The weakness is due to hypocortisolism not

The weakness is due to hypocortisolism, not hyperkalemia.
The weakness is due to hypocortisolism, not hypoglycemia.
The weakness is due to hypocortisolism, not metabolic acidosis.
REF: p. 471
47. What is the cause of the hyperpigmentation seen in people with Cushing syndrome?
a. Abnormal levels of cortisol
b. Permissive effects of aldosterone when cortisol levels are altered
c. Elevated levels of ACTH

d. Hypersensitivity of melanocytes with sun exposure
ANS: C
Bronze or brownish hyperpigmentation of the skin, mucous membranes, and hair occurs when
there are very high levels of ACTH.
The pigmentation changes associated with Cushing and Addison are due to increased levels of
ACTH, not cortisol.
The pigmentation changes associated with Cushing and Addison are due to increased levels of
ACTH, not aldosterone, which affects fluid balance.
The pigmentation changes associated with Cushing and Addison are due to increased levels of
ACTH, not hypersensivity of melanocytes.
REF: p. 470
48. A 30-year-old female presents with hypertension, headache, tachycardia, impaired glucose
tolerance, and weight loss. Which of the following diagnosis will the nurse see documented on
the chart?
a. Addison disease
b. Conn disease
c. Cushing disease
d. Pheochromocytoma
ANS: D
Symptoms of pheochromocytoma include hypertension, palpitations, tachycardia, glucose
intolerance, excessive sweating, and constipation.

Manifestations of Addison disease include weakness, fatigability, hypoglycemia and related
metabolic problems, lowered response to stressors, hyperpigmentation, vitiligo, and
manifestations of hypovolemia and hyperkalemia.
Hypertension and hypokalemia are the hallmarks of Conn disease.
Weight gain is the most common feature in Cushing disease and results from the accumulation of
adipose tissue in the trunk, facial, and cervical areas. These characteristic patterns of fat
deposition have been described as “truncal obesity,” “moon face,” and “buffalo hump.”
REF: p. 472
49. A nurse wants to determine if there is kidney dysfunction in a patient with diabetes. Which of the
following is the earliest manifestation?
a. Polyuria
b. Glycosuria
c. Microalbuminuria
d. Decreased glomerular filtration
ANS: C
Microalbuminuria is the first manifestation of kidney dysfunction.
Polyuria occurs due to increased fluid in the vascular space, and microalbuminuria is the earliest
manifestation.
Glycosuria occurs due to hyperglycemia, but microalbuminuria is the first sign of kidney
dysfunction.
Decreased glomerular filtration can occur due to changes, but microalbuminuria is the first sign
of kidney dysfunction.

REF: p. 467
50. Which of the following diseases should the nurse teach the patient to prevent as it is the ultimate
cause of death in the patient with diabetes?
a. Renal disease
b. Stroke
c. Cardiovascular disease
d. Cancer
ANS: C
Cardiovascular disease is the ultimate cause of death in up to 75% of people with diabetes.