Deck 42: Coordinating Care for Patients With Adrenal Disorders

Question 1

A patient has received doses of prednisone for treatment of rheumatoid arthritis for the past 3 months. If this medication is suddenly discontinued, the nurse assesses for which complication?
1)Hypovolemia
2)Hypokalemia
3)Hypernatremia
4)Hyperglycemia

Answer 1

1

Question 2

A patient being treated for adrenal insufficiency has a serum potassium level of 5.9 mEq/L. The nurse correlates that the action of which medication is indicated in this situation?
1)Kayexalate
2)Hydrocortisone
3)Dexamethasone
4)Dextrose 5% and 0.45% normal saline

Answer 2

1

Question 3

A patient recovering from emergency surgery after a motor vehicle crash is demonstrating clinical manifestations of adrenal insufficiency. What treatment is indicated for this patient?
1)Regular insulin 10 units
2)Potassium chloride 20 mEq
3)Intravenous infusion 0.9% normal saline
4)Hydrocortisone sodium succinate (Solu-Cortef)

Answer 3

4

Question 4

A patient is being evaluated for hypercortisolism. Which laboratory test does the nurse expect to be prescribed initially for this patient?
1)Serum sodium level
2)Serum potassium level 3.24-hour urine for cortisol
4)Fasting blood glucose level

Question 5

A patient is having a vanillylmandelic acid (VMA) urine test. What food should the nurse instruct the patient to avoid before undergoing this test?
1)Red meat
2)Chocolate
3)Whole grains
4)Green vegetables

Question 6

A patient asks for a definition of adrenal insufficiency. Which response by the nurse is best?
1)Increased secretion of hormones from the adrenal cortex
2)Decreased secretion of hormones from the adrenal medulla
3)Increased secretion of hormones from the anterior pituitary gland
4)Decreased secretion of hormones from the anterior pituitary gland

Question 7

The nurse monitors for which clinical manifestations in the patient with adrenal insufficiency?
1)Hematocrit 52%
2)Serum cortisol 20 mcg/dL
3)Serum sodium 150 mEq/L
4)Serum potassium 3.2 mEq/L

Question 8

A patient is admitted for treatment of Cushing's syndrome. The nurse correlates this disease process to which alteration in endocrine function?
1)Elevated glucocorticoid level
2)Elevated aldosterone secretion
3)Decreased glucocorticoid level
4)Decreased aldosterone secretion

Question 9

The nurse provides care to a patient who is scheduled for a corticotropic stimulation test. Which times require the nurse to draw blood for serum cortisol levels?
1)15 and 30 minutes after medication administration
2)30 and 60 minutes after medication administration
3)15 and 30 minutes before medication administration
4)30 and 60 minutes before medication administration

Question 10

The nurse formulates the nursing diagnosis "High Risk for Fluid Volume Deficit related to increased sodium excretion." This nursing diagnosis is most relevant to which disease process?
1)Adrenal cortex hyperfunction
2)Conn's syndrome
3)Hypoaldosteronism
4)Cushing's disease

Question 11

The nurse correlates which clinical manifestations in the patient diagnosed with hyperaldosteronism?
1)Elevated blood pressure
2)Thin, friable skin
3)Dependent edema
4)Fat maldistribution

Question 12

In completing a health history on a patient with hypercortisolism, the nurse correlates which clinical manifestation to this disorder?
1)Dry skin
2)Weight gain
3)Excessive thirst
4)Hypotension

Question 13

The nurse notes that a patient with adrenal insufficiency has muscular weakness and correlates this to which laboratory data?
1)White blood cell count 12 10³/mm^3-
2)Serum glucose of 150 mg/dL
3)Serum potassium 5.8 mEq/L
4)Serum sodium 150 mEq/L

Question 14

A patient is prescribed to have a cortisol blood level drawn. At which time should this sample be drawn?
1)Midnight 2.0700
3)1200
4)2200

Question 15

The nurse monitors for which clinical manifestations in the patient diagnosed with a pheochromocytoma?
1)Bradycardia
2)Hypotension
3)Hypoglycemia
4)Widening pulse pressure

Question 16

The nurse monitors for which potential complication in the patient receiving aminoglutethimide for an adrenal cortex disorder?
1)Serum potassium 3.0 mEq/L
2)Serum glucose 60 mg/dL
3)Serum sodium 155 mEq/L
4)Serum BUN 15 mg/dL

Question 17

The nurse provides care to a patient, diagnosed with adrenal insufficiency, who is scheduled for an insulin tolerance test to evaluate the hypothalamic-pituitary axis. Which information noted in the patient's history requires an intervention by the nurse?
1)Epilepsy
2)Anorexia
3)Depression
4)Gastroesophageal reflux disease (GERD)

Question 18

The nurse monitors for which clinical manifestation in the patient diagnosed with Conn's syndrome?
1)Muscle wasting
2)Elevated blood glucose
3)Abnormal fat distribution
4)Tachyarrhythmias

Question 19

A patient with adrenal insufficiency asks why their skin looks so tan. What is the best response by the nurse?
1)"The darker skin means the hormones from the hypothalamus are low."
2)"The darker skin is caused by the destruction of the cells of the adrenal glands."
3)"The darker skin means that you have too much of the hormones cortisol and aldosterone."
4)"The hormone causing the darker skin shares the same hormone as the one helping to overcome the insufficiency."

Question 20

The nurse is providing discharge instructions to a patient with adrenal insufficiency. Which statement by the patient indicates the need for further teaching?
1)"I should obtain a Medic-Alert bracelet."
2)"I should report changes in urine output."
3)"I should take my medication every day."
4)"I should expect to gain weight."

Question 21

The nurse correlates which assessment data to a diagnosis of Cushing's syndrome in a female patient? Select all that apply.
1)Leg cramps
2)Amenorrhea
3)Breast atrophy
4)Menstrual pain
5)Deepening of the voice

Question 22

The nurse is reviewing the medical history of a patient with adrenal insufficiency and correlates which findings to causes of primary adrenal insufficiency? Select all that apply.
1)Cancer
2)Trauma
3)Infection
4)Tumor of the anterior pituitary gland
5)Autoimmune disorder

Question 23

The nurse correlates examination of which body structures in the patient admitted to determine the cause for adrenal insufficiency? Select all that apply.
1)Ovaries
2)Thyroid
3)Hypothalamus
4)Adrenal glands
5)Anterior pituitary gland

Question 24

A patient is scheduled for a bilateral adrenalectomy. The nurse includes teaching about which disorder in preparing the patient for this procedure?
1)Hypertension
2)Hypercortisolism
3)Hyperaldosteronism
4)Adrenal insufficiency

Question 25

The nurse correlates which assessment data as risk factors for development of Conn's syndrome? Select all that apply.
1)Age 35
2)Caucasian
3)Male gender
4)Female gender
5)African American

Question 26

In assessing the patient with hypercortisolism, the nurse correlates which clinical manifestations to this diagnosis? Select all that apply.
1)Moon face
2)Skin breakdown
3)Buffalo hump
4)Increased muscle mass
5)Decreased blood pressure

Question 27

The nurse develops the nursing diagnosis: "Acute pain: Headache related to increased levels of circulating catecholamines" for the patient with which disorder?
1)Conn's syndrome
2)Cushing's syndrome
3)Hyperaldosteronism
4)Pheochromocytoma

Question 28

The nurse is visiting the home of a patient with adrenal insufficiency. Which observations indicate that the patient needs to be seen by the healthcare provider immediately? Select all that apply.
1)Fatigue
2)Poor skin turgor
3)Skin hyperpigmentation
4)Dry mucous membranes
5)Blood pressure 90/50 mm Hg

Question 29

The nurse notes that a patient with pheochromocytoma is prescribed sodium nitroprusside (Nipride). What is the purpose of this medication?
1)Decrease the secretion of catecholamines
2)Increase chronotropic and inotropic effects
3)Limit the development of tachydysrhythmias
4)Reduce blood pressure through vasodilation

Question 30

The nurse monitors for which clinical manifestations in the patient diagnosed with a pheochromocytoma? Select all that apply.
1)Dry skin
2)Palpitations
3)Weight gain
4)Hypertension
5)Hyperglycemia