Question 1

The nurse suspects that a patient with Conn's syndrome has a decreased potassium level.What finding did the nurse use to make this clinical decision?

Accepted Answer

Development of U waves on the cardiac monitor is a finding seen in patients with decreased potassium levels (hypokalemia). Conn's syndrome is a disorder characterized by excess secretion of aldosterone, which can cause hypokalemia. Therefore, the nurse may suspect hypokalemia in a patient with Conn's syndrome who also exhibits U waves on the cardiac monitor.

Question 2

The nurse is providing discharge instructions to a patient with adrenal insufficiency.Which statement indicates that additional teaching is required?

Accepted Answer

Patients with adrenal insufficiency may experience weight gain due to fluid retention; however, it is not expected to occur every day. This statement is not accurate and requires additional teaching.

Question 3

A patient with adrenal insufficiency asks why the skin looks so tan.What should the nurse respond to this patient?

Accepted Answer

The darker skin in adrenal insufficiency is due to increased production of ACTH, which shares a precursor with melanocyte-stimulating hormone, leading to increased pigmentation.

Question 4

A patient is being evaluated for hyperaldosteronism.What should the nurse expect to assess in this patient?

Accepted Answer

Hyperaldosteronism often leads to hypertension, which can cause headaches.

Question 5

The nurse is preparing discharge teaching for a patient with hypercortisolism.What should the nurse emphasize to this patient?

Accepted Answer

Patients with hypercortisolism have increased cortisol levels which can lead to sodium retention and edema. Restricting salt intake can help manage these symptoms. Increasing fluids and activity may not necessarily be helpful and increasing salt intake can worsen symptoms.

Question 6

A patient is being evaluated for hypercortisolism.Which laboratory test should the nurse expect to be prescribed initially for this patient?

Accepted Answer

A 24-hour urine for cortisol is the initial laboratory test ordered to evaluate for hypercortisolism. This test measures the amount of cortisol excreted in the urine over a 24-hour period and is considered the most reliable test for evaluating excess cortisol production. Serum sodium and potassium levels and fasting blood glucose levels may also be ordered as part of the evaluation, but they are not the initial tests ordered.

Question 7

A patient being treated for adrenal insufficiency has a serum potassium level of 5.9 mEq/L.What should the nurse expect to be prescribed for this patient?

Accepted Answer

Kayexalate is used to treat hyperkalemia, which is indicated by the elevated serum potassium level of 5.9 mEq/L in this patient.

Question 8

A patient recovering from emergency surgery after a motor vehicle crash is demonstrating signs of adrenal insufficiency.What medication should the nurse expect to be prescribed for this patient?

Accepted Answer

Adrenal insufficiency, also known as Addisonian crisis, is a life-threatening condition that occurs when the body doesn't produce enough cortisol. Treatment for adrenal insufficiency involves replacing the deficient cortisol. Hydrocortisone sodium succinate (Solu-Cortef) is a medication used to replace cortisol in patients with adrenal insufficiency. Therefore, the nurse should expect hydrocortisone sodium succinate to be prescribed for this patient. Choices A, B, and C do not address the underlying problem of adrenal insufficiency.

Question 9

The nurse notes that a patient with adrenal insufficiency has muscular weakness.To what should the nurse attribute this finding?

Accepted Answer

Muscular weakness is a common symptom of adrenal insufficiency due to the body's decreased ability to regulate potassium levels, leading to hyperkalemia.

Question 10

A patient with hypercortisolism has significant fluid retention.Which nursing action would be most appropriate for this patient?

Accepted Answer

Turning and repositioning every two hours helps prevent fluid retention and skin breakdown in patients with hypercortisolism.

Question 11

A patient is having a vanillylmandelic acid (VMA)urine test.What food should the nurse instruct the patient to avoid before undergoing this test?

Accepted Answer

The patient should avoid chocolate before undergoing a vanillylmandelic acid (VMA) urine test. Chocolate contains catecholamines, which can increase VMA levels in the urine and interfere with the accuracy of the test. Red meat, whole grains, and green vegetables do not need to be avoided for this test.

Question 12

The nurse is reviewing data collected on a patient with adrenal insufficiency.Which finding suggests that the patient is experiencing dehydration?

Accepted Answer

A hematocrit level of 52% is elevated and can indicate hemoconcentration, which is a sign of dehydration.

Question 13

A patient asks for a definition of adrenal insufficiency.Which response should the nurse make?

Accepted Answer

Adrenal insufficiency is characterized by decreased secretion of hormones, specifically cortisol, from the adrenal cortex due to malfunction or damage of the adrenal gland or lack of stimulation from the anterior pituitary gland. While the adrenal medulla secretes hormones such as epinephrine and norepinephrine, these are not affected in adrenal insufficiency. Increased secretion of hormones from the adrenal cortex or anterior pituitary gland is not a characteristic of adrenal insufficiency.

Question 14

A patient with no predisposing risk factors develops ventricular fibrillation.For which health problem should the patient be evaluated?

Accepted Answer

Ventricular fibrillation is a serious arrhythmia that can be caused by various factors, including electrolyte imbalances, drug toxicity, and underlying structural heart disease. Pheochromocytoma, a rare tumor of the adrenal gland that secretes excess catecholamines, can also cause ventricular arrhythmias like ventricular fibrillation. Therefore, the patient should be evaluated for pheochromocytoma. The other options (A, C, and D) are not commonly associated with ventricular fibrillation.

Question 15

The nurse plans to evaluate a patient for hypoglycemia and hypernatremia.Which medication did this patient most likely receive?

Accepted Answer

Aminoglutethimide can cause adrenal insufficiency, leading to hypoglycemia and hypernatremia.

Question 16

A patient is diagnosed with a unilateral pheochromocytoma.For which treatment should the nurse prepare this patient?

Accepted Answer

The definitive treatment for a unilateral pheochromocytoma is surgical removal of the affected adrenal gland (adrenalectomy). This will eliminate the source of excessive catecholamine production and prevent the potential complications associated with uncontrolled hypertension. Smooth muscle relaxants, beta-adrenergic blocking agents, and alpha-adrenergic blocking agents may be used preoperatively to manage hypertension and prepare the patient for surgery, but they are not curative.

Question 17

A patient is admitted for treatment of Cushing's syndrome.What is the primary reason for this disorder?

Accepted Answer

Cushing's syndrome is caused by the excess secretion of glucocorticoids, typically due to a pituitary tumor or long-term use of corticosteroid medications.

Question 18

A patient is prescribed to have a cortisol blood level drawn.At which time should this sample be drawn?

Accepted Answer

Cortisol levels tend to follow a diurnal pattern, peaking in the morning (around 6-8 am) and decreasing over the course of the day. Therefore, 0700 hours would be the best time to draw a cortisol blood sample.

Question 19

A patient is diagnosed with pheochromocytoma.Which manifestation should the nurse expect as a result of catecholamine secretion?

Accepted Answer

Pheochromocytoma is a tumor of the adrenal medulla that secretes excessive amounts of catecholamines, including adrenaline and noradrenaline. This can cause hypertension, tachycardia, and a widening pulse pressure. Bradycardia, hypotension, and hypoglycemia are not typical manifestations of pheochromocytoma.

Question 20

The results of a patient's MRI show evidence of enlarged adrenal glands.Which health problem is most likely causing this finding?

Accepted Answer

The answer of The results of a patient's MRI show...

Quiz 42: Coordinating Care for Patients With Adrenal Disorders