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.

Option A: Edema is an expected finding because aldosterone overproduction causes sodium and fluid retention.
Option C: Dry mucous membranes is not a symptom of Cushing’s syndrome. Thinning of the skin and mucous membranes occur because cortisol causes the breakdown of some dermal proteins along with the weakening of small blood vessels.
Option D: Frequent urination signals dehydration, which isn’t associated with Cushing’s syndrome. Short term administration of adrenocorticotropic hormone or glucocorticoids causes an increased glomerular filtration rate. Glomerular dysfunction leads to proteinuria and albuminuria.

In diabetes insipidus, excessive polyuria causes dilute urine, resulting in a below-normal urine osmolality level. At the same time, polyuria depletes the body of water, causing dehydration that leads to an above-normal serum osmolality level.

Option A: Urine osmolality level should be below normal because of excessive polyuria.
Option B: Serum osmolality levels should be above normal because of dehydration.
Option C: For the same reasons, diabetes insipidus doesn’t cause above-normal urine osmolality or below-normal serum osmolality levels.

Inadequate fluid intake during hyperglycemic episodes often leads to HHNS. By recognizing the signs of hyperglycemia (polyuria, polydipsia, and polyphagia) and increasing fluid intake, the client may prevent HHNS.

Option B: Drinking a glass of non-diet soda would be appropriate for hypoglycemia.
Option C: A client whose diabetes is controlled with oral antidiabetic agents usually doesn’t need to monitor blood glucose levels.
Option D: A high carbohydrate diet would exacerbate the client’s condition, particularly if fluid intake is low.

Hyperparathyroidism is most common in older women and is characterized by bone pain and weakness from excess parathyroid hormone (PTH). Clients also exhibit hypercalciuria-causing polyuria.

Option A: Common symptoms of diabetes mellitus include polyuria, polydipsia, and polyphagia
Option B: While clients with diabetes insipidus also have polyuria, they don’t have bone pain and increased sleeping.
Option C: Hypoparathyroidism is characterized by urinary frequency rather than polyuria.

Hydrocortisone, a glucocorticoid, should be administered according to a schedule that closely reflects the body’s own secretion of this hormone; therefore, two-thirds of the dose of hydrocortisone should be taken in the morning and one-third in the late afternoon. This dosage schedule reduces adverse effects.

Option A: Taking the medicine at this schedule may cause adverse effects.
Option B: The dosage should be according to the imitation of when the body secretes glucocorticoids.
Option D: Taking an entire dose might cause severe adverse effects.