Prep U QC: Metabolic/ endocrine/ genetic

The health care provider has prescribed a thyroid scan to confirm a diagnosis. What intervention should the nurse perform before the examination?

Assess the client for allergies.

The nurse is preparing the care plan regarding medication therapy for a client with hyperpituitarism. The child is receiving dexamethasone. What interventions should the nurse add to the care plan? Select all that apply.

Do not abruptly stop administering medication. Monitor client for edema. Monitor client for high glucose levels.

The nurse provides education to the parents of a female child with Fragile X syndrome. Which statement made by the family demonstrates an understanding of this disorder?

"A normal life span is expected."

Which of the following women has the greatest risk of having a child with Down syndrome?

42-year-old

A child admitted for gastritis and vomiting has a medical history of medium-chain acyl-coA dehydrogenase (MCAD) deficiency. What is the priority action by the nurse?

Administer IV dextrose per orders.

The nurse knows that which condition is caused by excessive levels of circulating cortisol?

Cushing syndrome

Rank the different types of insulin based on their duration of action beginning with the shortest to the longest duration.

Lispro Humulin R Humulin N Lantus

A 9-year-old male is coming into the office to be seen for possible precocious puberty. The nurse would expect that the lab will perform which test?

hCG test

The nurse is caring for an adolescent male in the clinic after a diagnosis of Klinefelter syndrome. What nursing action would be appropriate for the nurse? Select all that apply.

Assess the child for the presence of decreased facial hair. Provide information about Klinefelter syndrome support groups. Discuss the need for hormone replacement therapy.

An infant was born with a genetic condition. The nurse is obtaining a neonatal health history from the parents. Which question(s) will the nurse ask the parents? Select all that apply.

"Did your infant require staying under the warmer or in an incubator to stay warm?" "Have you had problems feeding your infant?" "Has your infant ever experienced a seizure?" "Do you ever feel like your infant's muscle tone is not good?"

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?

"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."

The nurse is providing discharge education to the parents of an infant newly diagnosed with phenylketonuria (PKU). Which statements made by the parents demonstrate an understanding of the education? Select all that apply.

"Our child will always need to be on a reduced phenylalanine diet." "Formula options are available that contain low levels of phenylalanine."

After explaining the causes of hypothyroidism to the parents of a newly diagnosed infant, the nurse should recognize that further education is needed when the parents ask which question?

"So, hypothyroidism can be treated by exposing our baby to a special light, right?"

A nurse is discussing genetic screening with a client who gave birth yesterday. Which statement by the nurse best explains the reason for genetic screening?

"This will help to detect for possible inborn errors of metabolism such as phenylketonuria (PKU)."

A 16-year-old recently diagnosed with Marfan syndrome states, "I feel fine. Why do I need to have this testing done?" What is the best response by the nurse?

"You are at risk of rupturing your aorta, and the echocardiogram will let us know if there are any problems."

The nurse is describing some of the developmental milestones the mother of a 3-month-old boy with Down syndrome can expect to see in her child. Which statement describes the milestones that are expected in a child with Down syndrome?

"You can expect him to eat with his hands by age 12 months."

The nurse is reviewing the recommended diet with the parents and child who was diagnosed with type 2 diabetes. The nurse determines that the parents and child understand the information when they identify that they will restrict carbohydrate intake to which amount at each of the three main meals?

45 grams

For a diagnosis of Klinefelter syndrome, what would be the chromosome pattern to identify this disorder?

47, XXY

A 10-year-old child is newly diagnosed with type 1 diabetes. The child's hemoglobin A1C level is being monitored. The nurse determines that additional intervention is needed with the child based on which result?

8.5%

The nurse is providing acute care for an 11-year-old boy with hypoparathyroidism. Which intervention is priority?

Administering intravenous calcium gluconate as ordered.

The nurse is caring for a 14-year-old boy with hyperpituitarism. What would be the priority treatment?

Administering octreotide acetate as ordered

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?

Decreased cognitive development of the fetus

A 4-year-old diagnosed with diabetes insipidus is being discharged. Which information below is most important to emphasize to the parents?

Diabetes insipidus is different from diabetes mellitus.

The nurse is caring for a client at 15 weeks' gestation who received an ultrasound. The results of the ultrasound show abnormal kidneys and a heart abnormality. Which intervention should occur next?

Discuss prenatal testing with the client.

A child is admitted to the pediatric medical unit with the diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Based on the typical signs and symptoms of this disorder, which nursing diagnosis will the nurse identify as relating to this client?

Excess fluid volume

A 12-year-old is being seen in the office and has hyperthyroidism; the nurse knows that the most common cause of hyperthyroidism is:

Graves disease

The nurse is reviewing expectations of care with the parents of a newborn with Down syndrome. What will the nurse include as recommendations? Select all that apply.

Hearing tests should be completed regularly. Regular vision assessment should be performed.

A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy?

Height increase of 4 inches

The nurse is caring for an adolescent client with a genetic disorder with the following assessment data: large head, long face, prominent ears, flat feet, flexible joints, and a short attention span. Which facts are true for the suspected genetic disorder? Select all that apply.

It has an X-linked dominant inheritance pattern. Focus of care is on developmental therapies.

A child with Addison disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids. Which intervention would the nurse implement?

Take glucometer readings as ordered.

A 6 year old boy who has intellectual disability secondary to fragile-X syndrome has been admitted to hospital with a mitral valve prolapse. A health care worker who is providing care for the family should have which statement as part of her knowledge base around the disease?

The boy will pass the gene to all his future daughters who will become carriers.

The nurse is preparing a child suspected of having a thyroid disorder for a thyroid scan. What information regarding the child should the nurse alert the doctor or nuclear medicine department about?

The child is allergic to shellfish.

The nurse is caring for a 6-year-old girl who has been diagnosed with neurofibromatosis. What is the priority intervention?

Urging the parents to schedule yearly physical examinations.

The nurse is obtaining an admission history of a school-aged child on the pediatric unit. The child says, "My mom won't let me play football or soccer, but I am really good at swimming and chess club." The nurse would review the child's medical record for what disorder?

VATER syndrome

A child with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. Which action would be the priority?

checking vital signs

A newborn is born with hypothyroidism. If it is not recognized and treated, what complication is likely?

cognitive impairment

The nurse cares for a newborn diagnosed with choanal atresia. What nursing intervention(s) will be important for the nurse to implement? Select all that apply.

∙ elevate the head of the bed ∙ initiate aspiration precautions ∙ allow nonnutritive sucking ∙ insert a peripheral IV

The nurse is caring for a client with trisomy 21. Which diagnostic procedures are recommended for potential complications with trisomy 21? Select all that apply.

echocardiogram ultrasound sleep apnea test

Which sign or symptom reported by a parent would not be consistent with a child diagnosed with CHARGE syndrome?

enlarged testes

After teaching a class of students about genetics and inheritance, the instructor determines that the teaching was successful when the students identify this as the basic unit of heredity.

gene

The nurse is examining a 2-year-old girl with VATER association. Which sign or symptom should be noted?

history of corrective surgery for anal atresia

The nurse is interpreting the negative feedback system that controls endocrine function. What secretion will the nurse correlate as decreasing while blood glucose levels decrease?

insulin

The 14-year-old boy may have Klinefelter syndrome. Which findings should the nurse expect? Select all that apply.

∙ significant amount of breast tissue ∙ smaller than normal scrotum ∙ diagnosis of dyslexia

One of the characteristic signs in prepubertal males with fragile X syndrome is:

macro-orchidism.

The nurse measures the client's blood glucose level prior to breakfast. The measurement obtained is 130 mg/dl. The orders read to administer 2 units of Humalog insulin for a blood glucose of 100 to 150 mg/dl. How soon should the nurse ensure that the client eats breakfast after receiving insulin?

within 15 to 30 minutes

A nurse is assessing a child and finds several major congenital anomalies. What might the nurse find? Select all that apply.

• Limb asymmetry • Cardiac conduction disorder • Cleft lip

A nurse is caring for a client with the karyotype shown above. Which clinical characteristic(s) should the nurse expect to find? Select all that apply.

∙ close-set eyes ∙ cleft lip ∙ low-set ears

A group of students are reviewing information about oral diabetic agents. The students demonstrate understanding of these agents when they identify which agent as reducing glucose production from the liver?

Metformin

A child is diagnosed with diabetes insipidus (DI) and will start on the medication desmopressin. Which instruction(s) would the nurse include in teaching the parent about administering this drug? Select all that apply.

Monitor the urine specific gravity while the child is taking the drug. Clear the nostrils before administering the drug. Keep the drug refrigerated. If the child sneezes, repeat the dose administration.

The nurse is assessing a 7-year-old girl with a headache, irritability, and vomiting. Her health history reveals she has had meningitis. Which intervention is priority?

Notifying the physician of the neurologic findings.