Question 1

A neonate born with ambiguous genitalia is diagnosed with congenital adrenogenital hyperplasia.Therapeutic management includes administration of which medication?
A) Vitamin D
B) Cortisone
C) Stool softeners
D) Calcium carbonate

Accepted Answer

The most common biochemical defect with congenital adrenal hyperplasia is partial or complete 21-hydroxylase deficiency.With complete deficiency,insufficient amounts of aldosterone and cortisol are produced,so circulatory collapse occurs without immediate replacement.Vitamin D,stool softeners,and calcium carbonate have no role in the therapy of adrenogenital hyperplasia.

Question 2

Which symptom is considered a cardinal sign of diabetes mellitus?
A) Nausea
B) Seizures
C) Impaired vision
D) Frequent urination

Accepted Answer

Hallmarks of diabetes mellitus are glycosuria,polyuria,and polydipsia.Nausea and seizures are not clinical manifestations of diabetes mellitus.Impaired vision is a long-term complication of the disease.

Question 3

What is the priority nursing goal for a 14 year old diagnosed with Graves' disease?
A) Relieving constipation
B) Allowing the adolescent to make decisions about whether or not to take medication
C) Verbalizing the importance of monitoring for medication side effects
D) Developing alternative educational goals

Accepted Answer

Children being treated with propylthiouracil or methimazole must be carefully monitored for side effects of the drug.Because sore throat and fever accompany the grave complication of leukopenia,these children should be seen by a health care practitioner if such symptoms occur.Parents and children should be taught to recognize and report symptoms immediately.The adolescent with Graves' disease is not likely to be constipated.Adherence to the medication schedule is important to ensure optimal health and wellness.Medications should not be skipped and dose regimens should not be tapered by the child without consultation with the child's medical provider.The management of Graves' disease does not interfere with school attendance and does not require alternative educational plans.

Question 4

A goiter is an enlargement or hypertrophy of which gland?
A) Thyroid
B) Adrenal
C) Anterior pituitary
D) Posterior pituitary

Accepted Answer

A goiter is an enlargement or hypertrophy of the thyroid gland.Goiter is not associated with the adrenals or the anterior and posterior pituitaries.

Question 5

A child will start treatment for precocious puberty.This involves injections of which synthetic medication?
A) Thyrotropin
B) Gonadotropins
C) Somatotropic hormone
D) Luteinizing hormone-releasing hormone

Accepted Answer

Precocious puberty of central origin is treated with monthly subcutaneous injections of luteinizing hormone-releasing hormone.Thyrotropin,gonadotropin,and somatotropic hormone are not appropriate therapies for precocious puberty.

Question 6

Exophthalmos may occur in children with what diagnosis?
A) Hypothyroidism
B) Hyperthyroidism
C) Hypoparathyroidism
D) Hyperparathyroidism

Accepted Answer

Exophthalmos (protruding eyeballs)is a clinical manifestation of hyperthyroidism.Hypothyroidism,hypoparathyroidism,and hyperparathyroidism are not associated with exophthalmos.

Question 7

Which statement best describes idiopathic hypopituitarism?
A) Growth is normal during the first 3 years of life.
B) Weight is usually more retarded than height.
C) Skeletal proportions are normal for age.
D) Most of these children have subnormal intelligence.

Accepted Answer

In children with idiopathic hypopituitarism,the skeletal proportions are normal.Growth is within normal limits for the first year of life.Height is usually more delayed than weight.Intelligence is not affected by hypopituitarism.

Question 8

A child diagnosed with hypoparathyroidism is receiving vitamin D therapy.The parents should be advised to watch for which sign of vitamin D toxicity?
A) Headache and seizures
B) Physical restlessness and voracious appetite without weight gain
C) Weakness and lassitude
D) Anorexia and insomnia

Accepted Answer

Vitamin D toxicity can be a serious consequence of therapy.Parents are advised to watch for signs including weakness,fatigue,lassitude,headache,nausea,vomiting,and diarrhea.Renal impairment is manifested through polyuria,polydipsia,and nocturia.Headaches may be a sign of vitamin D toxicity,but seizures are not.Physical restlessness and a voracious appetite with weight loss are manifestations of hyperthyroidism.Anorexia and insomnia are not characteristic of vitamin D toxicity.

Question 9

At what age is sexual development in boys and girls considered to be precocious?
A) Boys, 11 years; girls, 9 years
B) Boys, 12 years; girls, 10 years
C) Boys, 9 years; girls, 8 years
D) Boys, 10 years; girls, 9.5 years

Accepted Answer

Manifestations of sexual development before age 9 in boys and age 8 in girls are considered precocious and should be investigated.Boys older than 9 years of age and girls older than 8 years of age fall within the expected range of pubertal onset.

Question 10

Type 1 diabetes mellitus is suspected in an adolescent.Which clinical manifestation may be present?
A) Moist skin
B) Weight gain
C) Fluid overload
D) Poor wound healing

Accepted Answer

Poor wound healing is often an early sign of type 1 diabetes mellitus.Dry skin,weight loss,and dehydration are clinical manifestations of type 1 diabetes mellitus.

Question 11

Glucocorticoids,mineralocorticoids,and sex steroids are secreted by which organ?
A) Thyroid gland
B) Parathyroid glands
C) Adrenal cortex
D) Anterior pituitary

Accepted Answer

These hormones are secreted by the adrenal cortex.The thyroid gland produces thyroid hormone and thyrocalcitonin.The parathyroid glands produce parathyroid hormone.The anterior pituitary produces hormones such as growth hormone,thyroid-stimulating hormone,adrenocorticotropic hormone,gonadotropin,prolactin,and melanocyte-stimulating hormone.

Question 12

Chronic adrenocortical insufficiency is also referred to as what?
A) Graves' disease
B) Addison's disease
C) Cushing's syndrome
D) Hashimoto's disease

Accepted Answer

Addison's disease is chronic adrenocortical insufficiency.Graves' and Hashimoto's diseases involve the thyroid gland.Cushing's syndrome is a result of excessive circulation of free cortisol.

Question 13

A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes.The nurse should base the explanation on what information?
A) It is a less expensive method of testing.
B) It is not as accurate as laboratory testing.
C) Children need to learn to manage their diabetes.
D) The parents are better able to manage the disease.

Accepted Answer

Blood glucose self-management has improved diabetes management and can be used successfully by children from the time of diagnosis.Insulin dosages can be adjusted based on blood sugar results.Blood glucose monitoring is more expensive but provides improved management.It is as accurate as equivalent testing done in laboratories.The ability to self-test allows the child to balance diet,exercise,and insulin.The parents are partners in the process,but the child should be taught how to manage the disease.

Question 14

What is a common clinical manifestation of juvenile hypothyroidism?
A) Insomnia
B) Diarrhea
C) Dry skin
D) Accelerated growth

Accepted Answer

Dry skin,mental decline,and myxedematous skin changes are associated with juvenile hypothyroidism.Children with hypothyroidism are usually sleepy.Constipation is associated with hypothyroidism.Decelerated growth is common in juvenile hypothyroidism.

Question 15

A child with growth hormone (GH)deficiency is receiving GH therapy.What is the best time for the GH to be administered?
A) At bedtime
B) After meals
C) Before meals
D) On arising in the morning

Accepted Answer

Injections are best given at bedtime to more closely approximate the physiologic release of GH.Before or after meals and on arising in the morning are times that do not mimic the physiologic release of the hormone.

Question 16

What is the most appropriate intervention for the parents of a 6-year-old girl with precocious puberty?
A) Advise the parents to consider birth control for their daughter.
B) Explain the importance of having the child foster relationships with same-age peers.
C) Assure the child's parents that there is no increased risk for sexual abuse because of her appearance.
D) Counsel parents that there is no treatment currently available for this disorder.

Accepted Answer

Despite the child's appearance,the child needs to be treated according to her chronologic age and to interact with children in the same age-group.An expected outcome is that the child will adjust socially by exhibiting age-appropriate behaviors and social interactions.Advising the parents of a 6 year old to put their daughter on birth control is not appropriate and will not reverse the effects of precocious puberty.Parents need to be aware that there is an increased risk of sexual abuse for a child with precocious puberty.Treatment for precocious puberty is the administration of gonadotropin-releasing hormone blocker,which slows or reverses the development of secondary sexual characteristics and slows rapid growth and bone aging.

Question 17

What is the characteristic of the immune-mediated type 1 diabetes mellitus?
A) Ketoacidosis is infrequent
B) Onset is gradual
C) Age at onset is usually younger than 18 years
D) Oral agents are often effective for treatment

Accepted Answer

The immune-mediated type 1 diabetes mellitus typically has its onset in children or young adults.Peak incidence is between the ages of 10 and 15 years.Infrequent ketoacidosis,gradual onset,and treatment with oral agents are more consistent with type 2 diabetes.

Question 18

The nurse is teaching the parents of a child who is receiving propylthiouracil for the treatment of hyperthyroidism (Graves' disease).Which statement made by the parent indicates a correct understanding of the teaching?
A) "I would expect my child to gain weight while taking this medication."
B) "I would expect my child to experience episodes of ear pain while taking this medication."
C) "If my child develops a sore throat and fever, I should contact the physician immediately."
D) "If my child develops the stomach flu, my child will need to be hospitalized."

Accepted Answer

Children being treated with propylthiouracil must be carefully monitored for the side effects of the drug.Parents must be alerted that sore throat and fever accompany the grave complication of leukopenia.These symptoms should be immediately reported.Weight gain,episodes of ear pain,and stomach flu are not usually associated with leukopenia.

Question 19

Diabetes insipidus is a disorder of which organ?
A) Anterior pituitary
B) Posterior pituitary
C) Adrenal cortex
D) Adrenal medulla

Accepted Answer

The principal disorder of posterior pituitary hypofunction is diabetes insipidus.The anterior pituitary produces hormones such as growth hormone,thyroid-stimulating hormone,adrenocorticotropic hormone,gonadotropin,prolactin,and melanocyte-stimulating hormone.The adrenal cortex produces aldosterone,sex hormones,and glucocorticoids.The adrenal medulla produces catecholamines.

Question 20

The nurse is caring for a child with suspected diabetes insipidus.Which clinical manifestation would be observable?
A) Oliguria
B) Glycosuria
C) Nausea and vomiting
D) Polydipsia

Accepted Answer

Excessive urination accompanied by insatiable thirst is the primary clinical manifestation of diabetes.These symptoms may be so severe that the child does little other than drink and urinate.Oliguria is decreased urine production and is not associated with diabetes insipidus.Glycosuria is associated with diabetes mellitus.Nausea and vomiting are associated with inappropriate antidiuretic hormone secretion.

Quiz 47: The Child With Endocrine Dysfunction

A neonate born with ambiguous genitalia is diagnosed with congenital adrenogenital hyperplasia.Therapeutic management includes administration of which medication?

Which symptom is considered a cardinal sign of diabetes mellitus?

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

A goiter is an enlargement or hypertrophy of which gland?

A child will start treatment for precocious puberty.This involves injections of which synthetic medication?

Exophthalmos may occur in children with what diagnosis?

Which statement best describes idiopathic hypopituitarism?

A child diagnosed with hypoparathyroidism is receiving vitamin D therapy.The parents should be advised to watch for which sign of vitamin D toxicity?

At what age is sexual development in boys and girls considered to be precocious?

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

Glucocorticoids,mineralocorticoids,and sex steroids are secreted by which organ?

Chronic adrenocortical insufficiency is also referred to as what?

A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes.The nurse should base the explanation on what information?

What is a common clinical manifestation of juvenile hypothyroidism?

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

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

What is the characteristic of the immune-mediated type 1 diabetes mellitus?

The nurse is teaching the parents of a child who is receiving propylthiouracil for the treatment of hyperthyroidism (Graves' disease) .Which statement made by the parent indicates a correct understanding of the teaching?

Diabetes insipidus is a disorder of which organ?

The nurse is caring for a child with suspected diabetes insipidus.Which clinical manifestation would be observable?