Question 1

Which type of nutrition should the nurse include when planning care for a newborn who is diagnosed with galactosemia?

Accepted Answer

Galactosemia is a condition where the body can't process galactose, which is found in lactose. Therefore, lactose-free formula is the best choice for a newborn diagnosed with galactosemia. Goat's milk formula, breast milk, and cow's milk-based formula all contain lactose and are not appropriate for infants with this condition.

Question 2

Which sequela should the nurse include in the teaching session for a parent who does not believe in medication for the treatment of the newborn's hypothyroidism?

Accepted Answer

Without medication to treat hypothyroidism, the newborn is at risk for long-term neurological and cognitive impairments, including intellectual disability.

Question 3

The nurse is giving discharge instructions to the parents of a child whose adrenal glands have been removed due to a tumor. Which parental statement indicates the need for further education?

Accepted Answer

The adrenal glands produce cortisol, a vital hormone for stress response, among other functions. After adrenal gland removal, patients must take synthetic cortisol (hydrocortisone) to replace what their body can no longer produce. Vomiting and diarrhea can lead to dehydration and stress, increasing the body's need for cortisol. Holding hydrocortisone during these times could lead to an adrenal crisis, a life-threatening condition. Therefore, the statement about holding hydrocortisone indicates a misunderstanding and the need for further education.

Question 4

Which clinical manifestations should the nurse anticipate when providing care to an adolescent client who presents with untreated Graves disease?

Accepted Answer

Graves disease is an autoimmune disorder that causes hyperthyroidism. Tachycardia, fatigue, and heat intolerance are common manifestations of hyperthyroidism, and therefore the nurse should anticipate these symptoms in an adolescent client with untreated Graves disease. Hyperglycemia, ketonuria, and glucosuria are clinical manifestations of diabetes. Weight gain, hirsutism, and muscle weakness are commonly associated with hypothyroidism. Dehydration, metabolic acidosis, and hypertension are not typically associated with Graves disease.

Question 5

Which changes should the school nurse implement to decrease the risk for the development of type 2 diabetes mellitus for a population who is identified as being at risk? Select all that apply.

Accepted Answer

Increasing daily physical activity, educating parents about the risk of obesity, and working with the cafeteria to decrease fat in the foods served can all help reduce the risk for type 2 diabetes mellitus. Testing each child's urine monthly and teaching parents to avoid administering aspirin to their children are not directly related to reducing the risk for type 2 diabetes mellitus.

Question 6

Which assessment finding would cause the nurse to question whether a preschool-age boy, diagnosed with phenylketonuria shortly after birth, is following the prescribed dietary restrictions?

Accepted Answer

A musty odor is a classic sign of untreated phenylketonuria, indicating that the child is not following the prescribed low-phenylalanine diet. Blue eyes and blond hair are not relevant to the diagnosis or management of PKU. Sleepiness and lack of interest in surroundings and sunburn are also not necessarily related to PKU or dietary restrictions.

Question 7

The home health nurse is visiting a 3-month-old infant who is diagnosed with congenital hypothyroidism and is prescribed daily levothyroxine. Which should the nurse include in the infant's continued plan of care?

Accepted Answer

Infants with congenital hypothyroidism are at risk for hypothermia due to their decreased metabolic rate. The nurse should emphasize the importance of keeping the infant adequately dressed and maintaining a warm environment. Stopping the medication or changing formula could have serious consequences for the infant's growth and development. Monitoring growth and development is important but not the only intervention needed for this condition.

Question 8

A child weighing
18)2 kg with a history of diabetes insipidus (DI) has been admitted to the hospital. Which healthcare provider prescription should the nurse question?

Accepted Answer

Children with diabetes insipidus require adequate hydration and fluid intake to prevent dehydration. Restricting oral fluids to only 500 mL every 24 hours would be harmful to the child and should be questioned by the nurse. The other options (A, B, and C) are appropriate interventions for a child with diabetes insipidus.

Question 9

A 5-year-old child with a history of hypopituitarism presents with complaints of right hip and leg pain. Which prescribed medication for the diagnosis should the nurse identify as the cause for the current symptoms?

Accepted Answer

Daily growth hormone can cause symptoms of hip and leg pain, especially if the child is growing rapidly. This may indicate a need for a dosage adjustment or close monitoring for side effects. Insulin and DDAVP do not typically cause these symptoms, and cortisone injections would be unlikely in a child with hypopituitarism.

Question 10

The nurse is teaching the caregiver of a child who is newly diagnosed with type 1 diabetes mellitus how to minimize pain with insulin injections. Which interventions should the nurse include in the teaching session? Select all that apply.

Accepted Answer

A) Using a new, sterile needle helps minimize pain and reduce the risk of infection.
B) Removing air bubbles from the syringe before injection reduces discomfort and ensures accurate dosing.
C) Having the child flex the muscle during injection can actually increase pain and discomfort.
D) Injecting cold insulin can cause pain and discomfort.
E) Changing the direction of the needle during insertion or withdrawal can cause pain and damage to the surrounding tissue.

Question 11

The nurse is providing information to an adolescent newly diagnosed with diabetes. Which clinical manifestations of diabetic ketoacidosis (DKA) should the nurse include in the teaching session? Select all that apply.

Accepted Answer

The answer of The nurse is providing information to an...

Question 12

Which action related to insulin administration should the nurse include in the teaching plan for an adolescent client who has been newly diagnosed with diabetes mellitus to avoid the development of lipoatrophy?

Accepted Answer

Lipoatrophy is a condition that occurs due to the breakdown of subcutaneous fat tissue at the injection site, resulting in a dent or a depression on the skin. This complication can be avoided by rotating injection sites. Therefore, rotating injection sites should be included in the teaching plan to prevent lipoatrophy. The other options - checking blood sugars, using a sliding scale, and administering insulin via an insulin pump - are important aspects of diabetes management but are not related to the prevention of lipoatrophy.

Question 13

A hospitalized child has been diagnosed with SIADH (syndrome of inappropriate antidiuretic hormone), a complication of his meningitis. Which laboratory data should the nurse anticipate for this child?

Accepted Answer

SIADH leads to increased ADH secretion, resulting in increased water retention and dilutional hyponatremia. Therefore, the nurse should anticipate hyponatremia in a child with SIADH. Hypocalcemia and hyperglycemia are not typically associated with SIADH. Hypernatremia is associated with a deficiency of antidiuretic hormone.

Question 14

An adolescent presents in the emergency department (ED) with confusion. The healthcare provider suspects diabetic ketoacidosis (DKA). A stat serum glucose is done, and the result is 7l5 mg/dL. Which clinical manifestations does the nurse anticipate upon assessment for this client?

Accepted Answer

The answer of An adolescent presents in the emergency department...

Question 15

Which prescription regarding an oral hydrocortisone for a toddler-age client diagnosed with congenital adrenal insufficiency should the nurse anticipate when the client is admitted to the hospital with pneumonia?

Accepted Answer

A client diagnosed with congenital adrenal insufficiency requires lifelong hormone replacement therapy with oral hydrocortisone to prevent adrenal crisis. During times of stress, such as infection or injury, the dosage of hydrocortisone should be increased to prevent adrenal crisis. Therefore, when the client is admitted to the hospital with pneumonia, the nurse should anticipate an increase in the dosage of oral hydrocortisone.

Question 16

Which food should the nurse remove from the food tray for a toddler-age client who is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)?

Accepted Answer

Clients with SIADH retain excess water and have low sodium levels. Watermelon has a high water content and would contribute to further fluid retention, making it a poor choice for a client with SIADH. Oatmeal, yogurt, and biscuits do not significantly impact fluid intake and can remain on the tray.

Question 17

Which teaching point should the nurse include when providing education to an adolescent client, who participates in soccer, regarding the plan of care for diabetes mellitus?

Accepted Answer

Adolescents who participate in sports, such as soccer, require increased food intake to meet the energy demands of the activity. It is important to balance food intake with insulin dosing to maintain blood glucose levels within the target range. Decreasing food intake or insulin doses can result in hypoglycemia, which can be dangerous during physical activity. The nurse should educate the client on the importance of monitoring blood glucose levels before, during, and after sports activities and adjusting insulin doses and food intake as needed to maintain blood glucose control.

Question 18

The nurse is providing care to a newborn female who is born with ambiguous genitalia. The follow-up investigation discovers adrenogenital syndrome (also called congenital adrenal hyperplasia [CAH]). The parents question why the baby's genitalia looks more male than female. Which response by the nurse is accurate?

Accepted Answer

Ambiguous genitalia in females with CAH is due to increased androgens, such as testosterone, which are produced because of a deficiency of cortisol. The excess androgens can cause masculinization of the female external genitalia. Option A is incorrect because the term "hermaphrodite" is outdated and considered offensive. Option C is incorrect because excessive cortisol would not cause enlargement of the female tissue, and it would not create a male appearance. Option D is incorrect because CAH is not a genetic disorder caused by a single sex chromosome abnormality.

Question 19

The nurse is providing care to a newborn who is suspected of having Turner syndrome. Which should the nurse assess the newborn for based on the current diagnosis?

Accepted Answer

Turner syndrome is associated with congenital heart anomalies, such as coarctation of the aorta, bicuspid aortic valve, and other structural heart defects. Club foot, hyperbilirubinemia due to liver abnormalities, and diaphragmatic hernia are not specifically associated with Turner syndrome.

Question 20

The nurse is caring for a child just admitted with diabetic ketoacidosis (DKA). Which healthcare provider prescription should the nurse question?
0)1 unit/kg per hour

Accepted Answer

NPH insulin should not be given intravenously as it can cause severe hypoglycemia and hypokalemia. The nurse should question this prescription and clarify with the healthcare provider.

Quiz 53: The Child With Alterations in Endocrine Function