NCLEX Child Health - Endocrine
The nurse is teaching parents of a diabetic child the signs/symptoms of hypoglycemia. Which signs/symptoms should the nurse include in the teaching session? Select all that apply.
1. Sweating 2. Dizziness 3. Trembling
The nurse is teaching parents of a child with diabetes mellitus about the difference between type 1 and type 2 diabetes mellitus. Which statements by the parents indicate understanding of the differences? Select all that apply.
1. The onset of diabetes is usually sudden with Type 1 2. Type 2 diabetes can be managed with oral hypoglycemics 3. Three symptoms of type 1 are polyuria, polydipsia and polyphagia.
The health care provider has prescribed a continuous insulin infusion to be initiated for a hospitalized child in diabetic ketoacidosis. The prescription is to administer regular insulin at a dosage of 0.1 units/kg/hr. Which is the correct dose if the child weighs 44 lb? Fill in the blank.
2 units
The nurse is planning care for a hospitalized child with syndrome of inappropriate antidiuretic hormone (SIADH). The health care provider has prescribed that the 24-hour fluid maintenance for the child weighing 12 kg be at ¾ of the maintenance. Using the formula what should the nurse plan as the 24-hour maintenance for this child? Refer to figure.
825 mL
The nurse is monitoring a child with type 1 diabetes mellitus for complications of the disorder. Which assessment data would be an indicator of the Somogyi effect in this child?
A 3:00 am blood glucose level of 60 mg/dL, followed by a 7:00 am blood glucose level of 180 mg/dL
The nurse is caring for an infant who has diarrhea. The nurse should monitor the infant for which early sign of dehydration?
Apical pulse rate of 200 beats per minute.
The nurse is assigned to give a child a tepid tub bath to treat hyperthermia. After the bath, which action should the nurse take?
Assist the child to put on a cotton sleep shirt.
Levothyroxine sodium (Synthroid) is administered to a hospitalized child with congenital hypothyroidism. The child vomits 10 minutes after administration of the dose. What is the best nursing action at this time?
Contact the health care provider.
The nurse is caring for a child with kidney disease and is analyzing the child's laboratory results. The nurse notes a sodium level of 148 mEq/L. On the basis of this finding, which clinical manifestation should the nurse expect to note in the child?
Dry, sticky mucous membranes.
A child's fasting blood glucose level ranges from 100 to 150 mg/dL daily. The before-dinner blood glucose levels range from 120 to 130 mg/dL with no reported episodes of hypoglycemia. Mixed insulin (NPH and regular) is administered before breakfast and before dinner. The nurse should make which interpretation based on this data?
Insulin doses are appropriate for food ingested and activity level.
A child's fasting blood glucose levels range between 100 and 130 mg/dL daily. The before-dinner blood glucose levels are between 110 and 120 mg/dL with no reported episodes of hypoglycemia. Both NPH and regular insulin are administered before breakfast and before dinner. Which analysis of data should the nurse make?
Insulin doses are appropriate for food ingested and activity level.
A 9-year-old child with type 1 diabetes mellitus is attending a band concert in the school gym. The child becomes flushed, hungry, and dizzy. The child goes to the nurse's office, and the nurse obtains a blood glucose level of 60 mg/dL. The nurse analyzes the assessment data and determines which intervention to be most appropriate
Make sure the child drinks a glass of orange juice.
A 3-year-old child is brought to the emergency department. The mother states that the child has had flu-like symptoms with vomiting and diarrhea for the past 2 days. On assessment, the nurse finds that the child's heart rate is slightly elevated and the blood pressure is normal. The child is irritable and crying few tears. The mother states that the child's weight before the illness was 33 pounds. The nurse finds the current weight to be 31 pounds. What level of dehydration should the nurse interpret that this child has?
Moderate Dehydration
The nurse is caring for a hospitalized child newly diagnosed with type 1 diabetes mellitus. At 11:00 a.m., the child suddenly complains of weakness, headache, and blurred vision. Which action should the nurse take immediately?
Obtain a glucose reading
The nurse determines that a child with type 1 diabetes mellitus is having a hypoglycemic reaction. The nurse should give the child which item to treat the reaction?
One-half cup of fruit juice
A mother and family of a 5-year-old newly diagnosed with diabetes mellitus are very concerned about the child going to school and participating in social events. What would be an appropriate goal to address this concern?
The child and family will integrate diabetes care into patterns of daily living
A mother of a 9-year-old child newly diagnosed with diabetes mellitus is very concerned about the child going to school and participating in social events. The nurse develops a plan of care and should formulate which goal?
The child and family will integrate diabetes care into patterns of daily living.
An adolescent client with type 1 diabetes mellitus is experiencing high glucose levels upon awakening in the morning. The nurse reviews the client's chart and determines the client is experiencing high glucose levels in the morning due to the Somogyi effect, if which is present? Refer to chart.
Glucose level at 2 am of 65 mg/dL
The nurse is planning to give a tepid tub bath to a child who has hyperthermia. Which action should the nurse plan to perform?
Have cool water available to add to the warm bath water.
Which clinical manifestations are consistent with infants who have congenital hypothyroidism? Select all that apply.
1. Hoarse Cry 2. Bradycardia 3. Constipation 4. Excessive sleeping
The clinic nurse is teaching an adolescent with type 1 diabetes mellitus about administration of insulin. Which statement by the adolescent indicates a need for further teaching? Select all that apply.
1. I should give my injections only in my thighs. 2. I should place any unopened vials in the freezer.
The nurse is assisting a school-aged client with type 1 diabetes mellitus to plan meals. Which recommendations should the nurse make to this client? Select all that apply.
1. Limit concentrated sweets. 2. Consume snacks between meals and at bedtime 3. Plan to eat a large snack during active times of the day.
A 10-year-old child in remission from leukemia is upset over the appearance of cushingoid characteristics from long-term use of corticosteroids, currently being administered every other day. Which therapeutic statements should the nurse make to the child about the cushingoid appearance? Select all that apply.
1. Which manifestations do you find most troublesome? 2. The manifestations are lessened by taking the prednisone every other day instead of daily. 3. The cushingoid appearance will gradually disappear once the corticosteroids are tapered and discontinued.
A 6-year-old child with diabetes mellitus is seen in the clinic for a routine examination. The nurse analyzes the data collected during the visit to determine whether the child was euglycemic since the last visit. Which assessment will provide reliable information about euglycemia?
A glycosylated hemoglobin
Propylthiouracil is prescribed for a child with Graves' disease, and the nurse provides instructions to the mother regarding the side/adverse effects of the medication. Which statement by the mother indicates a need for further teaching?
A yellow discoloration of the skin may occur but will disappear when the medication is discontinued.
A school-aged child with type 1 diabetes mellitus who is taking insulin is seen in the health care clinic. The nurse develops a teaching plan for the child regarding food and exercise, because the child has told the nurse that she will begin soccer practice. Which instruction should the nurse provide to the child?
Eat an extra snack of carbohydrates before the soccer starts.
A 16-year-old client is admitted to the hospital with hyperglycemia from failure to follow a diet, insulin, and glucose monitoring regimen. The client states, "I'm fed up with having my life ruled by doctors' prescriptions and drugs." The nurse identifies that the client is experiencing which problem?
Failure to care for self because of feelings of loss of control.
The nurse is admitting an infant with gastroenteritis to the hospital for treatment of dehydration. The nurse notes that the health care provider has documented that the infant is mildly dehydrated. The nurse should expect to note which assessment finding in the infant?
Pale skin color
A toddler who is dehydrated from vomiting after receiving his weekly dose of chemotherapy asks the nurse for something to drink. Which beverage is appropriate for the nurse to offer this child?
Pedialyte
The nurse has provided information to the parents of a child with congenital hypothyroidism about the disorder and care of the child. Which statement by the parents indicates the need for further information?
The only reason that this condition could have happened to my child is because i took asthma medicine while i was pregnant.
The nurse is planning the hospital discharge of a young client who has been newly diagnosed with type 1 diabetes mellitus. The client tells the nurse that she is concerned about self-administering insulin while in school with other students around. Which statement by the nurse best supports the client's need at this time?
You could contact the school nurse, who could provide a private area for you to administer your insulin.
The nurse is planning care for a child with type 1 diabetes mellitus. Which items should the nurse plan to provide to treat an early mild hypoglycemic episode? Select all that apply.
1. Orange Juice 2. Glucose tablets 3. Candy
The nurse is planning care for a pediatric client experiencing thyrotoxicosis (thyroid storm). Which prescribed medications should the nurse plan to administer? Select all that apply.
1. Propanolol 2. Atenolol 3. Tapazole
The nurse has provided instructions to the parents of a child with diabetes mellitus about management of hypoglycemia. The nurse determines that the family understands the instructions if they indicate that they will take which action?
Have the child carry LifeSavers with him whenever he leaves the home.
