Question 1

The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. Which of the following would the nurse most likely assess?

Accepted Answer

Congenital hypothyroidism can lead to symptoms such as lethargy and excessive sleeping in infants, making it difficult to keep the child awake. This condition slows down the body's metabolism, which can affect energy levels.

Question 2

The nurse is caring for an 8-year-old girl with hyperpituitarism. Which of the following ordered treatments will the nurse expect to perform?

Accepted Answer

Octreotide acetate is used in the treatment of hyperpituitarism because it mimics somatostatin, a hormone that inhibits the release of growth hormone, thereby addressing the overproduction associated with the condition.

Question 3

The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. Which of the following would the nurse most likely identify as the priority nursing diagnosis?

Accepted Answer

Diabetes insipidus is characterized by an inability of the body to conserve water, leading to excessive urination and risk of dehydration. Therefore, "Deficient fluid volume related to dehydration" is the priority nursing diagnosis.

Question 4

The nurse is assessing a 9-year-old girl with a history of tuberculosis at age 6 years. She has been losing weight and has no appetite. The nurse suspects Addison disease based on which of the following assessment findings?

Accepted Answer

Hyperpigmentation and hypotension are classic signs of Addison's disease, which is a condition characterized by insufficient production of hormones by the adrenal glands. Hyperpigmentation occurs due to increased production of melanocyte-stimulating hormone (MSH) as a byproduct of increased ACTH production in response to low cortisol levels. Hypotension results from decreased aldosterone production, leading to reduced sodium and water reabsorption by the kidneys.

Question 5

The nurse is caring for a 10-year-old boy with hyperpituitarism due to a tumor on the anterior pituitary gland. Which of the following would be a priority for this child?

Accepted Answer

The priority for a child with hyperpituitarism due to a tumor is to address the immediate medical needs, which include providing pre- and postoperative care if surgery is required to remove the tumor.

Question 6

The nurse is caring for a 13-year-old girl with delayed puberty. Based on the nurse's knowledge of this condition, the nurse would include which nursing diagnosis in the child's plan of care?

Accepted Answer

Delayed puberty often requires hormone therapy, such as estradiol, and the patient and family may need education on its administration.

Question 7

The nurse is preparing a teaching plan for the family and their 6-year-old son who has just been diagnosed with diabetes mellitus. Which of the following would the nurse identify as the initial goal for the teaching plan?

Accepted Answer

The answer of The nurse is preparing a teaching plan...

Question 8

The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. Which of the following would the nurse expect to implement?

Accepted Answer

The posterior pituitary gland is responsible for the secretion of antidiuretic hormone (ADH), and a disorder involving this gland often leads to conditions such as diabetes insipidus, which is treated with desmopressin acetate (a synthetic form of ADH). Teaching the parents how to administer desmopressin acetate would be appropriate for managing a disorder of the posterior pituitary gland.

Question 9

The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. Which of the following would the nurse correlate with disorder?

Accepted Answer

In type 2 diabetes, increased thirst (polydipsia) is a common symptom due to high blood sugar levels.

Question 10

The nurse is preparing a teaching plan for a 10-year-old girl with hyperthyroidism. Which of the following would the nurse include in the plan?

Accepted Answer

Hyperthyroidism is often treated with radioactive iodine to reduce thyroid function. The other options are not related to the treatment of hyperthyroidism. Surgery to remove an anterior pituitary tumor, injections of growth hormone, and DDAVP intranasally are treatments for conditions other than hyperthyroidism.

Question 11

Which of the following would the nurse expect to assess in a child with hypothyroidism?

Accepted Answer

Hypothyroidism slows down the body's metabolism, leading to symptoms such as weight gain, fatigue, and cold intolerance, rather than symptoms associated with hyperthyroidism like nervousness, heat intolerance, and smooth velvety skin.

Question 12

The parents of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. Which of the following would lead the nurse to suspect that the child is experiencing an acute adrenal crisis?

Accepted Answer

Hyperkalemia is a common sign of acute adrenal crisis in patients with congenital adrenal hyperplasia. This condition leads to decreased cortisol production, which can cause the body to retain potassium, leading to hyperkalemia.

Question 13

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. Which of the following would the nurse do next?

Accepted Answer

The child is experiencing mild hypoglycemia (blood glucose level of 70 mg/dL) and is symptomatic (shaky, slight tremors, sweating). The immediate treatment for mild hypoglycemia is to give 10 to 15 grams of a simple carbohydrate to quickly raise the blood sugar level.

Question 14

A child with growth hormone deficiency is receiving growth hormone. Which of the following would the nurse interpret as indicating effectiveness of this therapy?

Accepted Answer

Height increase is a primary indicator of the effectiveness of growth hormone therapy in children with growth hormone deficiency. Rapid weight gain, complaints of headaches, and growth plate closure are not direct indicators of therapy effectiveness.

Question 15

After teaching the parents of a daughter with central precocious puberty about medication therapy, which statement by the parents indicates successful teaching?

Accepted Answer

The correct statement is that puberty will resume once the medication is stopped. Medications for central precocious puberty, such as GnRH analogs, temporarily halt the progression of puberty, and normal puberty will resume after discontinuation.

Question 16

A group of nursing students are reviewing information about the endocrine system in infants and children. The students demonstrate understanding of the information when they state which of the following?

Accepted Answer

Infants have immature endocrine systems, which can lead to difficulties in balancing glucose and electrolytes.

Question 17

A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which of the following?

Accepted Answer

Vasopressin is a synthetic form of antidiuretic hormone (ADH) used to treat diabetes insipidus by reducing urine output and increasing water retention. Excessive vasopressin can lead to water retention and hyponatremia, mimicking the Syndrome of Inappropriate Antidiuretic Hormone (SIADH), where the body retains too much water.

Question 18

The nurse is reviewing the laboratory test results of a child with Addison disease. Which of the following would the nurse expect to find?

Accepted Answer

Addison's disease is characterized by adrenal insufficiency, leading to decreased production of aldosterone. This results in the body's inability to retain sodium and excrete potassium, causing hyperkalemia (elevated potassium levels).

Question 19

A nurse is teaching the parents of an infant with congenital adrenal hyperplasia about the signs and symptoms of adrenal crisis. The nurse determines that the teaching was successful when the parents identify which of the following?

Accepted Answer

Adrenal crisis in the context of congenital adrenal hyperplasia can lead to severe vomiting due to electrolyte imbalances and inadequate cortisol levels. Persistent vomiting is a sign that may indicate an adrenal crisis, necessitating immediate medical attention.

Question 20

A group of students are reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which insulin listed below as having the longest duration?

Accepted Answer

Glargine insulin is known for its long-acting properties, typically lasting up to 24 hours or more, making it the insulin with the longest duration among the options listed.

Quiz 48: Nursing Care of the Child With an Alteration in Metabolism/Endocrine Disorder