Deck 46: Endocrine Dysfunction

Question 1

Chronic adrenocortical insufficiency is also referred to as:

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

Answer 1

Addison's disease.

Question 2

The nurse is caring for a child with suspected diabetes insipidus.Which clinical manifestation would she or he expect to observe?

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

Answer 2

Polyuria and polydipsia

Question 3

Which statement 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.

Answer 3

Skeletal proportions are normal for age.

Question 4

What is the most appropriate intervention for the parents of a 6-year-old girl with precocious puberty?

A)Advise the parents to consider birth control for their daughter.
B)Explain the importance of having the child foster relationships with same-age peers.
C)Assure the child's parents that there is no increased risk for sexual abuse because of her appearance.
D)Counsel parents that there is no treatment currently available for this disorder.

Question 5

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

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

Question 6

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

A)At bedtime.
B)After meals.
C)Before meals.
D)On arising in the morning.

Question 7

A common clinical manifestation of juvenile hypothyroidism is:

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

Question 8

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, 9.5 years

Question 9

A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes.The nurse should base the explanation on knowing that:

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 better able to manage the disease.

Question 10

Exophthalmos (protruding eyeballs)may occur in children with:

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

Question 11

Type 1 diabetes mellitus is suspected in an adolescent.Which clinical manifestation may be present?

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

Question 12

What 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 18 years.
D)Oral agents are often effective for treatment.

Question 13

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

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

Question 14

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

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

Question 15

What is the priority nursing goal for a 14-year-old with Graves' disease?

A)Relieving constipation
B)Allowing the adolescent to make decisions about whether or not to take medication
C)Verbalizing the importance of adherence to the medication regimen
D)Developing alternative educational goals

Question 16

Diabetes insipidus is a disorder of the:

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

Question 17

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 18

A goiter is an enlargement or hypertrophy of which gland?

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

Question 19

The nurse is teaching the parents of a child who is receiving propylthiouracil for the treatment of hyperthyroidism (Graves' disease).Which statement made by the parent indicates a correct understanding of the teaching?

A)"I would expect my child to gain weight while taking this medication."
B)"I would expect my child to experience episodes of ear pain while taking this medication."
C)"If my child develops a sore throat and fever, I should contact the physician immediately."
D)"If my child develops the stomach flu, my child will need to be hospitalized."

Question 20

Which symptom is considered a cardinal sign of diabetes mellitus?

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

Question 21

A child is diagnosed with hypothyroidism.The nurse should expect to assess which symptoms associated with hypothyroidism (Select all that apply)?

A)Weight loss
B)Fatigue
C)Diarrhea
D)Dry, thick skin
E)Cold intolerance

Question 22

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

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

Question 23

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

A)Saturated and unsaturated fat.
B)Fruit juice.
C)Several glasses of water.
D)Complex carbohydrate and protein.

Question 24

The nurse is caring for an 11-year-old boy who has recently been diagnosed with diabetes.What should be included in the teaching plan for daily injections?

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.

Question 25

The nurse is admitting a toddler with the diagnosis of juvenile hypothyroidism.Which is a common clinical manifestation of this disorder?

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

Question 26

What should a nurse advise the parents of a child with type 1 diabetes mellitus who is not eating as a result of a minor illness?

A)Give the child half his regular morning dose of insulin.
B)Substitute simple carbohydrates or calorie-containing liquids for solid foods.
C)Give the child plenty of unsweetened, clear liquids to prevent dehydration.
D)Take the child directly to the emergency department.

Question 27

Which clinical manifestation may occur in the child who is receiving too much methimazole (Tapazole)for the treatment of hyperthyroidism (Graves' disease)?

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

Question 28

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

A)Glucose is needed before administration of insulin.
B)Glucose is needed four times a day.
C)Glycosylated hemoglobin is required.
D)Ketonuria is suspected.

Question 29

A nurse is reviewing the laboratory results on a school-age child with hypoparathyroidism.Which results are consistent with this condition?

A)Decreased serum phosphorus
B)Decreased serum calcium
C)Increased serum glucose
D)Decreased serum cortisol

Question 30

Which laboratory finding confirms that a child with type 1 diabetes is experiencing diabetic ketoacidosis?

A)No urinary ketones
B)Low arterial pH
C)Elevated serum carbon dioxide
D)Elevated serum phosphorus

Question 31

Manifestations of hypoglycemia include:

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

Question 32

A nurse is planning care for a school-age child with type 1 diabetes.Which insulin preparations are rapid and short acting (Select all that apply)?

A)Novolin N
B)Lantus
C)NovoLog
D)Novolin R

Question 33

A child with hypopituitarism is being started on growth hormone (GH)therapy.Nursing considerations should be based on 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 the child's lifetime.

Question 34

Nursing care of a child diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)should include (Select all that apply):

A)Weigh daily.
B)Encourage fluids.
C)Turn frequently.
D)Maintain nothing by mouth.
E)Restrict fluids.

Question 35

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

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

Question 36

An adolescent is being seen in the clinic for evaluation of acromegaly.The nurse understands that which occurs with acromegaly?

A)There is a lack of growth hormone (GH) being produced.
B)There is excess GH after closure of the epiphyseal plates.
C)There is an excess of GH before the closure of the epiphyseal plates.
D)There is a lack of thyroid hormone being produced.

Question 37

The nurse should expect to assess which clinical manifestations in an adolescent with Cushing's syndrome (Select all that apply)?

A)Hyperglycemia
B)Hyperkalemia
C)Hypotension
D)Cushingoid features
E)Susceptibility to infections

Question 38

The nurse is implementing care for a school-age child admitted to the pediatric intensive care in diabetic ketoacidosis (DKA).Which prescribed intervention should the nurse implement first?

A)Begin 0.9% saline solution intravenously as prescribed.
B)Administer regular insulin intravenously as prescribed.
C)Place child on a cardiac monitor.
D)Place child on a pulse oximetry monitor.

Question 39

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 glucose.
B)Exercise should be restricted.
C)Extra snacks are needed before exercise.
D)Extra insulin is required during exercise.

Question 40

Which children admitted to the pediatric unit would the nurse monitor closely for development of syndrome of inappropriate antidiuretic hormone (SIADH)(Select all that apply)?

A)A newly diagnosed preschooler with type 1 diabetes
B)A school-age child returning from surgery for removal of a brain tumor
C)An infant with suspected meningitis
D)An adolescent with blunt abdominal trauma following a car accident
E)A school-age child with head trauma

Question 41

The clinic nurse is reviewing hemoglobin Ac levels on several children with type 1 diabetes.Hemoglobin Ac levels of less than _____ % are a goal for children with type 1 diabetes.Record your answer as a whole number.

Question 42

The nurse is caring for a school-age child with hyperthyroidism (Graves' disease).Which clinical manifestations should the nurse monitor that may indicate a thyroid storm (Select all that apply)?

A)Constipation
B)Hypotension
C)Hyperthermia
D)Tachycardia
E)Vomiting