Practice Question
A nurse is assisting with the care for a client who has Cushing's syndrome and expresses concern regarding physical changes associated with the syndrome. Which of the following should the nurse recognize as a physical change caused by this disorder?
Answer Choices:
Correct Answer:
Truncal obesity
Rationale:
🟣 Cushing’s syndrome results from excess cortisol, which causes fat redistribution leading to truncal (central) obesity, moon face, and buffalo hump.
🟣 Patients often have thin extremities with muscle wasting but increased fat in the abdomen, upper back, and face.
🟣 This central obesity is a hallmark physical change and is often very distressing to clients because it alters body image significantly.
🟣 Other features include purple striae, easy bruising, hypertension, and glucose intolerance, but truncal obesity is one of the most characteristic.
🟣 Therefore, truncal obesity is the best answer describing a Cushing’s-related physical change.
Hyperpigmentation of the skin
🟣 Hyperpigmentation is more typical of Addison’s disease (adrenal insufficiency) or very high ACTH states, not classic Cushing’s syndrome as tested on exams.
🟣 In Addison’s, low cortisol leads to increased ACTH, which cross-stimulates melanocytes, causing bronze or darkened skin.
🟣 Clients with Cushing’s generally have cortisol excess, not deficiency, and exam questions usually associate them with striae and bruising, not widespread hyperpigmentation.
🟣 While there can be some ACTH-related pigmentation in specific variants, that is not the standard NCLEX-style association for Cushing’s syndrome.
🟣 Thus, hyperpigmentation is not the best choice here.
Lordosis
🟣 Lordosis is an abnormal inward curvature of the lumbar spine, often seen in pregnancy, obesity, or posture issues, not specifically due to Cushing’s.
🟣 Although trunk weight can affect posture, lordosis is not a classic diagnostic sign of Cushing’s syndrome.
🟣 The question is testing recognition of hallmark endocrine physical changes, not general postural problems.
🟣 Therefore, lordosis is too nonspecific and not the best answer.
🟣 It is Cushing’s hallmark fat redistribution (truncal obesity, moon face, buffalo hump) that you should focus on.
Exophthalmos
🟣 Exophthalmos (bulging eyes) is classically associated with Graves’ disease (hyperthyroidism), not Cushing’s syndrome.
🟣 It results from autoimmune inflammation and tissue deposition behind the eyes, not from cortisol excess.
🟣 Cushing’s affects fat, protein, and glucose metabolism, causing central obesity and skin changes, but not eye protrusion.
🟣 Exams strongly link exophthalmos with thyroid disease, so choosing it for Cushing’s would be incorrect.
🟣 Thus, exophthalmos is not a Cushing’s-related physical change.
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This question is from ATI PN Adult Medical Surgical Online Practice 2023 B which contains 87 questions.
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From Exam
ATI PN Adult Medical Surgical Online Practice 2023 B
87 Questions
View Full Exam Start PracticingQuestion Details
- Category: LPN Nursing Exam(s)
- Subcategory: LPN ATI Exams
- Domain: Medical-Surgical
- Answer Choices: 4