Question 1

The health care provider has prescribed desmopressin acetate (DDAVP) 0.05mg/kg/day PO divided twice daily for a child with diabetes insipidus. The child weighs 110 lb. The nurse is preparing to administer the 0900 dose. Calculate the dose the nurse should administer in milligrams. Record your answer in a whole number.
_________

Accepted Answer

The answer of The health care provider has prescribed desmopressin...

Question 2

The nurse is planning to admit a 12-year-old with Graves disease (GD). What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)
A) Insomnia
B) Irritability
C) Tonic rigidity
D) Hyperactivity
E) Muscle cramps

Accepted Answer

Signs and symptoms of hyperthyroidism develop gradually, with an interval between onset and diagnosis of approximately 6 to 12 months. Clinical features include irritability, hyperactivity, short attention span, tremors, insomnia, and emotional lability. Tonic rigidity and muscle cramps are signs of hypoparathyroidism.

Question 3

A child is having tests done to determine parathyroid function. The clinic nurse knows that the parathyroid hormone (PTH) regulates the homeostasis of what in the serum?
A) Sodium
B) Calcium
C) Potassium
D) Magnesium

Accepted Answer

The parathyroid glands secrete PTH. Along with vitamin D and calcitonin, PTH regulates the homeostasis of serum calcium concentrations.

Question 4

What are characteristics of diabetic ketoacidosis? (Select all that apply.)
A) Pallor
B) Acidosis
C) Bradypnea
D) Dehydration
E) Electrolyte imbalance

Accepted Answer

Characteristics of diabetic ketoacidosis include acidosis, dehydration, and electrolyte imbalance. Respirations are rapid (Kussmaul respirations), not slow, and flushing, not pallor, would occur.

Question 5

The nurse is preparing to assist with a growth hormone provocative test for a child with short stature. The nurse recognizes that which pharmacologics should be used to provoke the release of growth hormone (GH)? (Select all that apply.)
A) Larodopa (levodopa)
B) Clonidine (Catapres)
C) Propranolol (Inderal)
D) Cortisone (hydrocortisone)
E) Biosynthetic growth hormone

Accepted Answer

GH stimulation, or provocative testing, involves the use of pharmacologics to provoke the release of GH either directly or indirectly. Provocative testing involves the use of neuromodulators such as levodopa or agents such as clonidine, arginine, insulin, propranolol, or glucagon followed by the measurement GH blood levels. Cortisone is given to replace hormone deficiencies that can occur with GH deficiency. Biosynthetic GH is used to treat GH deficiency.

Question 6

The nurse is planning to admit a 14-year-old adolescent with Cushing syndrome. What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)
A) Truncal obesity
B) Decreased pubic hair
C) Petechial hemorrhage
D) Hyperpigmentation of elbows
E) Facial plethora
F) Headache and weakness

Accepted Answer

Clinical manifestations of Cushing syndrome include truncal obesity, petechial hemorrhage, and facial plethora. Decreased pubic and axillary hair; hyperpigmentation of elbows, knees, and wrists; and headache and weakness are clinical manifestations of adrenocortical insufficiency.

Question 7

The nurse is taking care of a child who had a thyroidectomy. The nurse recognizes what as a positive Chvostek sign?
A) Paresthesia occurring in feet and toes
B) Frequent sharp flexion of wrist and ankle joints
C) Carpal spasm elicited by pressure applied to the nerves of the upper arm
D) Facial muscle spasm elicited by tapping the facial nerve in the region of the parotid gland

Accepted Answer

A positive Chvostek sign is a facial muscle spasm that is elicited by tapping the facial nerve in the region of the parotid gland. Paresthesia occurring in the feet and toes and frequent sharp flexion of the wrist and ankle joints can be signs of hypoparathyroidism but are not part of a positive Chvostek sign. Carpal spasm elicited by pressure applied to nerves of the upper arm is called a positive Trousseau sign.

Question 8

The nurse is preparing a community outreach program for adolescents about the characteristic differences between type 1 and type 2 diabetes mellitus (DM). What concepts should the nurse include? (Select all that apply.)
A) Type 1 DM has an abrupt onset.
B) Type 1 DM is often controlled with oral glucose agents.
C) Type 1 DM occurs primarily in whites.
D) Type 2 DM always requires insulin therapy.
E) Type 2 DM frequently has a familial history.
F) Type 2 DM occurs in people who are overweight.

Accepted Answer

Characteristics of type 1 DM include having an abrupt onset, primarily occurring in whites, and not being controlled with oral glucose agents (insulin is required for therapy). Type 2 DM frequently has a familial history, occurs in people who are overweight, and does not always require insulin therapy (it is used in 20% to 30% of patients).

Question 9

The nurse is preparing to admit a 9-year-old child with syndrome of inappropriate antidiuretic hormone (SIADH). What interventions should the nurse include in the child's care plan? (Select all that apply.)
A) Provide a low-sodium, low-fat diet.
B) Initiate seizure precautions.
C) Weigh daily at the same time each day.
D) Encourage intake of 1 l of fluid per day.
E) Measure intake and output hourly.

Accepted Answer

Nursing care of the child with SIADH includes placing the child on seizure precautions, obtaining a daily weight at the same time each day, and accurately measuring the child's intake and output. The nurse does not need to provide a low-sodium, low-fat diet because there are no diet restrictions. The child would be on fluid precautions to avoid fluid overload, so 1 l of fluid would not be encouraged.

Question 10

The nurse is caring for a child with an anterior pituitary tumor. What hormones are secreted by the anterior pituitary? (Select all that apply.)
A) Oxytocin
B) Luteinizing hormone
C) Antidiuretic hormone
D) Thyroid-stimulating hormone
E) Adrenocorticotrophic hormone

Accepted Answer

The anterior pituitary is responsible for secreting the following hormones: growth hormone, thyroid-stimulating hormone, adrenocorticotrophic hormone, follicle-stimulating hormone, luteinizing hormone, and prolactin. The posterior pituitary secretes antidiuretic hormone and oxytocin.

Question 11

The nurse is planning to admit a 14-year-old adolescent with hyperparathyroidism. What clinical manifestations should the nurse expect to observe in this patient? (Select all that apply.)
A) Polyuria
B) Diarrhea
C) Hypotension
D) Vague bone pain
E) Paresthesia in extremities

Accepted Answer

Clinical manifestations of hyperparathyroidism include polyuria, vague bone pain, and paresthesia in the extremities. Constipation, not diarrhea, and hypertension, not hypotension, are manifestations of hyperparathyroidism.

Question 12

The health care provider has prescribed leuprolide acetate (Lupron Depot) 0.2 mg/kg IM every 4 weeks for a child with precocious puberty. The child weighs 55 lb. The nurse is preparing to administer the dose. Calculate the dose the nurse should administer in milligrams. Record your answer below in a whole number.
_________

Accepted Answer

The answer of The health care provider has prescribed leuprolide...

Question 13

The nurse is preparing to admit a 7-year-old child with type 2 diabetes. What clinical features of type 2 diabetes should the nurse recognize? (Select all that apply.)
A) Oral agents are effective.
B) Insulin is usually needed.
C) Ketoacidosis is infrequent.
D) Diet only is often effective.
E) Chronic complications frequently occur.

Accepted Answer

The clinical features of type 2 diabetes include the following: oral agents are effective, ketoacidosis is infrequent, and diet only is often effective. Insulin is only needed in 20% to 30% of cases and chronic complications occur infrequently.

Question 14

The clinic nurse is assessing a child with central precocious puberty. What conditions can cause central precocious puberty? (Select all that apply.)
A) Trauma
B) Neoplasms
C) Radiotherapy
D) Exogenous sex hormones
E) Primary hypothyroidism

Accepted Answer

Trauma, neoplasms, and radiotherapy can be the cause of central precocious puberty. Exogenous sex hormones and primary hypothyroidism can cause peripheral precocious puberty.

Question 15

The health care provider has prescribed levothyroxine (Synthroid) 4 mcg/kg/day PO for a child with hypothyroidism. The child weighs 77 lb. The nurse is preparing to administer the daily dose. Calculate the dose the nurse should administer in micrograms. Record your answer below in a whole number.
________

Accepted Answer

The answer of The health care provider has prescribed levothyroxine...

Question 16

The nurse is teaching the family of a child with type 1 diabetes about insulin. What should the nurse include in the teaching session? (Select all that apply.)
A) Unopened vials are good for 60 days.
B) Diabetic supplies should not be left in a hot environment.
C) Insulin can be placed in the freezer if not used every day.
D) After it has been opened, insulin is good for up to 28 to 30 days.
E) Insulin bottles that have been opened should be stored at room temperature or refrigerated.

Accepted Answer

Insulin bottles that have been "opened" (i.e., the stopper has been punctured) should be stored at room temperature or refrigerated for up to 28 to 30 days. After 1 month, these vials should be discarded. Unopened vials should be refrigerated and are good until the expiration date on the label. Diabetic supplies should not be left in a hot environment. Insulin need not be refrigerated but should be maintained at a temperature between 15° and 29.5° C (59° and 85° F). Freezing renders insulin inactive.

Question 17

The nurse is caring for a child after a parathyroidectomy. What medication should the nurse have available if hypocalcemia occurs?
A) Insulin
B) Calcium gluconate
C) Propylthiouracil (PTU)
D) Cortisone (hydrocortisone)

Accepted Answer

Because hypocalcemia is a potential complication after a parathyroidectomy, observing for signs of tetany, instituting seizure precautions, and having calcium gluconate available for emergency use are part of the nursing care.

Question 18

The nurse is preparing to administer a prescribed dose of desmopressin acetate (DDAVP) intramuscularly (IM) to a child with diabetes insipidus. What action should the nurse take before drawing the medication into a syringe?
A) Mix the medication with sterile water.
B) Mix the medication with sterile normal saline.
C) Have another nurse double-check the medication dose.
D) Hold the medication under warm water for 10 to 15 minutes and then shake vigorously.

Accepted Answer

To be effective, vasopressin must be thoroughly mixed in the oil by being held under warm running water for 10 to 15 minutes and shaken vigorously before being drawn into the syringe. If this is not done, the oil may be injected minus the antidiuretic hormone. Small brown particles, which indicate drug dispersion, must be seen in the suspension.

Question 19

The nurse is planning to admit a 10-year-old child with syndrome of inappropriate antidiuretic hormone (SIADH). What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)
A) Polyuria
B) Anorexia
C) Polydipsia
D) Irritability
E) Stomach cramps

Accepted Answer

Clinical signs of SIADH are directly related to fluid retention and hyponatremia. When cells in the brain are exposed to too much water as opposed to sodium, swelling occurs. When serum sodium levels are diminished to 120?9?mEq/l, affected children may display anorexia, nausea, vomiting, stomach cramps, irritability, and personality changes. Polyuria and polydipsia are manifestations of diabetes insipidus.

Question 20

The nurse is planning to admit an 8-year-old child with hypoparathyroidism. What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)
A) Muscle cramps
B) Positive Chvostek sign
C) Emotional lability
D) Laryngeal spasms
E) Short attention span

Accepted Answer

Clinical manifestations of hypoparathyroidism include muscle cramps, positive Chvostek sign, and laryngeal spasms. Emotional lability and short attention span are signs of Graves disease.

Quiz 33: The Child with Endocrine Dysfunction

The nurse is planning to admit a 12-year-old with Graves disease (GD) . What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)

A child is having tests done to determine parathyroid function. The clinic nurse knows that the parathyroid hormone (PTH) regulates the homeostasis of what in the serum?

What are characteristics of diabetic ketoacidosis? (Select all that apply.)

The nurse is preparing to assist with a growth hormone provocative test for a child with short stature. The nurse recognizes that which pharmacologics should be used to provoke the release of growth hormone (GH) ? (Select all that apply.)

The nurse is planning to admit a 14-year-old adolescent with Cushing syndrome. What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)

The nurse is taking care of a child who had a thyroidectomy. The nurse recognizes what as a positive Chvostek sign?

The nurse is preparing a community outreach program for adolescents about the characteristic differences between type 1 and type 2 diabetes mellitus (DM) . What concepts should the nurse include? (Select all that apply.)

The nurse is preparing to admit a 9-year-old child with syndrome of inappropriate antidiuretic hormone (SIADH) . What interventions should the nurse include in the child's care plan? (Select all that apply.)

The nurse is caring for a child with an anterior pituitary tumor. What hormones are secreted by the anterior pituitary? (Select all that apply.)

The nurse is planning to admit a 14-year-old adolescent with hyperparathyroidism. What clinical manifestations should the nurse expect to observe in this patient? (Select all that apply.)

The nurse is preparing to admit a 7-year-old child with type 2 diabetes. What clinical features of type 2 diabetes should the nurse recognize? (Select all that apply.)

The clinic nurse is assessing a child with central precocious puberty. What conditions can cause central precocious puberty? (Select all that apply.)

The nurse is teaching the family of a child with type 1 diabetes about insulin. What should the nurse include in the teaching session? (Select all that apply.)

The nurse is caring for a child after a parathyroidectomy. What medication should the nurse have available if hypocalcemia occurs?

The nurse is preparing to administer a prescribed dose of desmopressin acetate (DDAVP) intramuscularly (IM) to a child with diabetes insipidus. What action should the nurse take before drawing the medication into a syringe?

The nurse is planning to admit a 10-year-old child with syndrome of inappropriate antidiuretic hormone (SIADH) . What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)

The nurse is planning to admit an 8-year-old child with hypoparathyroidism. What clinical manifestations should the nurse expect to observe in this child? (Select all that apply.)