Deck 42: Coordinating Care for Patients With Adrenal Disorders

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?

A) Muscle wasting
B) Elevated blood glucose
C) Abnormal fat distribution
D) Development of U waves on the cardiac monitor

Answer 1

Development of 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?

A) "I should obtain a MedicAlert bracelet."
B) "I should report changes in urine output."
C) "I should take my medication every day."
D) "I should expect to gain weight every day."

Answer 2

"I should expect to gain weight every day."

Question 3

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

A) "The darker skin means the hormone from the hypothalamus is low."
B) "The darker skin is caused by the destruction of the cells of the adrenal glands."
C) "The darker skin means that you have too much of the hormones cortisol and aldosterone."
D) "The hormone causing the darker skin shares the same hormone as the one helping to overcome the insufficiency."

Answer 3

"The hormone causing the darker skin shares the same hormone as the one helping to overcome the insufficiency."

Question 4

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

A) Headache
B) Thin,friable skin
C) Dependent edema
D) Fat maldistribution

Question 5

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

A) Increase fluids
B) Increase activity
C) Restrict salt intake
D) Increase salt intake

Question 6

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

A) Serum sodium level
B) Serum potassium level
C) 24-hour urine for cortisol
D) Fasting blood glucose level

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?

A) Kayexalate
B) Hydrocortisone
C) Dexamethasone
D) Dextrose 5% and 0.45% normal saline

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?

A) Regular insulin 10 units
B) Potassium chloride 20 mEq
C) Intravenous infusion 0.9% normal saline
D) Hydrocortisone sodium succinate (Solu-Cortef)

Question 9

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

A) Infection
B) Inflammation
C) Hyperkalemia
D) Hypernatremia

Question 10

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

A) Monitor blood glucose level
B) Turn and reposition every two hours
C) Elevate the head of the bed 45 degrees
D) Administer medications that interfere with production/secretion of cortisol

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?

A) Red meat
B) Chocolate
C) Whole grains
D) Green vegetables

Question 12

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

A) Hematocrit 52%
B) Serum cortisol 11 mcg/dL
C) Serum sodium 134 mEq/L
D) Serum potassium 4.8 mEq/L

Question 13

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

A) Increased secretion of hormones from the adrenal cortex
B) Decreased secretion of hormones from the adrenal medulla
C) Increased secretion of hormones from the anterior pituitary gland
D) Decreased secretion of hormones from the anterior pituitary gland

Question 14

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

A) Hypercortisolism
B) Pheochromocytoma
C) Hyperaldosteronism
D) Cushing's syndrome

Question 15

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

A) Dexamethasone
B) Potassium chloride
C) Aminoglutethimide
D) Spironolactone (Aldactone)

Question 16

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

A) Adrenalectomy
B) Smooth muscle relaxants
C) Beta-adrenergic blocking agents
D) Alpha-adrenergic blocking agents

Question 17

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

A) Elevated glucocorticoid level
B) Elevated aldosterone secretion
C) Decreased glucocorticoid level
D) Decreased aldosterone secretion

Question 18

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

A) Midnight
B) 0700 hours
C) 1200 hours
D) 2200 hours

Question 19

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

A) Bradycardia
B) Hypotension
C) Hypoglycemia
D) Widening pulse pressure

Question 20

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

A) Cancer
B) Stenosis
C) Infection
D) Autoimmunity

Question 21

The nurse notes that a patient with pheochromocytoma is prescribed sodium nitroprusside (Nipride).What is the purpose of this medication?

A) Decrease the secretion of catecholamines
B) Increase chronotropic and inotropic effects
C) Limit the development of tachyarrhythmias
D) Reduce blood pressure through vasodilation

Question 22

A patient is scheduled for a bilateral adrenalectomy.For which health problem should the nurse prepare this patient?

A) Hypoglycemia
B) Hypercortisolism
C) Hyperaldosteronism
D) Adrenal insufficiency