Question 1

Which is the nurse's best response to the parents of a 10-year-old child newly diagnosed with type 1 diabetes mellitus who are concerned about the child's continued participation in soccer?

Accepted Answer

A)   "Consider the swim team as an alternative to soccer."
B)   "Encourage intellectual activity rather than participation in sports."
C)   "It is okay to play sports such as soccer unless the weather is too hot."
D)   "Give the child an extra 15 to 30 g of carbohydrate snack before soccer practice." D

Question 2

A nurse is caring for a child undergoing an ACTH stimulation test.After administering the Cortrosyn according to policy,what action by the nurse takes priority?

Accepted Answer

A)   Obtain a set of vital signs.
B)   Monitor the urine output.
C)   Facilitate a lab draw in 30 minutes.
D)   Keep the child NPO. C

Question 3

What is the best time for the nurse to assess the peak effectiveness of subcutaneously administered regular insulin?

Accepted Answer

A)   Two hours after administration
B)   Four hours after administration
C)   Immediately after administration
D)   Thirty minutes after administration A

Question 4

A goiter is an enlargement or hypertrophy of which gland?

Accepted Answer

A)   Thyroid
B)   Adrenal
C)   Anterior pituitary
D)   Posterior pituitary

Question 5

A common clinical manifestation of congenital hypothyroidism is

Accepted Answer

A)   insomnia.
B)   diarrhea.
C)   hoarse cry.
D)   jitteriness.

Question 6

Which children admitted to the pediatric unit would the nurse monitor closely for development of SIADH? (Select all that apply.)

Accepted Answer

A)   A newly diagnosed preschooler with type 1 diabetes
B)   A school-age child returning from surgery for removal of a brain tumor
C)   An infant with suspected meningitis
D)   An adolescent with blunt abdominal trauma following a car accident
E)   A school-age child with head trauma

Question 7

Which nursing interventions are appropriate for a child with type 1 diabetes who is experiencing deficient fluid volume related to abnormal fluid losses through diuresis and emesis? (Select all that apply.)

Accepted Answer

A)   Initiate IV access.
B)   Begin IV fluid replacement with normal saline.
C)   Begin IV fluid replacement with D5 1/2NS.
D)   Weigh on arrival to the unit and then every other day.
E)   Maintain strict intake and output monitoring.

Question 8

A child with growth hormone deficiency is receiving GH therapy.What is the best time for the GH to be administered?

Accepted Answer

A)   At bedtime
B)   After meals
C)   Before meals
D)   On arising in the morning

Question 9

A neonate born with ambiguous genitalia is diagnosed with congenital adrenal hyperplasia.Therapeutic management includes administration of

Accepted Answer

A)   vitamin D.
B)   cortisone acetate.
C)   stool softeners.
D)   calcium carbonate.

Question 10

A nurse is explaining growth hormone deficiency to parents of a child admitted to rule out this problem.Which metabolic alteration that is related to growth hormone deficiency should the nurse explain to the parent?

Accepted Answer

A)   Hypocalcemia
B)   Hypoglycemia
C)   Diabetes insipidus
D)   Hyperglycemia

Question 11

A child is hospitalized after a serious motor vehicle crash and has developed increased urination.What action by the nurse takes priority?

Accepted Answer

A)   Weigh the child daily.
B)   Monitor the child's intake and output.
C)   Assess the daily serum sodium level.
D)   Restrict dietary sodium intake.

Question 12

What is the priority nursing goal for a 14-year-old with Graves' disease?

Accepted Answer

A)   Relieving constipation
B)   Allowing the adolescent to make decisions about whether or not to take medication
C)   Verbalizing the importance of adherence to the medication regimen
D)   Developing alternative educational goals

Question 13

What is the most appropriate intervention for the parents of a 6-year-old child with precocious puberty?

Accepted Answer

A)   Advise the parents to consider birth control for their daughter.
B)   Explain the importance the child having relationships with same-age peers.
C)   Reassure parents that there are no long-term consequences.
D)   Counsel parents that there is no treatment currently available for this disorder.

Question 14

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

Accepted Answer

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

Question 15

New parents ask the nurse,"Why is it necessary for our baby to have the newborn blood test?" The nurse explains that the priority outcome of mandatory newborn screening for inborn errors of metabolism is

Accepted Answer

A)   appropriate community referral for affected infants.
B)   parental education about raising a special needs child.
C)   early identification of serious genetically transmitted metabolic diseases.
D)   early identification of electrolyte imbalances.

Question 16

Type 1 diabetes mellitus is suspected in an adolescent.Which clinical manifestation may be present?

Accepted Answer

A)   Moist skin
B)   Weight gain
C)   Fluid overload
D)   Blurred vision

Question 17

When would a child diagnosed with type 1 diabetes mellitus most likely demonstrate a decreased need for insulin?

Accepted Answer

A)   During the "honeymoon" phase
B)   During adolescence
C)   During growth spurts
D)   During minor illnesses

Question 18

Which sign is the nurse most likely to assess in a child with hypoglycemia?

Accepted Answer

A)   Urine positive for ketones and serum glucose greater than 300 mg/dL
B)   Normal sensorium and serum glucose greater than 160 mg/dL
C)   Irritability and serum glucose less than 60 mg/dL
D)   Increased urination and serum glucose less than 120 mg/dL

Question 19

What should a nurse advise the parents of a child with type 1 diabetes mellitus who is not eating as a result of a minor illness?

Accepted Answer

A)   Give the child half his regular morning dose of insulin.
B)   Substitute simple carbohydrates or calorie-containing liquids for solid foods.
C)   Give the child plenty of unsweetened, clear liquids to prevent dehydration.
D)   Take the child directly to the emergency department.

Question 20

A child is diagnosed with hypothyroidism.The nurse should expect to assess which symptoms associated with hypothyroidism? (Select all that apply.)

Accepted Answer

A)   Weight loss
B)   Fatigue
C)   Diarrhea
D)   Dry, thick skin
E)   Cold intolerance

Exam 51: The Child with an Endocrine or Metabolic Alteration