Chapter 31 Endocrine Disorders Adaptive Quizzing

The nurse is taking a history on a 10-year-old child who has a diagnosis of hypopituitarism. Which question is important for the nurse to ask the parents? "Does your child get upset about being taller than friends?" "Is your child taking vasopressin IM or SC?" "What time each day does your child take his growth hormone?" "How often do you test your child's blood glucose?"

"What time each day does your child take his growth hormone?"

A newborn exhibits significant jittery movements, convulsions, and apnea. Hypoparathyroidism is suspected. What would the nurse expect to be administered? Calcium gluconate Levothyroxine Hydrocortisone Desmopressin

Calcium gluconate Explanation: Intravenous calcium gluconate is used to treat acute or severe tetany

A child is undergoing diagnostic testing for an endocrine dysfunction. The results indicate excessive levels of circulating cortisol. The nurse interprets this finding as indicating which of the following? Turner syndrome Graves disease Cushing syndrome Addison disease

Cushing syndrome Explanation: Cushing syndrome is a characteristic cluster of signs and symptoms resulting from excessive levels of circulating cortisol

After teaching the parents of a child with central precocious puberty about medication therapy, which statement by the parents indicates successful teaching? "Our child needs to use the nasal spray once every day." "Once therapy is done, our child will need surgery." "This medicine will reverse the symptoms and onset of puberty." "Our child will start puberty again when the medication stops."

Our child will start puberty again when the medication stops."

The nurse is caring for a 10-year-old boy with hyperpituitarism due to a tumor on the anterior pituitary gland. Which would be a priority nursing action? Promoting a healthy body image Providing pre- and postoperative care Encouraging effective family coping Promoting knowledge about treatment options

Providing pre- and postoperative care

A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer? NPH Regular insulin Lispro Detemir

Regular insulin Explanation: Insulin for diabetic ketoacidosis is given intravenously. Only regular insulin can be administered by this route.

A 19-year-old client with hypothyroidism asks the nurse if she will need to take thyroid medication during her pregnancy. The nurse's response is based on the knowledge that It is more difficult to maintain thyroid regulation during pregnancy due to the slowing of metabolism. Fetal growth is arrested if the thyroid medications are continued during pregnancy. There is no need to take a thyroid medication because the fetus's thyroid produces thyroid-stimulating hormone. Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy.

Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy.

The nurse is caring for 1-month-old girl with thyrotoxicosis. What finding would the nurse expect to assess? Skin is cool, dry, and scaly to the touch. The child is hypoactive and hypotonic. Observation reveals lethargy and irritability. The child has a strong appetite but fails to thrive.

The child has a strong appetite but fails to thrive. Explanation: Infants with thyrotoxicosis may display hyperphagia but fail to gain weight.

A hospitalized child with DiGeorge Syndrome has a low calcium level, a high phosphorus level, a low potassium level, and a low magnesium level. Based on these results, what is the priority of care for this child? administer phosphate binders correct the low magnesium administer calcium correct the low potassium

administer calcium Explanation: DiGeorge Syndrome is a genetic defect that is manifested by hypoplasia of the thymus and the parathyroid glands.

The nurse is preparing a teaching plan for the family and their 6-year-old child who has just been diagnosed with diabetes mellitus. What would the nurse identify as the initial goal for the teaching plan? developing management and decision-making skills evaluating the child's literacy level and readiness to learn promoting independence with self-administration of insulin developing a nutritionally sound, 30-day meal plan

developing management and decision-making skills

The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. In caring for a child that has issues with the anterior pituitary, the nurse knows that this child has issues with which hormone? growth hormone oxytocin vasopressin antidiuretic hormone

growth hormone

A school-aged girl is diagnosed as having Cushing syndrome from long-term therapy with oral prednisone. This means that the child: is excessively tall for her age. has hypoglycemia. has purple striae on her abdomen. appears pale and fatigued.

has purple striae on her abdomen

The child is diagnosed with hypocalcemia. The nurse should assess the child for which possible complication? neurologic deficiencies kidney failure cardiac arrhythmias urinary tract disorders

neurologic deficiencies

The nurse is caring for a child recently diagnosed with hypoparathyroidism disorder. Which medication would the nurse expect to be ordered? oral corticosteroids intravenous diuretic therapy oral calcium oral potassium

oral calcium

An 8-year-old child is seen for moodiness and irritability. The child has begun to develop breast and pubic hair and the parents are concerned that these changes are occurring at too early an age. Which would the nurse suspect? adrenal hyperplasia neurofibromatosis precocious puberty pseudopuberty

precocious puberty

The nurse is teaching a group of caregivers of children diagnosed with diabetes mellitus. The nurse is explaining insulin shock and the caregivers make the following statements. Which statement indicates the best understanding of a reason an insulin reaction might occur? "She monitors her glucose levels to keep them from going too high." "He measures his own medication but sometimes doesn't administer the correct amount." "If my child eats as much as her older brother eats she could have an insulin reaction." "On the weekends we encourage him to participate in lots of sports activities and stay busy so he doesn't have an insulin reaction."

"He measures his own medication but sometimes doesn't administer the correct amount."

A child and parents are being seen in the office after discharge from the hospital. The child was newly diagnosed with type 2 diabetes. When talking with the child and parents, which statement by the nurse would be most appropriate? "Young people can usually be managed with an oral agent, meal planning, and exercise." "You are lucky that you did not have to learn how to give yourself a shot." "A weight-loss program should be implemented and maintained." "This will rectify itself if you follow all of the doctor's directions."

"Young people can usually be managed with an oral agent, meal planning, and exercise."

Question 7 of 10 Which adolescents may have delayed puberty? Select all that apply. 14-year-old male who has no pubic hair 13-year-old male who has no changes in the appearance of his scrotum 15-year-old male who has had no changes to the size of testicles 14-year-old female who has not developed breasts 13-year-old female who has no pubic hair

14-year-old female who has not developed breasts 15-year-old male who has had no changes to the size of testicles

The primary health care provider has ordered a thyroid scan to confirm the diagnosis of hyperthyroidism. Which would the nurse do before the scan? Tell the client he or she will be asleep. Give the client a bolus of fluids Insert a urinary catheter. Assess the client for allergies.

Assess the client for allergies.

Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism? Normal T4 level and low TSH level Normal TSH level and high T4 level High thyroxine (T4) level and low thyroid stimulating hormone (TSH) level Low T4 level and high TSH level

Low T4 level and high TSH level

A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy? reports of headaches height increase of 4 inches growth plate closure rapid weight gain

height increase of 4 inches

A client is being treated for hyperthyroidism with propylthiouracil. The nurse suspects the client's dose of medication is inadequate when assessing which signs and/or symptoms? Select all that apply. diarrhea irritability fever tachycardia cold intolerance

tachycardia diarrhea fever irritability

A 15-year-old girl has had type 1 diabetes since she was 2 years old. She recently began dialysis and is also struggling with exhaustion. She has been hospitalized with an infection and confides to the nurse that she feels hopeless due to her failing health. How should the nurse respond? "What do you think would help you feel better or improve your situation?" "After we get the infection under control, you will start feeling better." "Have you talked with your parents about the things that concern you?" "Would you like to help me create your daily schedule while you are here?"

"What do you think would help you feel better or improve your situation?"

The nurse is speaking with the parents of a child recently diagnosed with hypothyroidism. Which statement by a parent indicates an understanding of symptoms of this disorder? "Most people with hypothyroidism have smooth, velvety skin." "When they get my son's thyroid levels normal, he won't be so tired." "My son's nervousness may be a symptom of his hypothyroidism." "Heat intolerance is a caused by low thyroid levels."

"When they get my son's thyroid levels normal, he won't be so tired."

When discussing care of an infant with congenital hypothyroidism, you would stress that the infant will need: administration of levothyroxine for a lifetime. administration of vitamin C until after growth is complete. an increased intake of calcium beginning in infancy. vitamin K administration until school age.

administration of levothyroxine for a lifetime.

Assessment of a newborn reveals that the child has hypothyroidism. How does the nurse document this finding? autoimmune thyroiditis congenital hypothyroidism secondary hypothyroidism acquired hypothyroidism

congenital hypothyroidism

A nurse is to see a child. Assessment reveals the chief complaints of urinating "a lot" and being "really thirsty." The nurse interprets these symptoms as being associated with which condition? precocious puberty hypopituitarism syndrome of inappropriate antidiuretic hormone secretion diabetes insipidus

diabetes insipidus

A child is diagnosed with hyperthyroidism. Which agent would the nurse expect the physician to prescribe? Methimazole Dexamethasone Mineralocorticoid Levothyroxine

Methimazole Explanation: Methimazole is an antithyroid drug that is used to treat hyperthyroidism.

Which findings should the nurse expect to assess when completing the health history of a child admitted for possible type 2 diabetes? Select all that apply. Polyuria Marked weight loss Polyphagia Abrupt onset of symptoms Polydipsia

Polyuria Polydipsia Polyphagia

The nurse is teaching a 12-year-old girl with type 2 diabetes mellitus and her parents about dietary measures to control her glucose levels. Which comment by the child indicates a need for additional teaching? "I can have nonfat milk to drink." "I can eat two small cookies with each meal." "I can have an apple or orange for snacks." "I will be eating more breads and cereals."

"I can eat two small cookies with each meal."

A 10-year-old child has been diagnosed with type 1 diabetes mellitus. The child is curious about the cause of the disease and asks the nurse to explain it. Which explanation will the nurse provide? "The pancreas inside your belly makes enough chemical called insulin, but your body does not want to use it to keep your blood sugar level normal." "Special cells in a part of your body called the pancreas cannot make a chemical called insulin, which helps control the sugar level in your blood." "The alpha and beta cells in your pancreas are fighting against each other; that is why your blood sugar stays high and you need insulin injection." "The part of your body called the pancreas is broken and produces too much chemical called glucagon, which makes you really thirsty and have to go to the bathroom a lot."

"Special cells in a part of your body called the pancreas cannot make a chemical called insulin, which helps control the sugar level in your blood."

An infant on the pediatric floor has diabetes insipidus. Which assessment data are important for the nurse to monitor while the infant is on strict fluid precautions? Urine output Color of mucous membranes Temperature and heart rate Oral intake

Urine output

A newborn girl is discovered to have congenital adrenal hyperplasia. When assessing her, the nurse would expect to find which physical characteristic? Small for gestational age Abnormal facial features Divergent vision Enlarged clitoris

Enlarged clitoris Explanation: Lack of production of cortisol by the adrenal gland leads to overproduction of androgen. This leads to female infants developing an enlarged clitoris.

The nurse is caring for a 12-year-old girl with a chronic endocrine condition that has resulted in weight gain, facial hair, and acne. During a routine examination, the girl confides that she doesn't participate in any extracurricular activities or have any social life because she is so unattractive. She feels it is pointless to get involved with anything or anyone because she is always going to be "fat and ugly." When responding to the girl, which of the following would be the priority? Assisting the girl with methods to enhance her physical appearance Exploring the girl's perception of her body image and health status Discussing ways to highlight good feelings about herself Suggesting the girl speak to a counselor about her feelings

Exploring the girl's perception of her body image and health status

A woman in her first trimester of pregnancy has just been diagnosed with acquired hypothyroidism. The nurse is alarmed because this condition can lead to which pregnancy complication? Gestational diabetes in the mother Congenital heart defects in the fetus Decreased cognitive development of the fetus Spina bifida in the fetus

Decreased cognitive development of the fetus Explanation: If acquired hypothyroidism exists in a woman during pregnancy, her infant can be born intellectually disabled, because there was not enough iodine present for fetal growth. It is important, therefore, that girls with this syndrome be identified before they reach childbearing age.

The parents of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. What finding would lead the nurse to suspect that the child is experiencing an acute adrenal crisis? Hyperkalemia Hypernatremia Bradycardia Hypertension

Hyperkalemia Explanation: Signs and symptoms of an acute adrenal crisis include hyperkalemia, hyponatremia, tachycardia, hypotension, persistent vomiting, dehydration, and shock.

During a visit to the clinic, the adolescent client with hypothyroidism tells the nurse that she takes her levothyroxine "whenever I think about it...sometimes I miss a dose, but not very often." What is the best response by the nurse? "As long as you are missing multiple doses it should be fine. Just as long as you take the levothyroxine at some point each day." "Maybe you could do something to remind yourself to take the medication on a daily basis." "If you forget a dose you can double up the next day. We just want your thyroid level to be maintained since you don't produce enough thyroid hormone." "I know it's hard to remember medicines, but it is really important for you to take it before breakfast each day to control your hypothyroidism."

Lispro Humulin R Humulin N Lantus Explanation: Lispro is a rapid-acting insulin. Humulin R is a short-acting insulin. Humulin N is an intermediate-acting insulin. Lantus is a long-acting insulin.