The nurse is admitting a client diagnosed with primary adrenal cortex insufficiency (Addison's disease). Which clinical manifestations would the nurse expect to find?

• A. Moon face, buffalo hump, and hyperglycemia
• B. Hirsutism, fever, and irritability
• C. Bronze pigmentation, hypotension, and anorexia
• D. Tachycardia, bulging eyes, and goiter

Answer: (C)

Primary adrenal cortex insufficiency (Addison disease) causes a deficiency of cortisol and aldosterone. The lack of aldosterone leads to salt-wasting, dehydration, and hypotension, while the cortisol deficiency contributes to fatigue, anorexia, and weight loss. A hallmark feature of primary adrenal insufficiency is increased ACTH, which stimulates melanocytes and causes bronze or hyperpigmented skin, especially on exposed areas and mucous membranes. So the combination of bronze pigmentation, low blood pressure, and anorexia fits Addison’s disease.

Other options reflect different endocrine problems: signs like moon face, buffalo hump, and high blood sugar point to Cushing's syndrome (cortisol excess); hirsutism with fever and irritability is not typical of Addison's; tachycardia with bulging eyes and goiter suggests a thyroid condition such as Graves' disease.