# A client with adrenal insufficiency stopped taking corticosteroids and now has vomiting, severe weakness, and blood pressure 78/42 mm Hg. Which action should the nurse anticipate first?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397324&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client with adrenal insufficiency stopped taking corticosteroids and now has vomiting, severe weakness, and blood pressure 78/42 mm Hg. Which action should the nurse anticipate first?

## Option

1. Administer IV hydrocortisone and isotonic fluids as prescribed. **✔ Correct answer**
2. Restrict fluids to prevent edema.
3. Give a potassium supplement.
4. Schedule routine outpatient follow-up.

**Correct answer: 1**

## Explanation

Vomiting, weakness, and severe hypotension in adrenal insufficiency indicate adrenal crisis. Treatment priorities include glucocorticoid replacement and isotonic fluid resuscitation. Fluid restriction, potassium replacement, or delayed follow-up can worsen shock and electrolyte instability.

## In-depth explanation

Clinical Judgment
Use the client cues, timing, labs, and safety risks to select the response that best fits Adrenal crisis after stopping steroids.

Memory Tip
Match the strongest cue cluster to the safest nursing judgment.

KR vs US
NCLEX items reward cue-based priority thinking rather than isolated recall.

## Clinical scenario

Clinical Practice Guide
For Adrenal crisis after stopping steroids, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Adrenal Crisis** — Acute adrenal hormone deficiency causing shock, weakness, and electrolyte abnormalities.
- **Hydrocortisone** — A glucocorticoid used for adrenal replacement in crisis.
- **Isotonic Fluid** — IV fluid used to restore circulating volume.

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