Cushing's Syndrome By Rnpedia.Com

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Cushings Syndrome By Rnpedia.Com - Quiz

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Questions and Answers
  • 1. 

    Nurse Ronn is assessing a client with possible Cushing’s syndrome. In a client with Cushing’s syndrome, the nurse would expect to find:

    • A.

      Hypotension.

    • B.

      Thick, coarse skin.

    • C.

      Deposits of adipose tissue in the trunk and dorsocervical area.

    • D.

      Weight gain in arms and legs.

    Correct Answer
    C. Deposits of adipose tissue in the trunk and dorsocervical area.
    Explanation
    Because of changes in fat distribution, adipose tissue accumulates in the trunk, face (moonface), and dorsocervical areas (buffalo hump). Hypertension is caused by fluid retention. Skin becomes thin and bruises easily because of a loss of collagen. Muscle wasting causes muscle atrophy and thin extremities.

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  • 2. 

    In a 29-year-old female client who is being successfully treated for Cushing’s syndrome, nurse Lyzette would expect a decline in:

    • A.

      Serum glucose level.

    • B.

      Hair loss.

    • C.

      Bone mineralization.

    • D.

      Menstrual flow.

    Correct Answer
    A. Serum glucose level.
    Explanation
    Hyperglycemia, which develops from glucocorticoid excess, is a manifestation of Cushing’s syndrome. With successful treatment of the disorder, serum glucose levels decline. Hirsutism is common in Cushing’s syndrome; therefore, with successful treatment, abnormal hair growth also declines. Osteoporosis occurs in Cushing’s syndrome; therefore, with successful treatment, bone mineralization increases. Amenorrhea develops in Cushing’s syndrome. With successful treatment, the client experiences a return of menstrual flow, not a decline in it.

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  • 3. 

    A female client with Cushing’s syndrome is admitted to the medical-surgical unit. During the admission assessment, nurse Tyzz notes that the client is agitated and irritable, has poor memory, reports loss of appetite, and appears disheveled. These findings are consistent with which problem?

    • A.

      Depression

    • B.

      Neuropathy

    • C.

      Hypoglycemia

    • D.

      Hyperthyroidism

    Correct Answer
    A. Depression
    Explanation
    Agitation, irritability, poor memory, loss of appetite, and neglect of one’s appearance may signal depression, which is common in clients with Cushing’s syndrome. Neuropathy affects clients with diabetes mellitus — not Cushing’s syndrome. Although hypoglycemia can cause irritability, it also produces increased appetite, rather than loss of appetite. Hyperthyroidism typically causes such signs as goiter, nervousness, heat intolerance, and weight loss despite increased appetite.

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  • 4. 

    Nurse Ruth is assessing a client after a thyroidectomy. The assessment reveals muscle twitching and tingling, along with numbness in the fingers, toes, and mouth area. The nurse should suspect which complication?

    • A.

      Tetany

    • B.

      Hemorrhage

    • C.

      Thyroid storm

    • D.

      Laryngeal nerve damage

    Correct Answer
    A. Tetany
    Explanation
    Tetany may result if the parathyroid glands are excised or damaged during thyroid surgery. Hemorrhage is a potential complication after thyroid surgery but is characterized by tachycardia, hypotension, frequent swallowing, feelings of fullness at the incision site, choking, and bleeding. Thyroid storm is another term for severe hyperthyroidism — not a complication of thyroidectomy. Laryngeal nerve damage may occur postoperatively, but its signs include a hoarse voice and, possibly, acute airway obstruction.

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  • 5. 

    Nurse Sugar is assessing a client with Cushing's syndrome. Which observation should the nurse report to the physician immediately?

    • A.

      Pitting edema of the legs

    • B.

      An irregular apical pulse

    • C.

      Dry mucous membranes

    • D.

      Frequent urination

    Correct Answer
    B. An irregular apical pulse
    Explanation
    Because Cushing's syndrome causes aldosterone overproduction, which increases urinary potassium loss, the disorder may lead to hypokalemia. Therefore, the nurse should immediately report signs and symptoms of hypokalemia, such as an irregular apical pulse, to the physician. Edema is an expected finding because aldosterone overproduction causes sodium and fluid retention. Dry mucous membranes and frequent urination signal dehydration, which isn't associated with Cushing's syndrome.

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  • 6. 

    The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?

    • A.

      The client with Cushing’s disease

    • B.

      The client with diabetes

    • C.

      The client with acromegaly

    • D.

      The client with myxedema

    Correct Answer
    A. The client with Cushing’s disease
    Explanation
    The client with Cushing’s disease has adrenocortical hypersecretion. This increase in the level of cortisone causes the client to be immune suppressed. In answer B, the client with diabetes poses no risk to other clients. The client in answer C has an increase in growth hormone and poses no risk to himself or others. The client in answer D has hyperthyroidism or myxedema and poses no risk to others or himself.

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  • 7. 

    Corticosteroids are potent suppressors of the body’s inflammatory response. Which of the following conditions or actions do they suppress?

    • A.

      Cushing syndrome.

    • B.

      Pain receptors.

    • C.

      Immune response.

    • D.

      Neural transmission.

    Correct Answer
    C. Immune response.
    Explanation
    Corticosteroids suppress eosinophils, lymphocytes, and natural-killer cells, inhibiting the natural inflammatory process in an infected or injured part of the body. This helps resolve inflammation, stabilizes lysosomal membranes, decreases capillary permeability, and depresses phagocytosis of tissues by white blood cells, thus blocking the release of more inflammatory materials. Excessive corticosteroid therapy can lead to Cushing syndrome.

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  • 8. 

    Which of the following disorders is characterized by a group of symptoms produced by an excess of free circulating cortisol from the adrenal cortex?

    • A.

      Cushing’s syndrome

    • B.

      Addison’s disease

    • C.

      Graves’ disease

    • D.

      Hashimoto’s disease

    Correct Answer
    A. Cushing’s syndrome
    Explanation
    The patient with Cushing’s syndrome demonstrates truncal obesity, moon face, acne, abdominal striae, and hypertension. In Addison’s disease, the patient experiences chronic adrenocortical insufficiency. In Graves’ disease, the patient experiences hyperthyroidism. The individual with Hashimoto’s disease demonstrates inflammation of the thyroid gland, resulting in hypothyroidism.

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  • 9. 

    The nurse is assessing a postcraniotomy client and finds the urine output from a catheter is 1500 ml for the 1st hour and the same for the 2nd hour. The nurse should suspect:

    • A.

      Cushing’s syndrome

    • B.

      Diabetes mellitus

    • C.

      Adrenal crisis

    • D.

      Diabetes insipidus

    Correct Answer
    D. Diabetes insipidus
    Explanation
    Diabetes insipidus is an abrupt onset of extreme polyuria that commonly occurs in clients after brain surgery. Cushing’s syndrome is excessive glucocorticoid secretion resulting in sodium and water retention. Diabetes mellitus is a hyperglycemic state marked by polyuria, polydipsia, and polyphagia. Adrenal crisis is undersecretion of glucocorticoids resulting in profound hypoglycemia, hypovolemia, and hypotension.

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  • 10. 

    As the shift begins, you are assigned these patients. Which patient should you assess first?  

    • A.

      A 38-year-old patient with Graves’ disease and a heart rate of 94/minute

    • B.

      A 63-year-old patient with type 2 diabetes and fingerstick glucose of 137 mg/dL

    • C.

      A 58-year-old patient with hypothyroidism and heart rate of 48/minute

    • D.

      A 49-year-old patient with Cushing’s disease and +1 dependent edema

    Correct Answer
    C. A 58-year-old patient with hypothyroidism and heart rate of 48/minute
    Explanation
    Although patients with hypothyroidism often have cardiac problems that include bradycardia, a heart rate of 48/minute may have significant implications for cardiac output and hemodynamic stability. Patients with Graves’ disease usually have a rapid heart rate, but 94/minute is within limits. The diabetic patient may need sliding scale insulin. This is important but not urgent. Patients with Cushing’s disease frequently have dependent edema. Focus: Prioritization

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  • 11. 

    You assess a patient with Cushing’s disease. For which finding will you notify the physician immediately?  

    • A.

      Purple striae present on abdomen and thighs

    • B.

      Weight gain of 1 pound since the previous day

    • C.

      +1 dependent edema in ankles and calves

    • D.

      Crackles bilaterally in lower lobes of lungs

    Correct Answer
    D. Crackles bilaterally in lower lobes of lungs
    Explanation
    The presence of crackles in the patient’s lungs indicate excess fluid volume doe to excess water and sodium reabsorption and may be a symptom of pulmonary edema, which must be treated rapidly. Striae (stretch marks), weight gain, and dependent edema are common findings in patients Cushing’s disease. These findings should be monitored, but are not urgent. Focus: Prioritization

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  • 12. 

    The old woman told John that she has osteoporosis; Arthur knew that all of the following factors would contribute to osteoporosis except

    • A.

      Hypothyroidism

    • B.

      End stage renal disease

    • C.

      Cushing’s Disease

    • D.

      Taking Furosemide and Phenytoin.

    Correct Answer
    A. Hypothyroidism
    Explanation
    Hypothyroidism is not a factor that contributes to osteoporosis. Osteoporosis is a condition characterized by weak and brittle bones, and it is typically caused by factors such as hormonal changes, aging, low calcium and vitamin D levels, smoking, excessive alcohol consumption, and certain medications. While hypothyroidism can affect bone health, it is more commonly associated with an increased risk of developing osteoarthritis rather than osteoporosis. Therefore, hypothyroidism is the exception among the listed factors that contribute to osteoporosis.

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  • 13. 

    Cushing's Syndrome is a hormone disorder caused by high levels of what?

    • A.

      Y Chromosomes

    • B.

      Fiber in the digestive tract

    • C.

      Cortisol in the blood

    • D.

      Unprotected sexual contact

    Correct Answer
    C. Cortisol in the blood
    Explanation
    Cushing's Syndrome is a hormone disorder characterized by high levels of cortisol in the blood. Cortisol is a hormone produced by the adrenal glands that helps regulate various bodily functions, including metabolism, immune response, and stress response. When cortisol levels are consistently elevated, it can lead to a range of symptoms such as weight gain, muscle weakness, high blood pressure, and mood disorders. Therefore, the correct answer is cortisol in the blood.

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  • 14. 

    Which would a person with Cushing's Syndrome prefer to eat?

    • A.

      Fat Free Yogurt

    • B.

      Salad

    • C.

      Bacon Grease

    • D.

      Fiber Bars

    Correct Answer
    C. Bacon Grease
    Explanation
    A person with Cushing's Syndrome would prefer to eat bacon grease because this condition is characterized by excessive levels of cortisol hormone in the body. This hormone can cause increased appetite and cravings for high-fat, high-calorie foods. Bacon grease is a high-fat food that can satisfy these cravings. However, it is important to note that a healthy diet is crucial for managing Cushing's Syndrome, and consuming bacon grease regularly would not be recommended.

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  • 15. 

    Which gland does Cushing's Syndrome originate in?

    • A.

      Adrenal glands

    • B.

      Pineal

    • C.

      Pancreas

    • D.

      Gonads

    Correct Answer
    A. Adrenal glands
    Explanation
    Cushing's Syndrome typically originates in the Pituitary gland or the Adrenal glands.
    Most cases of Cushing's Syndrome are caused by excessive production of cortisol, a hormone, either by a tumor in the pituitary gland (Cushing's disease) or by tumors in the adrenal glands. Cushing's Syndrome can also occur due to certain medications or other medical conditions, but the pituitary and adrenal glands are the primary sources of this syndrome.

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  • 16. 

    Which is an obvious sign or sympton of Cushing's Syndrome?

    • A.

      Getting really, really fat.

    • B.

      Losing a lot of weight

    • C.

      Becoming constipated

    • D.

      Kidney Failure

    Correct Answer
    A. Getting really, really fat.
    Explanation
    Getting really, really fat is an obvious sign or symptom of Cushing's Syndrome. This condition is caused by prolonged exposure to high levels of cortisol, a hormone that regulates metabolism and the immune system. Excess cortisol can lead to weight gain, particularly in the abdomen, face, and neck. Other symptoms of Cushing's Syndrome may include thinning skin, easy bruising, muscle weakness, fatigue, and high blood pressure.

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  • 17. 

    Which of the following is NOT another name for Cushing's Syndrome?

    • A.

      Hypercorticism

    • B.

      Hyperadrenocorticism

    • C.

      Itsenko-Cushing syndrome

    • D.

      Fatty Disease

    Correct Answer
    D. Fatty Disease
    Explanation
    Cushing's Syndrome is a condition caused by prolonged exposure to high levels of cortisol. It is characterized by a variety of symptoms, including weight gain and fatty deposits in certain areas of the body. However, "Fatty Disease" is not another name for Cushing's Syndrome. The term "Fatty Disease" is not commonly used to refer to this condition and does not accurately describe the underlying hormonal imbalances that occur in Cushing's Syndrome.

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  • 18. 

    The pituitary gland is also known as the ____________.

    • A.

      Hypophysis

    • B.

      Infundibulum

    • C.

      Hypothalamus

    • D.

      Neurohypophysis

    Correct Answer
    A. Hypophysis
    Explanation
    The correct answer is "Hypophysis." The pituitary gland is commonly referred to as the hypophysis. It is a small pea-sized gland located at the base of the brain. The pituitary gland plays a crucial role in regulating various bodily functions by producing and releasing hormones that control growth, metabolism, reproduction, and other essential processes in the body.

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  • 19. 

    Adrenocorticotropic hormone (ACTH) from the pituitary stimulates the __________ glands to release _________.

    • A.

      Pineal, cortisol

    • B.

      Adrenal, cortisol

    • C.

      Pineal, TSH

    • D.

      Adrenal, TSH

    Correct Answer
    B. Adrenal, cortisol
    Explanation
    ACTH is a hormone secreted by the pituitary gland that stimulates the adrenal glands. The adrenal glands then release cortisol, a hormone that helps regulate various bodily functions, including metabolism, immune response, and stress response. Therefore, the correct answer is "adrenal, cortisol."

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  • 20. 

    Signs and/or symptoms of Cushing's Disease include: (check correct boxes)    

    • A.

      Moon face

    • B.

      Fatty limbs

    • C.

      Osteoporosis

    • D.

      Acne

    • E.

      Euphoria

    Correct Answer(s)
    A. Moon face
    C. Osteoporosis
    D. Acne
    Explanation
    s/s include fatty abdomen and thinning limbs, euphoria is not a s/s

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  • 21. 

    Cushing's Disease and Cushing's Sydrome have the same cause.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    They have the same effect.
    Disease is a pituitary cause
    Syndrome is an adrenal cause

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  • 22. 

    The most common cause of Cushing's Disease is ____________.

    • A.

      Alcohol abuse

    • B.

      Steroid use

    • C.

      Genetic disposition

    • D.

      Adenoma (benign tumor)

    Correct Answer
    D. Adenoma (benign tumor)
    Explanation
    Cushing's Disease is a hormonal disorder caused by prolonged exposure to high levels of cortisol in the body. The most common cause of this disease is the presence of an adenoma, which is a benign tumor in the pituitary gland. This tumor causes the pituitary gland to produce excessive amounts of adrenocorticotropic hormone (ACTH), which in turn stimulates the adrenal glands to produce too much cortisol. This overproduction of cortisol leads to the symptoms of Cushing's Disease. Alcohol abuse and steroid use can also contribute to the development of Cushing's Disease, but they are not the most common cause.

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  • Oct 09, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Feb 19, 2013
    Quiz Created by
    RNpedia.com
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