Edition – 50 Questions with 100% Verified Correct
Answers-Galen
50 Questions with Step-by-Step Answers | 100% Verified | A+ Graded Review
INTRODUCTION:
NSG 4100 Adult Health III - Exam 2 covers critical endocrine and metabolic disorders essential
for advanced nursing practice. This comprehensive review focuses on adrenal dysfunction
including Cushing and Addison's disease, pituitary disorders such as diabetes insipidus and
SIADH, thyroid complications, and diabetes emergencies like DKA and HHS, plus chronic
microvascular and macrovascular complications, emphasizing pathophysiology, clinical
manifestations, priority interventions, and patient education with evidence-based rationales.
Answers are in bold Green, with rationales after.
1. The nurse is caring for someone with adrenal hyperfunction,
screams at her spouse, & burst into tears, and screams at the
wall. The client tells the nurse I feel like I'm going crazy. Which of
the following is the appropriate response for the nurse to make?
A. You feel like this because of your hormone levels (Addison's disease?)
B. I will close the door to your room and restrict visitors
C. I will bring you information about support groups
D. I will ask your doctor about ordering a psychiatric consult
Rationale: Adrenal hyperfunction / Cushing syndrome causes excess cortisol leading to
emotional lability, irritability, anxiety, depression, mood swings. It is not a primary
psychiatric disorder. The therapeutic response is to explain the physiologic cause,
validate feelings, and reassure.
2. The nurse is caring for a client who is taking high doses of
corticosteroids therapy and asks the nurse why do they need to
keep taking the steroids when they no longer feel bad. Which of
the following is an appropriate response for the nurse to make?
A. You must decrease the storage slow that way your hormones work again
B. Once you start steroids he had to get weaned off of them
, C. this is possible for the inflammation to reoccur if you stop the drug.
D. The drug suppresses your immune system that needs to be built back up.
Rationale: Corticosteroids suppress inflammation. Abrupt stop causes rebound
inflammation and adrenal insufficiency because exogenous steroids suppress HPA axis.
Must taper, not stop when symptoms improve.
3. The nurses came for a client who has Cushing's syndrome.
Which of the following interventions could the nurse incorporate
in the plan of care?
A. Assess abdominal girth at the same time each day
B. Assess Bony prominence every shift or as needed
C. Initiate a fluid restriction with a low protein diet
D. place in a private room and initiate contact precautions
Rationale: Cushing causes protein catabolism, thin fragile skin, fat redistribution, poor
wound healing. Bony prominences are high risk for skin breakdown. Diet should be high
protein, high potassium, low sodium, low calorie. No fluid restriction needed. No contact
precautions.
4. The nurse preceptor is observing a newly hired nurse provide
discharge instructions to a client who has Cushings syndrome.
Which are which of the following instructions Requires
intervention by the nurse. (which one is wrong)
A. Avoid any unnecessary exposure to others who may be sick or have an infection
B. He should maintain moderate activity Like walking with frequent rest periods
C. maintain a high carb diet and drink plenty of water throughout the day
D. Be sure to wear a medical bracelet and medical card with you every time
Rationale: Cushing clients need low carbohydrate, low sodium, high protein, high
potassium, adequate calcium diet due to hyperglycemia, fluid retention, protein wasting.
High carb diet worsens hyperglycemia. A, B, D are correct: infection risk, muscle
weakness/fatigue needs moderate activity with rest, medical alert ID essential.
5. The nurse has taught the claim with Cushing syndrome about
changes in dietary habit. Which of the following meal choices
indicates a correct understanding?
A. Ham and bean soup, diet carbonated drink
B. Fried fish and tartar sauce
C. a BLT with wheat toast And Apple juice
D. baked chicken breast, bean broccoli and a glass of low-fat milk
Rationale: Cushing diet: low sodium, low calorie/fat, high protein, high potassium, high
calcium, low carb. Ham, fried foods, BLT are high sodium/fat. Baked chicken breast +
broccoli + low-fat milk is low sodium, high protein, high potassium, high calcium.
6. The nurse is assessing clients for the risk of developing
Cushing syndrome. the nurse should identify the greatest risk
client?