Deck 30: Alterations in Endocrine Function

Question 1

Which teaching tips should be included when instructing parents on hydrocortisone administration? Select all that apply.
1) Maintain prescribed administration times.
2) Never discontinue medication abruptly.
3) Injections might be necessary when unable to take by mouth.
4) Lower doses are needed during illness.
5) Keep an emergency kit with the child at all times.

Answer 1

1, 2, 3, 5

Question 2

A nurse is planning care for a pediatric client diagnosed with adrenal insufficiency (Addison disease). Which nursing diagnosis is the priority for this client?
1) Risk for Deficient Fluid Volume
2) Risk for Injury Secondary to Hypertension
3) Acute Pain
4) Imbalanced Nutrition: More than Body Requirements

Answer 2

1

Question 3

The nurse is providing education to a pediatric client diagnosed with diabetes. The client will be playing soccer over the summer. Which change in the client's management will the nurse explore during this education session?
1) Increased food intake
2) Decreased food intake
3) Increased need for insulin
4) Decreased risk of insulin reaction

Answer 3

1

Question 4

A pediatric client is admitted to the hospital unconscious. The client has a history of type 1 diabetes, and according to the client's mother, has been to two birthday parties in the last few days and has resisted taking the prescribed insulin. At school the client had two more pieces of birthday cake and some ice cream at a class birthday party. What is the likely reason for this client's unconscious state?
1) Metabolic alkalosis
2) Metabolic ketoacidosis
3) Insulin shock
4) Insulin reaction

Question 5

A nurse is conducting a daily weight on a pediatric client diagnosed with diabetes insipidus and notes the child has lost 2 pounds in 24 hours. Which action by the nurse is the most appropriate?
1) Continue to monitor the child.
2) Notify the healthcare provider regarding the weight loss.
3) Chart the weight and report the loss to the next shift.
4) Do nothing more than chart the weight, as this would be a normal finding.

Question 6

The nurse is providing education to a group of student nurses regarding disorders of the endocrine system that can cause short stature. Which disorders will the nurse include in the educational session? Select all that apply.
1) Hypothyroidism
2) Turner syndrome
3) Type 1 diabetes mellitus
4) Diabetes insipidus
5) Cushing syndrome

Question 7

A pediatric client is diagnosed with type 1 diabetes. The nurse teaches the client the difference between insulin shock and diabetic hyperglycemia. The nurse evaluates that the client understands the teaching when the client states which characteristics of diabetic hyperglycemia?
1) Tremors and lethargy
2) Hunger and hypertension
3) Thirst and flushed skin
4) Shakiness and pallor

Question 8

A pediatric client diagnosed with Turner syndrome tells the nurse, "I feel different from my peers." Which response by the nurse is the most appropriate?
1) "Tell me more about the feelings you are experiencing."
2) "These feelings are not unusual and should pass soon."
3) "You'll start to grow soon, so don't worry."
4) "You seem to be upset about your disease."

Question 9

A school-age child is being assessed for syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should watch the child for which symptoms? Select all that apply.
1) Polyphagia
2) Retention of fluid
3) Hypernatremia
4) Hyponatremia
5) Hyperglycemia

Question 10

The nurse is administering a dose of rapid-acting insulin at 0800 to an insulin-dependent pediatric client. Based on when the insulin peaks, when will the client be at greatest risk for a hypoglycemic episode?
1) At about noon
2) Between bedtime and breakfast the next morning
3) Between lunch and dinner
4) Around 0930

Question 11

A parent of a newborn asks the nurse why a heel stick is being done on the baby to test for phenylketonuria (PKU). Which response by the nurse is the most appropriate?
1) "This screening is required and detection can be done before symptoms develop."
2) "The infant has high-risk characteristics."
3) "Because the infant was born by cesarean, this test is necessary."
4) "Because the infant was born by vaginal delivery, this test is recommended."

Question 12

A school-age client diagnosed with diabetes insipidus (DI) is admitted to the pediatric unit. Which laboratory value does the nurse anticipate for this client based on the diagnosis?
1) Hyperglycemia
2) Hypernatremia
3) Hypercalcemia
4) Hypoglycemia

Question 13

The nurse is planning care for a pediatric client diagnosed with adrenal hyperplasia. Which nursing diagnosis is most appropriate for this client?
1) Impaired Social Interaction Related to Unnatural Facial Features
2) Nutrition: Less than Body Requirements due to Nausea and Vomiting
3) Depression Related to Inability to Take in Oral Fluids
4) Risk for Deficient Fluid Volume Related to Failure of Regulatory Mechanisms

Question 14

An adolescent is admitted to the intensive care unit (ICU) with diabetic ketoacidosis. The client weighs 115 pounds.
The healthcare provider orders: Regular insulin 0.15 units/kg bolus via IVF, then regular insulin 0.1 units/kg/hr in 0.9 percent NSS
Medication on hand: 250 mL 0.9 percent NSS with 250 units of regular insulin.
Calculate the mL/hr for the continuous infusion of regular insulin at 0.1 unit/kg/hr in 0.9 percent NSS.

Question 15

The nurse is caring for a pediatric client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) disorder. Which interventions should the nurse implement for this child? Select all that apply.
1) Encouragement of fluids
2) Strict intake and output
3) Administration of ordered diuretics
4) Specific gravity of urine
5) Weight only on admission but not daily

Question 16

The nurse is teaching the parent of a type 1 diabetic preschool-age client about management of the disease. Which teaching point is appropriate for the nurse to include in this session?
1) Allowing the client to administer all the insulin injections
2) Allowing the client to choose which finger to stick for glucose testing
3) Allowing the client to draw up the insulin dose
4) Allowing the client to test blood glucose

Question 17

The nurse educator is teaching a group of nursing students about the endocrine system. Which statements are appropriate for the educator to include in the teaching session? Select all that apply.
1) Gonadotropin-releasing hormone stimulates the anterior pituitary to produce LH and FSH.
2) Growth hormone regulates linear bone growth and growth of all tissues.
3) Antidiuretic hormone regulates urine concentration by the kidneys.
4) Thyroid hormone regulates serum calcium levels and phosphorus excretion.
5) Parathyroid hormone regulates metabolism of cells and body heat production.

Question 18

The nurse is planning care for pediatric clients who have diagnoses that impact the endocrine system. Which changes occurring during the school-age and adolescence have a direct impact on the endocrine system? Select all that apply.
1) Puberty
2) Adrenarche
3) Menarche
4) Sexual exploration
5) Risk-taking behavior

Question 19

A pediatric client is seen in the clinic with a possible diagnosis of type 2 diabetes. The mother asks what the healthcare provider uses to make the diagnosis. The nurse explains that type 2 diabetes is suspected if the child has obesity, acanthosis nigricans, and two non-fasting blood-glucose levels above which level?
1) 120
2) 80
3) 200
4) 50

Question 20

An adolescent client diagnosed with Graves' disease is admitted to the hospital. Which clinical manifestations would the nurse expect on assessment?
1) Weight gain, hirsutism, and muscle weakness
2) Dehydration, metabolic acidosis, and hypertension
3) Tachycardia, fatigue, and heat intolerance
4) Hyperglycemia, ketonuria, and glucosuria