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Which findings during the admission assessment should the nurse document that are related to a client diagnosed with Cushing's syndrome?

A.

Visible swelling of the neck, with no pain.

B.

Warm, soft, moist, salmon-colored skin.

C.

Husky voice and troubled by hoarseness.

D.

Central type obesity, with thin extremities.

Answer and Explanation

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. Administering opioid and non-opioid medications together is an effective pain management strategy for severe pain. This approach can provide better pain relief by targeting different pain pathways and may reduce the total dosage of opioids needed, thus minimizing side effects.

B. Alternating IV and IM analgesic medications is not the best approach; instead, consistent pain management is necessary to keep pain levels under control.

C. Waiting until the pain score reaches 10 before administering the maximum dosage is inappropriate and could lead to inadequate pain control. Pain management should be proactive, not reactive.

D. While educating the client on narcotic dependency is important, it is not the priority intervention in this acute situation where pain control is essential. The immediate focus should be on effective pain relief.

Correct Answer is A

Explanation

A. A headache that worsens upon sitting up is characteristic of a post-lumbar puncture headache, indicating a potential complication related to cerebrospinal fluid leakage.

B. Pain in the lower back after the procedure can be normal and does not necessarily indicate a complication.

C. Nausea and vomiting can occur but are not specific indicators of a complication following a lumbar puncture.

D. Sore throat when swallowing and talking is not typically associated with lumbar puncture complications and may relate to other causes such as anxiety or dehydration.

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