ESTUDYR
NCLEX-RN Case Study: Cushing’s Syndrome
Client Scenario
1000 Nurses' Notes:
A 45-year-old female presents to the endocrinology clinic for a follow-up. She has been
taking high-dose prednisone for the past 6 months to manage severe rheumatoid arthritis.
She reports, "I don't recognize myself in the mirror anymore. My face is round, and I've
gained 20 pounds, but only in my stomach."
Physical Assessment:
General: Rounded face with prominent cheeks; a fatty deposit is noted on the upper
back/base of the neck.
Integumentary: Skin appears thin and fragile; purple striae (stretch marks) are noted
across the abdomen and thighs. Multiple bruises are present on the forearms.
Vital Signs: BP 158/96, HR 88, RR 16, Temp 98.2°F.
Item 1: Recognizing Cues (Visual Identification)
Question: The nurse notes the client's physical appearance. Which diagram correctly
identifies the classic physical manifestations of Cushing's Syndrome?
Correct Findings to Identify:
✅Moon Face (Rounded, puffy face)
✅Buffalo Hump (Supraclavicular fat pads)
✅Truncal Obesity (Weight gain in the center, thin arms/legs)
✅Abdominal Striae (Purple/red stretch marks)
✅Hirsutism (Excessive body hair)
Rationale: Cushing’s Syndrome results from an excess of glucocorticoids (cortisol). This
leads to a unique redistribution of fat (center of the body and face) and the breakdown of
protein in the skin and muscles, leading to thin skin, easy bruising, and purple striae.
NCLEX-RN Case Study: Cushing’s Syndrome
Client Scenario
1000 Nurses' Notes:
A 45-year-old female presents to the endocrinology clinic for a follow-up. She has been
taking high-dose prednisone for the past 6 months to manage severe rheumatoid arthritis.
She reports, "I don't recognize myself in the mirror anymore. My face is round, and I've
gained 20 pounds, but only in my stomach."
Physical Assessment:
General: Rounded face with prominent cheeks; a fatty deposit is noted on the upper
back/base of the neck.
Integumentary: Skin appears thin and fragile; purple striae (stretch marks) are noted
across the abdomen and thighs. Multiple bruises are present on the forearms.
Vital Signs: BP 158/96, HR 88, RR 16, Temp 98.2°F.
Item 1: Recognizing Cues (Visual Identification)
Question: The nurse notes the client's physical appearance. Which diagram correctly
identifies the classic physical manifestations of Cushing's Syndrome?
Correct Findings to Identify:
✅Moon Face (Rounded, puffy face)
✅Buffalo Hump (Supraclavicular fat pads)
✅Truncal Obesity (Weight gain in the center, thin arms/legs)
✅Abdominal Striae (Purple/red stretch marks)
✅Hirsutism (Excessive body hair)
Rationale: Cushing’s Syndrome results from an excess of glucocorticoids (cortisol). This
leads to a unique redistribution of fat (center of the body and face) and the breakdown of
protein in the skin and muscles, leading to thin skin, easy bruising, and purple striae.
