A patient is admitted to the hospital with a diagnosis of Cushing syndrome. On physical assessment of the patient, what should the nurse expect to find?

Correct Answer: A

Rationale: In Cushing syndrome, the body is exposed to high levels of cortisol over a prolonged period, leading to characteristic signs and symptoms. The correct answer is A) Hypertension, peripheral edema, and petechiae. Hypertension is common due to cortisol's role in fluid and electrolyte balance. Peripheral edema results from sodium retention and increased capillary permeability. Petechiae may occur due to fragile capillaries from cortisol-induced skin changes. Option B is incorrect as weight gain, not loss, is typical in Cushing syndrome. Buffalo hump and moon face are due to fat redistribution, not acne. Option C is incorrect as truncal obesity and striae are expected, not hypotension. Option D is incorrect as hyperpigmentation, anorexia, and dehydration are more indicative of Addison's disease, not Cushing syndrome. Educationally, understanding these specific manifestations of Cushing syndrome aids nurses in recognizing and managing patients with this condition effectively. It emphasizes the importance of differentiating between various endocrine disorders based on clinical presentations for accurate diagnosis and treatment.

Correct Answer: B

Rationale: The correct answer is B) corns. Corns are areas of thickened skin that develop on the feet due to excessive pressure or friction, common in individuals with diabetes. By observing for the presence of corns on the patient's feet during the next visit, the nurse can assess whether the patient is following the foot care instructions provided. Corns indicate that there is still excessive pressure or friction on certain areas of the feet, suggesting that the patient may not be implementing the recommended foot care practices effectively. Option A) colored socks is incorrect as the color of the socks does not provide any direct indication of the patient's foot care practices or diabetic management. Option C) straight toenails is incorrect as well because while proper nail care is important for diabetic patients, it is not the most reliable indicator of the effectiveness of foot care teaching. Option D) dermatophytosis is a fungal infection that can affect the feet, but it is not directly related to the effectiveness of the foot care teaching provided by the nurse. In an educational context, understanding the significance of assessing foot health in diabetic patients is crucial. Poor foot care can lead to serious complications such as ulcers and infections, which can result in amputations. Nurses play a vital role in educating diabetic patients on proper foot care practices to prevent such complications. By evaluating the outcomes of their teaching, nurses can tailor their education to meet the specific needs of each patient and promote better health outcomes.

Correct Answer: B

Rationale: In the case of Mrs. J, a 40-year-old woman diagnosed with hypothyroidism, the most appropriate treatment plan would involve option B, which is thyroid hormone replacement therapy. This is the correct answer because hypothyroidism is a condition characterized by an underactive thyroid gland, leading to insufficient production of thyroid hormones. As a result, replacing these hormones through medication is essential to restore the body's normal functioning and alleviate symptoms associated with hypothyroidism. Option A, a high-protein diet, and option C, a high-fiber diet, are not directly related to the treatment of hypothyroidism. While a balanced diet is important for overall health, dietary modifications alone cannot address the underlying hormonal imbalance caused by hypothyroidism. Similarly, option D, low-sodium medications, is not a primary treatment for hypothyroidism and would not address the root cause of the condition. Educationally, understanding the appropriate treatment for hypothyroidism is crucial for healthcare professionals and patients alike. By knowing that thyroid hormone replacement therapy is the cornerstone of managing hypothyroidism, healthcare providers can ensure that patients like Mrs. J receive the necessary treatment to improve their quality of life and prevent complications associated with untreated hypothyroidism. This knowledge also empowers patients to advocate for themselves and actively participate in their treatment plans, leading to better health outcomes.

Correct Answer: A

Rationale: In assessing a client's mental and emotional status before initiating therapy for an endocrine disorder, it is crucial to evaluate their ability to respond to questions (Option A). This is the correct answer because assessing the client's cognitive function, communication skills, and comprehension abilities through their responses provides valuable insight into their mental state, emotional well-being, and capacity to engage in therapy effectively. Option B, motor function, is not the most appropriate choice for assessing mental and emotional status in this context as it primarily evaluates physical movement and coordination, which may not directly correlate with the client's cognitive or emotional functioning related to endocrine disorders. Option C, sleep and awake cycles, while important for overall health assessment, focuses more on the client's circadian rhythm and rest patterns rather than their mental and emotional status specifically in relation to initiating therapy for an endocrine disorder. Option D, facial expression, can convey emotions and potential neurological issues but may not provide a comprehensive assessment of the client's mental and emotional status required for initiating therapy for an endocrine disorder. Educationally, understanding the rationale behind assessing a client's mental and emotional status before treatment is crucial for nurses and healthcare professionals to tailor interventions effectively, address potential barriers to therapy, and ensure optimal outcomes in managing endocrine disorders. It emphasizes the holistic approach to patient care and highlights the significance of thorough assessment in providing patient-centered care.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Clients with hypertension that is difficult to control should be assessed for pheochromocytoma. Pheochromocytoma is a rare tumor of the adrenal gland that can cause excess production of catecholamines, leading to symptoms like severe hypertension. Therefore, individuals with uncontrolled hypertension should be evaluated for this condition. Option B) Clients with high blood glucose levels are more indicative of conditions like diabetes rather than pheochromocytoma. Pheochromocytoma does not typically present with high blood glucose levels. Option C) Clients who take more than two medicines to control their blood pressure may have resistant hypertension, but this alone is not a specific indicator for pheochromocytoma. Option D) Clients with either primary or secondary adrenal insufficiency would not typically present with symptoms suggestive of pheochromocytoma. Adrenal insufficiency is characterized by low levels of adrenal hormones, which is distinct from the excess catecholamines seen in pheochromocytoma. Educational context: Understanding the signs and symptoms of pheochromocytoma is crucial for healthcare professionals, especially those working in primary care or endocrinology. Recognizing the appropriate patient populations for further evaluation can lead to timely diagnosis and management of this potentially life-threatening condition. By assessing patients with difficult-to-control hypertension for pheochromocytoma, healthcare providers can ensure comprehensive care and appropriate treatment strategies for their patients.