Deck 32: Alterations in Endocrine and Metabolic Function

Question 1

A hospitalized child has been diagnosed with SIADH (syndrome of inappropriate antidiuretic hormone), a complication of his meningitis. What would the nurse expect to see on this child's lab results?

A)Hyponatremia
B)Hypocalcemia
C)Hyperglycemia
D)Hypernatremia

Answer 1

Hyponatremia

Question 2

Based on physical findings, including a webbed neck and low hairline, the newborn female infant is suspected of having Turner's syndrome. The baby is in the newborn nursery while preparations are made for further evaluation including karyotyping. The nurse will want to monitor this baby for common associated conditions including:

A)Club foot (talipes equinovarus).
B)Congenital heart anomalies.
C)Hyperbilirubinemia due to liver abnormalities.
D)Diaphragmatic hernia.

Answer 2

Congenital heart anomalies.

Question 3

A three-year-old child was born with congenital adrenal insufficiency and is being treated with oral hydrocortisone. When the child develops pneumonia and is admitted to the hospital, the nurse would expect the dose of hydrocortisone to be:

A)Stopped.
B)Reduced by 50%.
C)Continued as previously prescribed.
D)Increased.

Answer 3

Increased.

Question 4

A five-year-old with a history of being treated for hypopituitarism comes to the physician with complaints of right hip and leg pain. The nurse understands that this symptom might be related to which medication that is used to treat hypopituitarism?

A)Daily growth hormone
B)Insulin before meals and bedtime
C)DDAVP (desmopressin acetate) at HS
D)Cortisone injections

Question 5

When the newborn female is born with ambiguous genitalia, the follow-up investigation discovers adrenogenital syndrome (also called congenital adrenal hyperplasia). The parents why the baby's genitalia looks more male than female. The nurse would explain that:

A)The disorder caused the infant to be a hermaphrodite with both male and female sex organs.
B)The changes in the genitalia are due to increased androgens secondary to deficient cortisol.
C)The excessive cortisol caused the enlargement of the female tissue, creating a male appearance.
D)The child has only one sex chromosome resulting in an XO configuration.

Question 6

The home health nurse is visiting a three-month-old who has been diagnosed with congenital hypothyroidism and is taking daily thyroxine. The baby is on soy formula and is at the 50^th percentile for height and weight. It is important that the mother understands that:

A)Parents may stop the thyroxine as long as the baby remains in the 50^th percentile for height and weight.
B)Soy-based formula can interfere with the absorption of thyroxine.
C)Dairy-based formula is contraindicated when an infant is taking thyroxine.
D)As long as the baby is growing along the same growth curve, no interventions are necessary.

Question 7

Mandatory testing in the newborn nursery determines that the infant has hypothyroidism. When discussing the treatment with the new mother, the mother states that she doesn't believe in taking medications. The nurse would explain that failure to treat the infant with the appropriate medication will result in:

A)Heart disease.
B)Mental retardation.
C)Renal failure.
D)Thyroid storm.

Question 8

The nurse is providing information to a teenager newly diagnosed with diabetes and his parents. The nurse teaches them that the signs of diabetic ketoacidosis (DKA) include: Standard Text: Select all that apply.

A)Change in mental status.
B)Tachycardia.
C)Fruity breath odor.
D)Rapid, shallow respirations.
E)Abdominal pain.

Question 9

The child was diagnosed with phenylketonuria shortly after birth and has been treated by the endocrine clinic for the last four years. The mother has missed the last three appointments. When the child keeps the next appointment, the mother assures the nurse that the child has followed the dietary restrictions. Which finding would make the nurse this statement?

A)The child's body has a musty odor.
B)This child is a blue-eyed blond.
C)The child appears sleepy and uninterested in the surroundings.
D)The child has a sunburn over his entire body.

Question 10

The school nurse has noticed an increase in the number of children in the school being diagnosed with type 2 diabetes. Which changes could the nurse implement at school to help reduce students' risk for developing type 2 diabetes? Standard Text: Select all that apply.

A)Increase the amount of daily physical activity.
B)Meet with all parents and explain the risk that is associated with obesity.
C)Test each child's urine monthly.
D)Teach the parents to avoid administering aspirin to their children.
E)Work with the cafeteria to decrease the amount of fat in the foods served.

Question 11

A 12-year-old has been selected to be a cheerleader for her middle school. This child has been recently diagnosed with type 1 diabetes. In teaching this child's mother about care for her child, the nurse wants the mother to understand that with increased physical activity, the child will need:

A)Decreased food intake.
B)Increased doses of insulin.
C)Increased food intake.
D)Decreased doses of insulin.

Question 12

The nurse is teaching the caregiver of a child who is newly diagnosed with type 1 diabetes mellitus how to minimize pain with insulin injections. Which interventions to minimize pain will the nurse include in the teaching? Standard Text: Select all that apply.

A)Do not reuse needles.
B)Remove all bubbles from the syringe before injecting.
C)Have the child flex the muscle during injection.
D)Inject insulin when it is cold.
E)Do not change the direction of the needle during insertion or withdrawal.

Question 13

An adolescent female with untreated Graves' disease is admitted to the hospital. The nurse expects to find which signs and symptoms in this client?

A)Hyperglycemia, ketonuria, and glucosuria
B)Weight gain, hirsutism, and muscle weakness
C)Tachycardia, fatigue, and heat intolerance
D)Dehydration, metabolic acidosis, and hypertension

Question 14

The nurse is teaching a teenage client newly diagnosed with type 1diabetes about complications of the disease. The nurse explains that clients with type 1 diabetes can avoid lipoatrophy by:

A)Rotating injection sites.
B)Checking blood sugars at mealtime and bedtime.
C)Using a sliding scale for additional coverage.
D)Administration of insulin via insulin pump.

Question 15

During the hospital stay in the newborn nursery, the infant is tested for galactosemia. When the test is positive, the parents are educated about treatment for galactosemia. The infant will be placed on what type of infant feeding?

A)Goat's milk formula
B)Breast milk
C)Cow's milk-based formula
D)Meat-based formula such as Nutramigen

Question 16

The nurse is caring for a hospitalized three-year-old admitted with a history of syndrome of inappropriate antidiuretic hormone (SIADH). He has just received his breakfast tray. Which food should the nurse remove from his tray?

A)Oatmeal
B)Yogurt
C)Biscuit
D)Cantaloupe

Question 17

The nurse is giving discharge instructions to the parents of a child whose adrenal glands have been removed due to a tumor. The nurse knows that the mother needs more instructions when the mother states:

A)"I will call the doctor if my child has restlessness and confusion."
B)"If my child has any gastric irritation, I will give him antacids."
C)"If my child has vomiting and diarrhea, I will hold his hydrocortisone."
D)"I will give my child his hydrocortisone in the morning."

Question 18

A teenager has arrived in the emergency department (ED) with confusion. The physician suspects diabetic ketoacidosis (DKA). A stat serum glucose is done, and the result is 76l5 mg/dL. The nurse expects that this teen has which symptoms?

A)Tachycardia, dehydration, and abdominal pain
B)Sweating, photophobia, and tremors
C)Dry mucous membranes, blurred vision, and weakness
D)Dry skin, shallow rapid breathing, and dehydration