Author Question: A client has an ACTH-secreting tumor. The nurse understands that which assessment findings would be ... (Read 28 times)

clmills979 · **on:** Jul 23, 2018

A client has an ACTH-secreting tumor. The nurse understands that which assessment findings would be consistent with this type of tumor?

1. Clubbing of the fingers and circumoral cyanosis
2. Extreme tachycardia and tremors
3. Weight gain and muscle atrophy
4. Exophthalmos and skin that is hot to the touch

Question 2

The nurse is administering cortisol to a client. This intervention should result in:

1. increased secretion from the pituitary.
2. decreased level of consciousness.
3. increased secretion from the hypothalamus.
4. decreased secretion from the pituitary.

debra928 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 3
Rationale 1: Clubbing of the fingers and circumoral cyanosis are not associated with an ACTH-secreting tumor.
Rationale 2: Extreme tachycardia and tremors are not associated with an ACTH-secreting tumor.
Rationale 3: Weight gain and muscle wasting are clinical manifestations seen in clients with hypersecretion of corticosteroids. This is consistent with an ACTH-secreting hormone.
Rationale 4: Exophthalmos and skin that is hot to the touch are not associated with an ACTH-secreting tumor.
Global Rationale: Weight gain and muscle wasting are clinical manifestations seen in clients with hypersecretion of corticosteroids. This is consistent with an ACTH-secreting hormone. Clubbing of the fingers, circumoral cyanosis, extreme tachycardia, tremors, exophthalmos and hot skin are not found in those with corticosteroid excess.

Answer to Question 2

Correct Answer: 4
Rationale 1: Cortisol would not increase secretion from the pituitary.
Rationale 2: Cortisol does not affect level of consciousness.
Rationale 3: Cortisol would not increase secretion from the hypothalamus.
Rationale 4: When the serum level of cortisol rises, it provides negative feedback to the hypothalamus and pituitary to shut off further release of glucocorticoids.
Global Rationale: When the serum level of cortisol rises, it provides negative feedback to the hypothalamus and pituitary to shut off further release of glucocorticoids. Secretion from the pituitary or hypothalamus would not occur. Cortisol does not affect LOC.