The female patient is admitted with a new diagnosis of Cushing syndrome with elevated serum and urine cortisol levels. Which assessment findings should the nurse expect to see in this patient?

Correct Answer: D

Rationale: In this scenario, option D, "Elevated blood pressure and blood glucose," is the correct answer. In Cushing syndrome, there is excess production of cortisol, leading to symptoms such as hypertension (elevated blood pressure) and hyperglycemia (elevated blood glucose levels). Option A, "Hair loss and moon face," is not indicative of Cushing syndrome. Hair loss can occur in some endocrine disorders but is not a typical finding in Cushing syndrome. Moon face, or a rounded face with prominent cheeks, is a classic sign of Cushing syndrome, but it is not the only or most prominent symptom. Option B, "Decreased weight and hirsutism," is not characteristic of Cushing syndrome. Patients with Cushing syndrome often experience weight gain, especially in the abdominal area, due to cortisol's role in metabolism. Hirsutism, or excessive hair growth, can occur in conditions such as polycystic ovary syndrome but is not a primary feature of Cushing syndrome. Option C, "Decreased muscle mass and thick skin," is also not typical of Cushing syndrome. In fact, patients with Cushing syndrome may experience muscle weakness and wasting due to the catabolic effects of excess cortisol. Thickened skin is not a common manifestation of this condition. From an educational perspective, understanding the characteristic signs and symptoms of endocrine disorders like Cushing syndrome is crucial for nurses to provide effective care. Recognizing the key clinical manifestations helps in timely diagnosis, intervention, and management of the condition, ultimately improving patient outcomes. It is essential for nurses to be familiar with the various presentations of endocrine disorders to provide comprehensive and holistic care to their patients.

Correct Answer: C

Rationale: The correct answer is C) HHS requires greater fluid replacement to correct the dehydration. In diabetic ketoacidosis (DKA), the primary issue is the presence of ketones and acidosis due to insulin deficiency. Treatment involves insulin administration, fluid replacement, and correction of electrolyte imbalances. Bicarbonate administration is not routinely recommended as the acidosis corrects with insulin therapy. Hyperosmolar hyperglycemic syndrome (HHS) is characterized by severe hyperglycemia and dehydration without significant ketoacidosis. In HHS, there is a marked increase in serum osmolality leading to severe dehydration. Therefore, fluid replacement is crucial in HHS to correct the dehydration and hyperosmolality. Option A is incorrect as bicarbonate administration is not a primary treatment for DKA. Option B is incorrect because potassium replacement is essential in both DKA and HHS due to electrolyte imbalances. Option D is incorrect because glucose administration is necessary in HHS to correct the hyperglycemia gradually and avoid osmotic shifts. Understanding the differences in treatment approaches for DKA and HHS is crucial for healthcare providers managing patients with diabetes. Recognizing the specific needs of each condition ensures appropriate and effective management, thereby preventing potential complications and improving patient outcomes.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Urine specific gravity. When a patient presents with symptoms of diabetes insipidus such as excessive urination and dehydration, measuring urine specific gravity is crucial in diagnosing the condition. In diabetes insipidus, the kidneys are unable to concentrate urine properly, leading to the excretion of large volumes of dilute urine. A low urine specific gravity indicates the inability of the kidneys to concentrate urine, supporting the diagnosis of diabetes insipidus. Option A) Blood glucose is not the correct choice in this case because diabetes insipidus is a disorder of water balance, not glucose metabolism. Measuring blood glucose levels would not provide relevant information for diagnosing diabetes insipidus. Option B) Serum sodium level may be altered in diabetes insipidus due to dehydration, but it is not a specific diagnostic test for this condition. While monitoring sodium levels is important in managing diabetes insipidus, it is not the primary test used for diagnosis. Option D) Computed tomography (CT) of the head is not typically performed as a diagnostic test for diabetes insipidus. CT scans are more useful in detecting structural abnormalities in the brain, which are not typically associated with diabetes insipidus. Educationally, understanding the rationale behind diagnostic tests in endocrine disorders like diabetes insipidus is crucial for healthcare providers to make accurate assessments and provide appropriate care. By knowing which tests are most relevant to specific conditions, nurses can contribute to timely and accurate diagnoses, leading to better patient outcomes.

Correct Answer: D

Rationale: In managing a patient with long-standing hypothyroidism who is starting replacement therapy, monitoring for dysrhythmias is crucial. The correct answer is D because when thyroid hormone replacement therapy is initiated, it can lead to an increase in the body's metabolic rate, potentially causing cardiac complications such as dysrhythmias, especially in individuals with preexisting heart conditions. Option A, insomnia, and option B, nervousness, are more commonly associated with hyperthyroidism rather than hypothyroidism or its treatment. Weight loss (option C) is also more indicative of hyperthyroidism, where patients typically experience unintentional weight loss due to an increased metabolic rate, whereas in hypothyroidism, weight gain is a more common symptom. Educationally, understanding the potential complications and monitoring parameters when initiating treatment for hypothyroidism is essential for nurses to ensure patient safety and optimal outcomes. This question highlights the importance of being vigilant for adverse effects when starting replacement therapy, particularly in patients with a history of hypothyroidism.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Weight loss. The fourth cardinal symptom of diabetes, in addition to polyuria, polydipsia, and polyphagia, is weight loss. This weight loss occurs due to the body's inability to properly utilize glucose for energy, leading to the breakdown of fats and proteins for energy production. Option A) Impaired vision is a common complication of diabetes but is not one of the cardinal symptoms used to diagnose the condition. Option C) Confused thought processes may occur in severe cases of uncontrolled diabetes but are not one of the cardinal symptoms. Option D) Fat intolerance is not a cardinal symptom of diabetes and is not directly related to the characteristic symptoms of polyuria, polydipsia, polyphagia, and weight loss. Educationally, understanding the cardinal symptoms of diabetes is crucial for healthcare professionals to recognize and diagnose the condition promptly. By knowing these key symptoms, healthcare providers can initiate timely interventions and prevent complications associated with uncontrolled diabetes. This question reinforces the importance of recognizing the cardinal symptoms of diabetes and their significance in clinical practice.