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

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?

A) The child has above-normal growth for his age.
B) The child is active and playful.
C) The skin is pink and healthy looking.
D) It is difficult to keep the child awake.

Answer 1

It is difficult to keep the child awake.

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?

A) Give desmopressin acetate intranasally
B) Inject octreotide acetate
C) Give 1 mg/kg/day of methimazole
D) Administer glipizide orally

Answer 2

Inject octreotide acetate

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?

A) Deficient fluid volume related to dehydration
B) Excess fluid volume related to edema
C) Deficient knowledge related to fluid intake regimen
D) Imbalanced nutrition, more than body requirements related to excess weight

Answer 3

Deficient fluid volume related to dehydration

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?

A) Arrested height and increased weight
B) Thin, fragile skin and multiple bruises
C) Hyperpigmentation and hypotension
D) Blurred vision and enuresis

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?

A) Promoting a healthy body image
B) Encouraging effective family coping
C) Providing pre- and postoperative care
D) Promoting knowledge about treatment options

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?

A) Disabled family coping related to the child's disorder
B) Imbalanced nutrition, less than body requirements related to the child's short stature
C) Noncompliance related to the need for lifelong hormone therapy
D) Deficient knowledge related to the administration of estradiol

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?

A) Developing management and decision-making skills
B) Educating the parents about diabetes mellitus type 1
C) Developing a nutritionally sound, 30-day meal plan
D) Promoting independence with self-administration of insulin

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?

A) Instructing the parents to report adverse reactions to the growth hormone treatment
B) Teaching the parents how to administer the desmopressin acetate
C) Informing the parents that treatment stops when puberty begins
D) Educating the parents to report signs of acute adrenal crisis

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?

A) The parents report that their child had "a cold or flu" recently.
B) Blood pressure is decreased when checking vital signs.
C) The parents report that their son "can't drink enough water."
D) Auscultation reveals Kussmaul breathing.

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?

A) Describing surgery to remove an anterior pituitary tumor
B) Teaching her parents to give injections of growth hormone
C) Explaining about the radioactive iodine procedure
D) Showing her parents how to give DDAVP intranasally

Question 11

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

A) Nervousness
B) Heat intolerance
C) Smooth velvety skin
D) Weight gain

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?

A) Hypernatremia
B) Bradycardia
C) Hypertension
D) 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?

A) Administer a sliding-scale dose of insulin
B) Give 10 to 15 grams of a simple carbohydrate
C) Offer a complex carbohydrate snack
D) Administer glucagon intramuscularly

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?

A) Rapid weight gain
B) Complaints of headaches
C) Height increase of 4 inches
D) Growth plate closure

Question 15

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

A) "She needs to use the nasal spray once every day."
B) "She'll start puberty again when the medication stops."
C) "This medication will slow down the changes but not reverse them."
D) "Once therapy is done, she'll need surgery."

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?

A) Endocrine glands begin developing in the third trimester of gestation.
B) At birth, the endocrine glands are completely functional.
C) Infants have difficulty balancing glucose and electrolytes.
D) A child's endocrine system has little effect on growth and development.

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?

A) Syndrome of inappropriate antidiuretic hormone (SIADH)
B) Thyroid storm
C) Cushing syndrome
D) Vitamin D toxicity

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?

A) Hypernatremia
B) Hyperkalemia
C) Hyperglycemia
D) Hypercalcemia

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?

A) Bradycardia
B) Constipation
C) Fluid overload
D) Persistent vomiting

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?

A) Lispro
B) Regular
C) NPH
D) Glargine

Question 21

A 5-year-old child with type 1 diabetes is brought to the clinic by his mother for a follow-up visit after having his hemoglobin A1C level drawn. Which result would indicate to the nurse that the child is achieving long-term glucose control?

A) 9.0%
B) 8.2%
C) 7.3%
D) 6.9%

Question 22

The parents of a 7-year-old girl with type 1 diabetes has been recording her blood glucose measurements before meals and at bedtime for the past 4 days; they are as follows: Monday Tuesday Wednesday Thursday B: 120 mg/dL 135 mg/dL 124 mg/dL 200 mg/dL L: 110 mg/dL 120 mg/dL 140 mg/dL 220 mg/dL D: 90 mg/dL 140 mg/dL 130 mg/dL 200 mg/dL Bed: 110 mg/dL 110 mg/dL 160 mg/dL 240 mg/dL The parents bring the child in for a follow-up visit and show the nurse the results. Based on the results, the nurse would need to obtain additional information from the parents and child about which day?

A) Monday
B) Tuesday
C) Wednesday
D) Thursday

Question 23

The nurse is administering 10 units of NPH insulin to a child at 8 a.m. The nurse would expect this insulin to begin acting at which time?

A) By 8:15 a.m.
B) Between 8:30 and 9 a.m.
C) Between 9 and 11 a.m.
D) Around 12 noon

Question 24

The nurse suspects that a 4-year-old with type 1 diabetes is experiencing hypoglycemia based on which of the following? Select all that apply.

A) Blurred vision
B) Dry, flushed skin
C) Diaphoresis
D) Slurred speech
E) Fruity breath odor
F) Tachycardia

Question 25

A nurse is preparing a presentation for a group of parents with children diagnosed with diabetes type 1. The children are all adolescents. Which of the following issues would the nurse need to address? Select all that apply.

A) Self-monitoring of blood glucose levels
B) Feelings of being different
C) Deficient decision-making skills
D) Body image conflicts
E) Struggle for independence

Question 26

A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify which of the following as the primary function of this system?

A) Regulation of water balance
B) Hormonal secretion
C) Cellular metabolism
D) Growth stimulation