Deck 55: The Child With Alterations in Endocrine Function

Question 1

During the summer,many children are more physically active.What changes in the management of the child with diabetes should be taught as a result of more exercise?

A)Increased food intake
B)Decreased food intake
C)Increased need for insulin
D)Decreased risk of insulin reaction

Answer 1

Increased food intake

Question 2

A nurse taking a daily weight on a child with diabetes insipidus notes the child has lost 2 pounds in 24 hours.Which is the nurse's priority action?

A)Continue to monitor the child.
B)Notify the physician regarding the weight loss.
C)Chart the weight and report the loss to the next shift.
D)Do nothing more than chart the weight,as this would be a normal finding.

Answer 2

Notify the physician regarding the weight loss.

Question 3

A child has been admitted to the hospital unconscious.The child has a history of insulin-dependent diabetes mellitus,and according to the child's mother,he took a normal dose of insulin this morning with breakfast.At school,the child had two pieces of birthday cake and some ice cream at a class birthday party.What is the likely reason for this child's unconscious state?

A)Metabolic alkalosis
B)Metabolic ketoacidosis
C)Insulin shock
D)Insulin reaction

Answer 3

Metabolic ketoacidosis

Question 4

A nurse is caring for a child with growth hormone deficiency.Which assessment finding would be most characteristic of this disorder?

A)Absence of abdominal fat
B)Mature facial features
C)Accelerated skeletal maturation
D)Decreased muscle mass

Question 5

A nurse is planning care for a child with adrenal insufficiency (Addison's disease).Which of the following is the priority nursing diagnosis?

A)Risk for deficient fluid volume
B)Risk for injury secondary to hypertension
C)Acute pain
D)Imbalanced nutrition: more than body requirements

Question 6

A child with growth hormone deficiency will be receiving a daily subcutaneous injection of biosynthetic growth hormone.The parents are being trained to administer the injection.Which instruction is most important for the nurse to include in parent instructions?

A)Avoid cleaning the area with alcohol before giving the injection.
B)Use only the legs for injection sites.
C)Delay giving the injection by 1 day if the child becomes upset.
D)Rotate the injection sites.

Question 7

The nurse is caring for a child with syndrome of inappropriate antidiuretic hormone (SIADH)disorder.Which interventions should the nurse implement for this child? Select all that apply.

A)Encouragement of fluids
B)Strict intake and output
C)Administration of ordered diuretics
D)Specific gravity of urine
E)Weight on admission,but not daily

Question 8

The child has been diagnosed with insulin-dependent diabetes mellitus.The nurse has taught the child the difference between insulin shock and diabetic hyperglycemia.The nurse knows that the child understood the teaching when the child identifies which of the following as characteristics of diabetic hyperglycemia?

A)Tremors and lethargy
B)Hunger and hypertension
C)Thirst and flushed skin
D)Shakiness and pallor

Question 9

A child will require lifelong cortisol replacement therapy following the removal of adrenal glands.Which is the priority instruction for the family?

A)To discontinue the injections after 1 week
B)That hydrocortisone is available only in oral form,so the medication will need to be held if the child has nausea or vomiting
C)To take the hydrocortisone on an empty stomach
D)To administer the medication early in the morning or every other day in the morning

Question 10

An adolescent girl with Graves' disease is admitted to the hospital.The nurse expects to find which clinical manifestation characteristics of Graves' disease (hyperthyroidism)present?

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

Question 11

The nurse is administering an 0800 dose of NPH insulin to an insulin-dependent diabetic child.Based on when the insulin peaks,at which period would the child be at greatest risk for a hypoglycemic episode?

A)Between breakfast and lunch
B)Between bedtime and breakfast the next morning
C)Between 0830 and a midmorning snack
D)Between lunch and dinner

Question 12

A child with diabetes insipidus has been admitted to the Pediatric Unit.The nurse would expect the child's lab value to demonstrate:

A)Hyperglycemia.
B)Hypernatremia.
C)Hypercalcemia.
D)Hypoglycemia.

Question 13

A child with Turner's syndrome tells the nurse she feels different from her peers.Which response should the nurse give?

A)"Tell me more about the feelings you are experiencing."
B)"These feelings are not unusual,and should pass soon."
C)"You'll start to grow soon,so don't worry."
D)"You seem to be upset about your disease."

Question 14

You are teaching the parent of a diabetic preschool-age child about management of the disease.The parent should be told to allow the preschool child to:

A)Administer all the insulin injections.
B)Pick which finger to stick for glucose testing.
C)Draw up the insulin dose.
D)Test blood glucose.