A nurse is assessing a client suspected of having hypercortisolism. Which question would help confirm the diagnosis?

A nurse is assessing a client suspected of having hypercortisolism. Which question would help confirm the diagnosis?

• A. Did you lose any weight unintentionally?
• B. Did you notice your extremities to be thin?
• C. Did you notice any roughness of your skin?
• D. Did you notice any skin darkening recently?

Answer: (B)

Hypercortisolism produces protein breakdown that leads to muscle wasting and thinning of the limbs, a hallmark sign of Cushing-like states. Asking a patient whether their extremities feel or look thinner directly taps into this muscle-wasting effect, making it the most informative question to help confirm suspected hypercortisolism.

Other options are less specific to this condition. Unintentional weight loss can occur with many problems and isn’t as characteristic of cortisol excess as loss of lean muscle mass. A question about skin roughness isn’t as indicative of cortisol’s catabolic impact on muscle. Skin darkening is more associated with increased ACTH in Addison’s disease, not hypercortisolism.