum phosphorus may be seen in Cushing syndrome, it is not an immediate concern. Hirsutism (excessive hair growth) is a characteristic feature of Cushing syndrome.
C. Serum calcium 10 mg/dL, and reports of feelings of depression - Although an elevated serum calcium level is not typical in Cushing syndrome, it is not an immediate concern. Reports of depression should be addressed but do not require immediate follow-up.
D. Serum sodium 145 mEq/L and reports of muscle weakness - These findings are not indicative of immediate danger. Elevated serum sodium and muscle weakness can occur in Cushing syndrome, but they do not warrant immediate attention compared to the potassium level and blood pressure in option A.
Similar Questions
Synthroid 0.3 mg p.o. daily is ordered. You have Synthroid in 150 mcg tablets. Give tablets.
Full Explanation
One mg is equal to 1000 mcg, so 0.3 mg is equal to 300 mcg.
Then, the nurse has to divide the ordered dose by the available dose.
300 mcg divided by 150 mcg is equal to 2.
Therefore, the nurse has to give 2 tablets of Synthroid 150 mcg p.o. daily.
A nurse is caring for a client who is being evaluated for acromegaly. Which of the following manifestations should the nurse expect to find during assessment? (Select all that apply.)
A. Hepatomegaly
Hepatomegaly is a common manifestation of acromegaly, as excess growth hormone can cause organ enlargement.
B. Moon face
Moon face - This is a characteristic manifestation of acromegaly. The face becomes enlarged and rounded in appearance.
C. Coarse facia features
Coarse facial features - Excessive growth hormone leads to changes in facial structure, resulting in a coarser appearance.
D. Enlarged distal extreme
Enlarged distal extremities - Growth hormone excess causes overgrowth of bones and tissues, particularly in the hands and feet.
E. Loss of color discrimination
This can occur due to optic nerve involvement, which is associated with pituitary tumors that can cause acromegaly. Vision changes, including loss of color discrimination, may be noted as a result of pressure on the optic chiasm.
Full Explanation
A: Hepatomegaly is a common manifestation of acromegaly, as excess growth hormone can cause organ enlargement.
B: Moon face is associated with Cushing's syndrome, not acromegaly. In acromegaly, facial changes are characterized by bony enlargement and coarsening of features, not the rounded face seen in Cushing's syndrome.
C: Coarse facial features are a classic sign of acromegaly due to the overgrowth of facial bones and soft tissue, leading to prominent brows, a larger nose, and a protruding jaw.
D: Enlarged distal extremities, such as hands and feet, are typical in acromegaly because of excessive growth hormone, which affects the growth plates in the bones and causes an increase in size and thickness.
E: This can occur due to optic nerve involvement, which is associated with pituitary tumors that can cause acromegaly. Vision changes, including loss of color discrimination, may be noted as a result of pressure on the optic chiasm.
The nurse is assessing an older patient with type 2 diabetes mellitus. What age-related endocrine change should the nurse expect in this patient?
A. More rapid insulin release
Incorrect. Aging is associated with a decrease in insulin production and a reduction in the speed of insulin release, not an increase.
B. intolerance of fatty foods
Incorrect. Intolerance of fatty foods is not typically an age-related endocrine change. It may be related to other factors such as digestive issues.
C. Decreased sensitivity to insulin
Correct. Decreased sensitivity to insulin is a common age-related endocrine change, particularly in individuals with type 2 diabetes mellitus.
D. Lower and prolonged blood glucose levels
Incorrect. Lower and prolonged blood glucose levels are not an expected age-related endocrine change. Instead, insulin resistance tends to result in elevated blood glucose levels.
Full Explanation
A. Incorrect. Aging is associated with a decrease in insulin production and a reduction in the speed of insulin release, not an increase.
B. Incorrect. Intolerance of fatty foods is not typically an age-related endocrine change. It may be related to other factors such as digestive issues.
C. Correct. Decreased sensitivity to insulin is a common age-related endocrine change, particularly in individuals with type 2 diabetes mellitus.
D. Incorrect. Lower and prolonged blood glucose levels are not an expected age-related endocrine change. Instead, insulin resistance tends to result in elevated blood glucose levels.