A nurse is caring for a client who had a brain tumor and chemotherapy as an infant. The assessment reveals short stature and delayed onset of menarche. The nurse recognizes the assessed problems are most likely caused by which of the following?
Low levels of Parathyroid hormone (PTH)
Impaired production of Growth Hormone (GH)
Lack of Adrenocorticotropic hormone (ACTH)
Impaired production of T3 and T4
The Correct Answer is B
A. Low levels of PTH would primarily affect calcium metabolism and would not directly explain short stature or delayed menarche.
B. Impaired production of GH is most likely the cause of short stature, as growth hormone plays a critical role in growth and development during childhood.
C. Lack of ACTH affects adrenal hormone production but does not directly lead to short stature or delayed menarche.
D. Impaired production of T3 and T4 would affect metabolism and growth but is less likely to be the primary cause of the symptoms presented compared to growth hormone deficiencies.
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Correct Answer is C
Explanation
A. A short-term, low-dose steroid use (one week) has minimal risk for adrenal suppression.
B. Three weeks of steroids increases risk, but daily use presents a higher risk.
C. Prolonged daily steroid use, especially in an older adult, poses the greatest risk for adrenal insufficiency due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis.
D. Intermittent steroid use is less likely to cause adrenal insufficiency compared to daily long-term use.
Correct Answer is B
Explanation
A. Profound hypocalcemia is not associated with hyperthyroidism; it is more common in hypoparathyroidism.
B. Thyroid Storm is a life-threatening complication of hyperthyroidism, characterized by high fever, tachycardia, hypertension, and altered mental status. It requires immediate medical intervention to prevent serious outcomes.
C. Diabetes Insipidus is unrelated to hyperthyroidism and typically occurs due to antidiuretic hormone dysfunction.
D. Severe hypotension is not a typical complication of hyperthyroidism; rather, hypertension is more likely due to increased metabolic rate and cardiac output.