Question 1

A common clinical manifestation of juvenile hypothyroidism is

Accepted Answer

Dry skin is a common clinical manifestation of juvenile hypothyroidism. Other possible symptoms include fatigue, weight gain, constipation, poor growth, delay in puberty, and difficulty with learning and cognition. Insomnia, diarrhea, and accelerated growth are not typical symptoms of juvenile hypothyroidism.

Question 2

What is the best time for the nurse to assess the peak effectiveness of subcutaneously administered Regular insulin?

Accepted Answer

Regular insulin typically peaks in effectiveness about 2 to 3 hours after subcutaneous administration.

Question 3

A child with GH deficiency is receiving GH therapy.What is the best time for the GH to be administered?

Accepted Answer

Administering GH at bedtime mimics the natural secretion pattern of growth hormone, which is typically released in pulses during sleep.

Question 4

What should the nurse include in the teaching plan for parents of a child with diabetes insipidus who is receiving DDAVP?

Accepted Answer

The child should have free access to water and toilet facilities at school because DDAVP is a synthetic analog of antidiuretic hormone (ADH), which is used to manage diabetes insipidus by reducing excessive urination and thirst. Therefore, it is important for the child to have easy access to water and toilet facilities to maintain adequate hydration and to prevent dehydration. Options A, B, and D are incorrect, as they are not relevant to the use of DDAVP, and may be harmful or ineffective in managing diabetes insipidus.

Question 5

What is the best nursing action when a child with type 1 diabetes mellitus is sweating,trembling,and pale?

Accepted Answer

The symptoms described are indicative of hypoglycemia, an abnormally low blood sugar level that can be life-threatening. The best nursing action to take in this situation is to offer the child a glass of orange juice, which is a source of quick-acting carbohydrates that can rapidly raise blood sugar levels. Insulin administration would worsen the hypoglycemic state, while glucagon injection is reserved for severe cases that do not respond to oral treatment. Water alone will not address the underlying problem of low blood sugar.

Question 6

Which sign,when exhibited by a hospitalized child,should the nurse recognize as a characteristic of diabetes insipidus?

Accepted Answer

Increased urination is a hallmark sign of diabetes insipidus, as it is caused by the inability of the kidneys to reabsorb water properly, leading to excess urine production. Weight gain would not be expected in a child with diabetes insipidus, as they would be losing excess fluid. An increased urine specific gravity would be expected in a child with dehydration, but not in diabetes insipidus. A serum sodium level of 130 mEq/L may be seen in diabetes insipidus, but it is not a primary sign of the condition.

Question 7

At what age is sexual development in boys and girls considered to be precocious?

Accepted Answer

According to the American Academy of Pediatrics, sexual development in boys younger than 9 years and girls younger than 8 years is considered to be precocious. Therefore, the best choice is C, which has the youngest ages for both boys and girls.

Question 8

What information provided by the nurse would be helpful to a 15-year-old adolescent taking methimazole three times a day?

Accepted Answer

Providing information about pill dispensers and alarms can be helpful for an adolescent who may have trouble remembering to take medication as prescribed. Additionally, this empowers the adolescent to take responsibility for remembering to take their medication on time. Option B is incorrect as the medication should only be taken as prescribed by the healthcare provider, not based on when the adolescent feels nervous. Option C may not be the best choice as it is important to space out medication doses as prescribed by the healthcare provider. Option D may not be the best choice as it is important to encourage adolescents to take responsibility for their own healthcare.

Question 9

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

Accepted Answer

Blurred vision is a common clinical manifestation of type 1 diabetes mellitus due to the high blood sugar levels damaging the blood vessels in the retina of the eye. Moist skin, weight gain, and fluid overload are not typically associated with type 1 diabetes mellitus.

Question 10

What is the primary concern for a 7-year-old child with type 1 diabetes mellitus who asks his mother not to tell anyone at school that he has diabetes?

Accepted Answer

Safety is the primary issue.School personnel need to be aware of the signs and symptoms of hypoglycemia and hyperglycemia and the appropriate interventions.While privacy is a concern,for the child's safety,key personnel need to know about the diagnosis and what to do in an emergency.The treatment of type 1 diabetes should not interfere with the school-age child's development of a sense of industry.Peer group acceptance,along with body image,are issues for the early adolescent with type 1 diabetes.This is not of greater priority than the child's safety.

Question 11

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

Accepted Answer

Cortisone is the standard treatment for congenital adrenogenital hyperplasia as it helps to suppress adrenal androgen production and prevent virilization. Vitamin D, stool softeners, and calcium carbonate are not directly related to the management of this condition.

Question 12

Exophthalmos (protruding eyeballs)may occur in children with which condition?

Accepted Answer

Exophthalmos is a common symptom of hyperthyroidism, also known as Graves' disease. It is caused by an autoimmune disorder in which the body produces antibodies that stimulate the thyroid gland, resulting in increased production of thyroid hormones. This causes a range of symptoms, including protruding eyeballs, weight loss, rapid heartbeat, and bulging eyes.

Question 13

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 the knowledge that

Accepted Answer

Self-monitoring of blood glucose empowers children to take an active role in managing their diabetes, helping them understand how different factors affect their blood sugar levels and make informed decisions about their care.

Question 14

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

Accepted Answer

The priority nursing goal for a 14-year-old with Graves' disease is verbalizing the importance of adherence to the medication regimen. This is because medication adherence is crucial for managing the disease and preventing complications. Relieving constipation is not a priority for this condition. Allowing the adolescent to make decisions about taking medication may not be appropriate if their decision puts their health at risk. Developing alternative educational goals is also not a priority for this condition.

Question 15

New parents ask the nurse,"Why is it necessary for our baby to have the newborn blood test?" The nurse explains that the priority outcome of mandatory newborn screening for inborn errors of metabolism is

Accepted Answer

The priority outcome of mandatory newborn screening for inborn errors of metabolism is the early identification of serious genetically transmitted metabolic diseases. Early detection and intervention can prevent or minimize the risk of serious complications, including developmental delays, intellectual disability, and even death. Appropriate community referral and parental education may also be important, but they are not the primary reason for newborn screening. Electrolyte imbalances are not typically tested through newborn screening for inborn errors of metabolism.

Question 16

A neonate is displaying mottled skin,has a large fontanel and tongue,is lethargic,and is having difficulty feeding.The nurse recognizes that this is most suggestive of

Accepted Answer

The symptoms described are suggestive of hypothyroidism, which is a condition where the thyroid gland does not produce enough thyroid hormone. Mottled skin, a large fontanel and tongue, lethargy, and difficulty feeding are all signs of hypothyroidism in newborns. Hypocalcemia, hypoglycemia, and PKU may also cause some similar symptoms, but are not typically associated with a large tongue.

Question 17

A nurse is explaining growth hormone deficiency to parents of a child admitted to rule out this problem.Which metabolic alteration that is related to growth hormone deficiency should the nurse explain to the parent?

Accepted Answer

Growth hormone plays a role in regulating glucose metabolism, so a deficiency can lead to hypoglycemia. Hypocalcemia and diabetes insipidus are not directly related to growth hormone deficiency, and hyperglycemia would not be expected in this condition.

Question 18

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

Accepted Answer

Precocious puberty can cause social and emotional difficulties for children, as they may not fit in with same-age peers due to their physical development. Advising parents to encourage their child to develop relationships with same-age peers and participate in age-appropriate activities can help mitigate these difficulties. Birth control and sexual abuse prevention may be important topics to address, but they are not the most appropriate interventions in this scenario. While there is no known cure for precocious puberty, there are treatment options to manage the condition.

Question 19

A goiter is an enlargement or hypertrophy of which gland?

Accepted Answer

A goiter is an enlargement or hypertrophy of the thyroid gland.

Question 20

Diabetes insipidus is a disorder of the

Accepted Answer

Diabetes insipidus is caused by a deficiency of antidiuretic hormone (ADH) released from the posterior pituitary gland. This hormone normally helps to regulate urine output by controlling water reabsorption in the kidneys. Without enough ADH, large amounts of dilute urine are produced, leading to dehydration and thirst.

Quiz 51: The Child With an Endocrine or Metabolic Alteration