Deck 29: The Child With Endocrine Dysfunction

Question 1

A neonate, born with ambiguous genitalia, is diagnosed with congenital adrenogenital hyperplasia. Therapeutic management will include administration of:

A)Vitamin D.
B)Cortisone.
C)Stool softeners.
D)Calcium carbonate.

Answer 1

Cortisone.

Question 2

Nursing care of a child diagnosed with syndrome of inappropriate ADH should include which of the following?

A)Encourage fluids.
B)Turn frequently.
C)Maintain nothing by mouth (NPO).
D)Restrict fluids.

Answer 2

Restrict fluids.

Question 3

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

A)At bedtime
B)After meals
C)Before meals
D)Arising in the AM

Answer 3

At bedtime

Question 4

Which of the following statements best describes 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.

Question 5

A goiter is an enlargement or hypertrophy of which gland?

A)Thyroid
B)Adrenal
C)Anterior pituitary
D)Posterior pituitary

Question 6

Chronic adrenocortical insufficiency also is referred to as:

A)Graves' disease.
B)Addison disease.
C)Cushing syndrome.
D)Hashimoto disease.

Question 7

Which of the following is a common clinical manifestation of juvenile hypothyroidism?

A)Insomnia
B)Diarrhea
C)Dry skin
D)Accelerated growth

Question 8

Which of the following is the primary clinical manifestation of diabetes insipidus?

A)Oliguria
B)Glycosuria
C)Nausea, vomiting
D)Polyuria, polydipsia

Question 9

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

A)Headache, seizures
B)Physical restlessness, voracious appetite without weight gain.
C)Weakness and lassitude
D)Anorexia and insomnia

Question 10

Which of the following clinical manifestations may occur in the child who is receiving too much propylthiouracil for the treatment of hyperthyroidism (Graves' disease)?

A)Seizures
B)Enlargement of all lymph glands
C)Pancreatitis or cholecystitis
D)Lethargy and somnolence

Question 11

Which of the following is a condition that can result if hypersecretion of GH occurs after epiphyseal closure?

A)Dwarfism
B)Acromegaly
C)Gigantism
D)Cretinism

Question 12

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 1/2 years

Question 13

A child will start treatment for precocious puberty. This involves injections of synthetic:

A)Thyrotropin.
B)Gonadotropins.
C)Somatotropic hormone.
D)Luteinizing hormone-releasing hormone.

Question 14

A child with hypopituitarism is being started on growth hormone therapy. Nursing considerations should be based on knowledge of which of the following?

A)Treatment is most successful if it is started during adolescence.
B)Treatment is considered successful if children attain full stature by adulthood.
C)Replacement therapy requires daily subcutaneous injections.
D)Replacement therapy will be required throughout child's lifetime.

Question 15

A nasal spray of desmopressin acetate (DDAVP) is used to treat:

A)Hypopituitarism.
B)Diabetes insipidus.
C)Acute adrenocortical insufficiency.
D)Syndrome of inappropriate ADH.

Question 16

A child is receiving propylthiouracil for the treatment of hyperthyroidism (Graves' disease). The parents and child should be taught to recognize and report which of the following symptoms immediately?

A)Anorexia
B)Ear pain
C)Fever, sore throat
D)Upper respiratory infection

Question 17

Glucocorticoids, mineralocorticoids, and sex steroids are secreted by the:

A)Thyroid gland.
B)Parathyroid glands.
C)Adrenal cortex.
D)Anterior pituitary.

Question 18

Diabetes insipidus is a disorder of which of the following?

A)Anterior pituitary
B)Posterior pituitary
C)Adrenal cortex
D)Adrenal medulla

Question 19

Exophthalmos (protruding eyeballs) may occur in children with which of the following conditions?

A)Hypothyroidism
B)Hyperthyroidism
C)Hypoparathyroidism
D)Hyperparathyroidism

Question 20

A 13-year-old girl is brought to the clinic with the complaint of "emotional lability and restlessness." Other symptoms include: gradual weight loss despite a good appetite; warm, moist skin; heat intolerance; and unusually fine hair. These manifestations are most suggestive of which of the following?

A)Hypothyroidism
B)Hyperthyroidism
C)Hypoparathyroidism
D)Hyperparathyroidism

Question 21

Hyperglycemia associated with diabetic ketoacidosis is defined as a blood glucose measurement equal to or greater than:

A)185 mg/dL.
B)220 mg/dL.
C)280 mg/dL.
D)330 mg/dL.

Question 22

Manifestations of hypoglycemia include which of the following?

A)Lethargy
B)Thirst
C)Nausea and vomiting
D)Shaky feeling and dizziness

Question 23

The parents of a neonate with adrenogenital hyperplasia tell the nurse that they will be afraid to have any more children. The nurse should explain that:

A)It is not hereditary.
B)Genetic counseling is indicated.
C)It can be prevented during pregnancy.
D)All future children will have the disorder.

Question 24

Which of the following is considered a cardinal sign of diabetes mellitus?

A)Nausea
B)Seizures
C)Impaired vision
D)Frequent urination

Question 25

Type 1 diabetes mellitus is suspected in an adolescent. Which of the following clinical manifestations may be present?

A)Moist skin
B)Weight gain
C)Fluid overload
D)Poor wound healing

Question 26

The nurse is discussing with a child and family the various sites used for insulin injections. Which of the following sites usually has the fastest rate of absorption?

A)Arm
B)Leg
C)Buttock
D)Abdomen

Question 27

Which of the following is 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 20 years.
D)Oral agents are often effective for treatment.

Question 28

To help the adolescent deal with diabetes, the nurse must consider which of the following characteristics of adolescence?

A)Desire to be unique
B)Preoccupation with the future
C)Need to be perfect and similar to peers
D)Making peers aware of the seriousness of hypoglycemic reactions.

Question 29

The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. The nurse should explain that:

A)Exercise will increase blood sugar.
B)Exercise should be restricted.
C)Extra snacks are needed before exercise.
D)Extra insulin is required during exercise.

Question 30

The parent of a child with diabetes mellitus asks the nurse when urine testing will be necessary. The nurse should explain that urine testing for:

A)Glucose is needed before administration of insulin.
B)Glucose is needed 4 times a day.
C)Urine is needed to test for glycosylated hemoglobin.
D)Urine will be tested when ketonuria is suspected.

Question 31

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

A)It is a less expensive method of testing.
B)It is not as accurate as laboratory testing.
C)Children are better able to manage the diabetes.
D)The parents are able to manage the disease better.

Question 32

A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid-releasing sugar should be followed by which of the following?

A)Fat
B)Fruit juice
C)Several glasses of water
D)Complex carbohydrate and protein

Question 33

An 1l-year-old boy has recently been diagnosed with diabetes. The nurse's teaching plan for daily injections should be based on which of the following?

A)The parents do not need to learn the procedure.
B)He is old enough to give most of his own injections.
C)Self-injections will be possible when he is closer to adolescence.
D)He can learn about self-injections when he is able to reach all injection sites.