A nurse is assessing a client who is admitted for elective surgery and has a history of Addison's disease. Which of the following findings should the nurse expect?

Choice A reason: Intention tremors are associated with neurological conditions such as multiple sclerosis or cerebellar disorders, not Addison’s disease. Addison’s disease is an endocrine disorder caused by adrenal insufficiency, leading to inadequate production of cortisol and aldosterone. Neurological tremors are not a hallmark feature of this condition. Choice B reason: Purple striations are characteristic of Cushing’s syndrome, which results from excess cortisol. In Addison’s disease, cortisol levels are deficient, so striae are not expected. Instead, patients may present with weight loss, hypotension, and electrolyte imbalances. Choice C reason: Hyperpigmentation is a classic finding in Addison’s disease. It occurs due to increased secretion of adrenocorticotropic hormone (ACTH) from the pituitary gland in response to low cortisol levels. ACTH shares a precursor molecule with melanocyte-stimulating hormone, leading to excess melanin deposition in the skin and mucous membranes. This manifests as darkened patches, especially in sun-exposed areas, palmar creases, and oral mucosa. This is the correct answer. Choice D reason: Hirsutism is more commonly associated with conditions of androgen excess, such as polycystic ovary syndrome or adrenal hyperplasia. Addison’s disease involves adrenal insufficiency, which reduces androgen production rather than increasing it. Therefore, hirsutism is not expected.