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The nurse is caring for a client diagnosed with Cushing's Syndrome. Which of the following actions should be the nurse's highest priority?

A.

Implementing fall precautions

B.

Address client's coping mechanisms due to physical changes

C.

Teach client to avoid unnecessary exposure to others with infections

D.

Encouraging client to use incentive spirometer for improved lung expansion

Answer and Explanation

The Correct Answer is A

A. Clients with Cushing’s Syndrome often experience muscle weakness, osteoporosis, and a risk of fractures due to excess cortisol. Implementing fall precautions is the highest priority to prevent injury.  

 

B. Addressing coping mechanisms is important but not as immediate a safety concern as fall prevention.  

 

C. Avoiding infections is crucial due to immunosuppression from elevated cortisol; however, preventing falls remains a more immediate concern.  

 

D. Encouraging incentive spirometer use may support lung function, but it is not the highest priority compared to preventing falls.


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Correct Answer is B

Explanation

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.

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.

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