Cushing syndrome is a constellation of clinical findings caused by prolonged, pathological exposure to excess glucocorticoids — either endogenous (hypercortisolism) or exogenous (iatrogenic). The most common endogenous cause is a pituitary ACTH-secreting adenoma (Cushing disease, ~70% of cases); adrenal tumours and ectopic ACTH (small-cell lung cancer, carcinoid) account for the remainder. Failure to recognize Cushing syndrome delays treatment of the underlying cause (malignant or benign) and allows progressive metabolic destruction: uncontrolled hyperglycaemia, pathological fractures from osteoporosis, opportunistic infections from cortisol-driven immune suppression, and fatal cardiovascular events from hypertension and hypercoagulability. Top 3 nursing priorities: 1. Blood glucose monitoring and glycaemic management (cortisol drives hepatic gluconeogenesis → persistent hyperglycaemia even in non-diabetics) 2. Fall and fracture prevention (osteoporosis, proximal muscle weakness, impaired balance) 3. Infection surveillance (cortisol suppresses neutrophil and lymphocyte function → atypical presentations of serious infections) Classic NCLEX trap: The question describes a patient on long-term prednisone with moon face, buffalo hump, and central obesity — the answer about "iatrogenic Cushing" is correct, but students often select the wrong intervention (e.g., abruptly stopping steroids rather than a supervised taper).