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Chapter 43- Drug Therapy for Addison’s Disease and Cushing’s Disease
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | An adult patient has been experiencing severe lethargy and fatigue over the past several days, and she describes herself as feeling “shaky.” Random blood glucose testing reveals a glucose level of 38 mg/dL, but the woman denies any significant change in her diet. The care team should suspect the possibility of what health problem? | |
| A) | Chronic renal failure | |
| B) | Acute renal failure | |
| C) | Cushing’s disease | |
| D) | Adrenal insufficiency | |
| Ans: | D | |
| Feedback: | ||
| Any patient with unexplained severe hypoglycemia requires assessment for adrenal insufficiency. Cushing’s disease and kidney disease do not result in hypoglycemia. | ||
| 2. | A patient who has been taking oral prednisone for several months abruptly ceased treatment several days ago on the advice of a family member. The patient has now been admitted to the emergency department with signs and symptoms that are characteristic of addisonian crisis. When assessing this patient, the nurse should prioritize what assessment? | |
| A) | Assessment of urine for ketones | |
| B) | Assessment of serum potassium levels | |
| C) | Assessment for adventitious lung sounds | |
| D) | Assessment for venous thromboembolism | |
| Ans: | B | |
| Feedback: | ||
| In addisonian crisis, the loss of sodium leads to retention of potassium, resulting in symptoms of hyperkalemia. As a result, vigilant monitoring of serum potassium levels is more important than respiratory effects, urinalysis, or hypercoagulation. | ||
| 3. | A 38-year-old patient has been living with Addison’s disease for many years and has achieved adequate symptom control through lifestyle modifications and drug therapy. However, the patient has now been admitted to the hospital in addisonian crisis. Which of the nurse’s following assessment questions is most appropriate? | |
| A) | “Have you been under an unusual amount of stress lately?” | |
| B) | “How would you describe your diet over the last few days?” | |
| C) | “When was the last time that you drank any alcohol?” | |
| D) | “Has your urine output been typical for the past few days?” | |
| Ans: | A | |
| Feedback: | ||
| Acute adrenal crisis, or addisonian crisis, is a life-threatening condition that occurs when Addison’s disease is the underlying problem and the patient is exposed to minor illness or increased stress. Diet, alcohol use, and impaired urinary function are less likely contributors. | ||
| 4. | A patient’s recent symptoms of unexplained fatigue and listlessness have prompted a referral to the endocrinology department. A plasma corticotropin (ACTH) stimulation test for adrenal insufficiency is being performed. Following the administration of ACTH, what finding would confirm the suspected diagnosis? | |
| A) | Low cortisol levels | |
| B) | Stupor | |
| C) | Increased levels of CRH | |
| D) | Signs of Cushing’s disease | |
| Ans: | A | |
| Feedback: | ||
| Confirming the diagnosis of adrenocortical insufficiency requires a short plasma corticotropin (ACTH) stimulation test. The examiner administers corticotropin in the morning, and a subnormal blood cortisol level in the morning and afternoon confirms the diagnosis. CRH is a precursor to ACTH, and would not be directly affected. Cushing’s disease is adrenocortical excess, with high cortisol levels. | ||
| 5. | A patient with suspected adrenal insufficiency has been administered 1 mcg of cosyntropin (Cortrosyn) as an IV bolus. Serum testing 30 minutes later reveals a markedly elevated level of cortisol. What conclusion should the nurse infer from this finding? | |
| A) | The patient has normal adrenocortical function. | |
| B) | The patient has primary adrenal insufficiency. | |
| C) | The patient has secondary adrenal insufficiency. | |
| D) | The patient has Addison’s disease. | |
| Ans: | A | |
| Feedback: | ||
| The low-dose test involves the administration of 1 mcg of cosyntropin (Cortrosyn) as an IV bolus. In people with normal adrenocortical function, an increase in cortisol occurs in 20 minutes. | ||
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Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.