Which findings during the admission assessment should the nurse document that are related to a client diagnosed with Cushing's syndrome?
Visible swelling of the neck, with no pain.
Warm, soft, moist, salmon-colored skin.
Husky voice and troubled by hoarseness.
Central type obesity, with thin extremities.
The Correct Answer is D
A. Visible swelling of the neck may indicate other conditions, such as thyroid issues, but it is not a characteristic finding of Cushing's syndrome.
B. Warm, soft, moist, salmon-colored skin is more indicative of hyperthyroidism rather than Cushing's syndrome, which typically presents with thin, fragile skin.
C. A husky voice and hoarseness can occur due to various reasons, but they are not classic symptoms of Cushing's syndrome.
D. Central type obesity, characterized by a rounded face and thin extremities, is a hallmark feature of Cushing's syndrome, caused by excessive cortisol levels leading to fat redistribution.
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Correct Answer is A
Explanation
A. Tenderness upon palpation and generalized erythema indicate skin irritation and possible sunburn, which are signs of overexposure to PUVA treatment. This finding suggests that the client may have received excessive ultraviolet exposure, leading to skin damage.
B. Thick skin plaques topped by silvery white scales are characteristic of psoriasis vulgaris itself, not a sign of overexposure to PUVA.
C. Requiring sunglasses because sunlight hurts the eyes may indicate sensitivity but is not a specific indicator of overexposure to PUVA treatment; it could relate to other issues such as underlying eye conditions.
D. Brown, rough, greasy, wart-like papules on the face are not typically associated with PUVA overexposure but could be related to other skin conditions or lesions.
Correct Answer is B
Explanation
A. "Don't worry, I'm sure your son will visit."
This response is dismissive and assumes that the son will visit, which may not be the case. It may come across as insensitive.
B. "Your son hasn't been around much lately?"
This response reflects the patient's statement, encouraging them to elaborate. It shows empathy and gives the patient space to express their feelings.
C. "My son doesn't come to visit me either."
This response shifts focus away from the patient and may make them feel that their concern is trivialized.
D. "How terrible that he doesn't visit you."
This response is judgmental and might make the patient feel worse or lead them to think the nurse disapproves of their son.