a. Renal toxicity b. Episodes of hypoglycemia c. Hypotension d. Type 2 DM ANS: D Overt DM develops in approximately 20% of individuals with hypercortisolism. Diabetes develops, not renal toxicity. Hypoglycemia does not occur; hyperglycemia does. Hypertension, not hypotension, occurs; hypotension occurs with Addison. REF: p. 470 42. A nurse is preparing to teach a patient about Addison disease. Which information should the nurse include? The most common cause of Addison disease is:
a. An autoimmune reaction b. Dietary deficiency of sodium and potassium c. Cancer d. Viral infection of the pituitary gland ANS: A Addison disease is caused by autoimmune mechanisms that destroy adrenal cortical cells and is more common in women. Addison disease is an autoimmune disorder and is not due to dietary deficiency. Addison disease is an autoimmune disorder and is not due to cancer. Addison disease is an autoimmune disorder and is not due to a viral infection. REF: p. 471 43. A 50-year-old female presents with lightheadedness and overall abnormal feelings. Hyperaldosteronism is diagnosed. Which of the following symptoms would the nurse expect? a. Hypovolemia b. Hypotension c. Hypokalemia d. Hyponatremia ANS: C Hypokalemia occurs due to increased renal secretion of potassium. Hypervolemia, not hypovolemia, occurs. Hypertension, not hypotension, occurs. Hypernatremia, not hyponatremia, occurs. REF: p. 470
44. A 49-year-old female is diagnosed with hypercortisolism. Which of the following would the nurse expect? a. Weight loss b. Hypoglycemia c. Decreased urination d. Osteoporosis ANS: D The effects of hypercortisolism in bone cause loss of the protein matrix leading to osteoporosis, with pathologic fractures, vertebral compression fractures, bone and back pain, kyphosis, and reduced height. Weight gain occurs especially in the face and upper back with hypercortisolism. Hyperglycemia occurs even leading to diabetes in hypercortisolism. Polyuria, or increased urination, occurs in association with hypercortisolism. REF: p. 470 45. The body’s inability to conserve water and sodium when affected by Addison disease is explained by which of the following conditions? a. Elevated levels of cortisol b. Decreased levels of ACTH c. Hypersecretion of ADH d. Aldosterone deficiency ANS: D The symptoms of Addison disease are primarily a result of hypocortisolism and hypoaldosteronism.
The symptoms of Addison disease are primarily a result of hypocortisolism and hypoaldosteronism, not elevated levels of cortisol. Addison disease is characterized by inadequate corticosteroid and mineralocorticoid synthesis and elevated serum ACTH. ADH does not play a role in Addison disease. REF: p. 471 46. A patient with Addison disease has weakness and easy fatigability. A nurse recalls this is due to: a. Hyperkalemia b. Hypoglycemia c. Hypocortisolism d. Metabolic acidosis ANS: C With mild to moderate hypocortisolism, symptoms usually begin with weakness and easy fatigability.
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- keisha lovence