Question 1

The nurse is planning to admit a 10-year-old child with syndrome of inappropriate antidiuretic hormone (SIADH). What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)

Accepted Answer

A)  Polyuria 
B)  Anorexia 
C)  Polydipsia 
D)  Irritability 
E)  Stomach cramps

Question 2

The school nurse practitioner is consulted by a fifth-grade teacher about a student who has become increasingly inattentive and hyperactive in the classroom. The nurse notes that the child's weight has changed from the 50th percentile to the 30th percentile. The nurse is concerned about possible hyperthyroidism. What additional sign or symptom should the nurse anticipate?

Accepted Answer

A)  Skin that is cool and dry 
B)  Blurred vision and loss of acuity 
C)  Running and being active during recess 
D)  Decreased appetite and food intake

Question 3

A child is having tests done to determine parathyroid function. The clinic nurse knows that the parathyroid hormone (PTH) regulates the homeostasis of what in the serum?

Accepted Answer

A)  Sodium 
B)  Calcium 
C)  Potassium 
D)  Magnesium

Question 4

A 20-kg (44-lb) child in ketoacidosis is admitted to the pediatric intensive care unit. What order should the nurse not implement until clarified with the physician?

Accepted Answer

A)  Weigh on admission and daily. 
B)  Replace fluid volume deficit over 48 hours. 
C)  Begin intravenous line with D5 0.45% normal saline with 20 mEq of potassium chloride. 
D)  Give intravenous regular insulin 2 units/kg/hr after initial rehydration bolus.

Question 5

The nurse is taking care of a child who had a thyroidectomy. The nurse recognizes what as a positive Chvostek sign?

Accepted Answer

A)  Paresthesia occurring in feet and toes 
B)  Frequent sharp flexion of wrist and ankle joints 
C)  Carpal spasm elicited by pressure applied to the nerves of the upper arm 
D)  Facial muscle spasm elicited by tapping the facial nerve in the region of the parotid gland

Question 6

Exophthalmos (protruding eyeballs) may occur in children with which condition?

Accepted Answer

A)  Hypothyroidism 
B)  Hyperthyroidism 
C)  Hypoparathyroidism 
D)  Hyperparathyroidism

Question 7

The nurse is planning to admit a 14-year-old adolescent with Cushing syndrome. What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)

Accepted Answer

A)  Truncal obesity 
B)  Decreased pubic hair 
C)  Petechial hemorrhage 
D)  Hyperpigmentation of elbows 
E)  Facial plethora
F) Headache and weakness

Question 8

A 12-year-old girl is newly diagnosed with diabetes when she develops ketoacidosis. How should the nurse structure a successful education program?

Accepted Answer

A)  Essential information is presented initially. 
B)  Teaching should take place in the child's semiprivate room. 
C)  Education is focused toward the parents because the child is too young. 
D)  All information needed for self-management of diabetes is taught at once.

Question 9

The health care provider has prescribed leuprolide acetate (Lupron Depot) 0.2 mg/kg IM every 4 weeks for a child with precocious puberty. The child weighs 55 lb. The nurse is preparing to administer the dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
_________

Accepted Answer

The answer of The health care provider has prescribed leuprolide...

Question 10

The nurse is caring for a child with an anterior pituitary tumor. What hormones are secreted by the anterior pituitary? (Select all that apply.)

Accepted Answer

A)  Oxytocin 
B)  Luteinizing hormone 
C)  Antidiuretic hormone 
D)  Thyroid-stimulating hormone 
E)  Adrenocorticotrophic hormone

Question 11

The nurse is teaching the parent of a preschool child how to administer the child's insulin injection. The child will be receiving 2 units of regular insulin and 12 units of NPH insulin every morning. What should the parent be taught?

Accepted Answer

A)  Draw the insulin in separate syringes. 
B)  Draw the regular insulin first and then the NPH into the same syringe. 
C)  Draw the NPH insulin first and then the regular into the same syringe. 
D)  Check blood sugar first, and if below 120, hold the regular insulin and give the NPH.

Question 12

Intranasal administration of desmopressin acetate (DDAVP) is used to treat which condition?

Accepted Answer

A)  Hypopituitarism 
B)  Diabetes insipidus (DI) 
C)  Syndrome of inappropriate antidiuretic hormone (SIADH) 
D)  Acute adrenocortical insufficiency

Question 13

An adolescent diabetic is admitted to the emergency department for treatment of hyperglycemia and pneumonia. What are characteristics of diabetic hyperglycemia?

Accepted Answer

A)  Cold, clammy skin and lethargy 
B)  Hunger and hypertension 
C)  Thirst, being flushed, and fruity breath 
D)  Disorientation and pallor

Question 14

What is a condition that can result if hypersecretion of growth hormone (GH) occurs after epiphyseal closure?

Accepted Answer

A)  Cretinism 
B)  Dwarfism 
C)  Gigantism 
D)  Acromegaly

Question 15

The health care provider has prescribed levothyroxine (Synthroid) 4 mcg/kg/day PO for a child with hypothyroidism. The child weighs 77 lb. The nurse is preparing to administer the daily dose. Calculate the dose the nurse should administer in micrograms. Record your answer below in a whole number.
________

Accepted Answer

The answer of The health care provider has prescribed levothyroxine...

Question 16

What clinical manifestation occurs with hypoglycemia?

Accepted Answer

A)  Lethargy 
B)  Confusion 
C)  Nausea and vomiting 
D)  Weakness and dizziness

Question 17

The nurse is preparing to admit a 7-year-old child with type 2 diabetes. What clinical features of type 2 diabetes should the nurse recognize? (Select all that apply.)

Accepted Answer

A)  Oral agents are effective. 
B)  Insulin is usually needed. 
C)  Ketoacidosis is infrequent. 
D)  Diet only is often effective. 
E)  Chronic complications frequently occur.

Question 18

To help an adolescent deal with diabetes, the nurse needs to consider which characteristic of adolescence?

Accepted Answer

A)  Desire to be unique 
B)  Preoccupation with the future 
C)  Need to be perfect and similar to peers 
D)  Awareness of peers that diabetes is a severe disease

Question 19

What clinical manifestation is considered a cardinal sign of diabetes mellitus?

Accepted Answer

A)  Nausea 
B)  Seizures 
C)  Impaired vision 
D)  Frequent urination

Question 20

The nurse is preparing to assist with a growth hormone provocative test for a child with short stature. The nurse recognizes that which pharmacologics should be used to provoke the release of growth hormone (GH)? (Select all that apply.)

Accepted Answer

A)  Larodopa (levodopa) 
B)  Clonidine (Catapres) 
C)  Propranolol (Inderal) 
D)  Cortisone (hydrocortisone) 
E)  Biosynthetic growth hormone

Exam 33: The Child with Endocrine Dysfunction

The nurse is planning to admit a 10-year-old child with syndrome of inappropriate antidiuretic hormone (SIADH) . What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)