Peds 17 Endocrine Disorders

The parent of a client with congenital adrenal hyperplasia is concerned because the client is experiencing a high fever. Which should the nurse respond to the parent? "Withhold all food and fluids." "Check all urine for glucose level." "Seek immediate medical attention." "Follow stress dosing medication guidelines."

"Follow stress dosing medication guidelines."

The nurse instructs an adolescent client and the parents on a beta blocker medication prescribed for hyperthyroidism. Which statement indicates that teaching about the medication was effective? "I won't need surgery if I take this medication." "This will make my thyroid gland shrink in size." "This will help my rapid heartbeat and nervousness." "This reduces the amount of thyroid hormone in my body."

"This will help my rapid heartbeat and nervousness."

The nurse teaches the parents of a school-age child with diabetes insipidus (DI). Which statement indicates that teaching was effective? "We should expect our child's skin to be dry." "A lack of tears when crying indicates the medication is effective." "A dry mouth is expected as an effect of the medication." "We will make sure the medication is taken the same time every day."

"We will make sure the medication is taken the same time every day."

The nurse instructs the parents of a client with adrenal insufficiency on actions to prevent an Addisonian crisis. Which statement indicates that additional teaching is required? "We've ordered a medical alert bracelet already." "We've shared all of the information with the school nurse." "We will give a dose of the steroid if symptoms of an infection occur." "We will restrict fluid and salt before our child plays soccer after school."

"We will restrict fluid and salt before our child plays soccer after school."

The nurse instructs the parents of a toddler with type 1 diabetes mellitus. Which statement indicates that additional teaching about sick day rules is required? Select all that apply. "We will not encourage fluids." "We will not give the regular dose of insulin." "We will monitor blood glucose levels frequently." "We will not give any over-the-counter medications." "We will call the health care provider for help if needed."

1,2

A client is diagnosed with a health problem affecting the medulla of the adrenal glands. Which manifestation should the nurse expect to assess in this client? Select all that apply. Dilated pupils Increased heart rate Increased respiratory rate Hyperactive bowel sounds Increased blood glucose level

1,2,3

An 18-month-old client is scheduled for a routine wellness visit. Which should the nurse include when assessing this client? Select all that apply. Remove diaper before weighing Place supine to measure height Prepare the stadiometer Measure head circumference Calculate body mass index

1,2,4

The nurse is assessing a 12-year-old client with hyperthyroidism. Which finding indicates that the client may be experiencing an adverse effect of antithyroid medication? Select all that apply. Hair loss Skin rash Extreme thirst Change in hair color Elevated body temperature

1,2,4,5

A toddler is experiencing delayed dental eruption and decreased muscle mass. Which diagnostic test should the nurse expect to be prescribed for this client? Select all that apply. MRI of the head Serum cortisol level Serum sodium level 24-hour urine collection Bone x-ray of the left hand and wrist

1,2,5

The nurse instructs the parents of a client with syndrome of inappropriate antidiuretic hormone (SIADH) on care at home. Which statement indicates that teaching was effective? Select all that apply. "Popsicles will not be offered." "A small weight gain is expected." "Any confusion or irritability should be reported." "A medical alert bracelet has been ordered." "Foods will be prepared that are high in salt and protein."

1,3,4,5

A school-age client is diagnosed with neurogenic diabetes insipidus (DI). For which medication should the nurse preparing teaching for this client and the parents? Select all that apply. Diuretic Dopamine agonist Vasopressin analog Somatostatin analog Cyclooxygenase inhibitor

1,3,5

A preschool-age client is suspected of having adrenal insufficiency. Which finding should the nurse expect when assessing this client? Select all that apply. Hypertension Weight loss Tanned skin Black freckles Loss of appetite

2,3,4,5

During a home visit, the nurse determines that a parent needs additional teaching about medication prescribed to treat a newborn's hypothyroidism. Which observation caused the nurse to provide additional instruction? Select all that apply. Mixed crushed medication with water Mixed crushed medication in soy formula Placed crushed medication in a feeding bottle Used a needleless syringe to administer the medication Prepared two doses of the medication with the morning bottle

2,3,5

A 7-year-old child with true central precocious puberty is prescribed leuprolide acetate (Lupron Depot Pediatric). Which should the nurse keep in mind when preparing teaching about this medication? Select all that apply. The maximum dose is 20 mg The beginning dose is 3.75 mg The medication must be given intravenously Dosages are increased according to body weight Intramuscular injection is a route of administration

2,4,5

The nurse is teaching about the structure and functions of the endocrine system. Which hormone should the nurse identify that is controlled by the hypothalamus? Select all that apply. Oxytocin Prolactin Growth hormone Thyroid-releasing hormone Corticotropin-releasing hormone

4,5

During a home visit during lunch, the nurse determines that a school-age child and the parents require additional teaching regarding the treatment of hypoparathyroidism. Which did the nurse observe to make this clinical determination? Spinach and romaine lettuce in the salad A glass of soda poured to have with lunch Sliced cheese and crackers placed on the table Salad prepared with oil and lemon juice dressing

A glass of soda poured to have with lunch

The nurse is preparing a teaching plan for the family of a pediatric client with type 2 diabetes mellitus. Which information should the nurse emphasize? Technique to administer insulin Prevention of diabetic ketoacidosis Actions to reduce a sedentary lifestyle Importance of maintaining current weight

Actions to reduce a sedentary lifestyle

A pediatric client is prescribed an insulin injection. Which should the nurse do when preparing the medication? Measure the client's current weight Assess the client's current blood glucose level Ask another nurse to verify the dose placed in the syringe Check to see which location the last dose was administered

Ask another nurse to verify the dose placed in the syringe

A school-age child is diagnosed with type 1 diabetes mellitus. Which should the nurse expect when assessing this client? Weight gain Blurred vision Abdominal distention Muscle and joint pain

Blurred vision

The nurse is preparing material for a prenatal class. Which hormone should the nurse identify that is produced by the developing embryo? Relaxin Estrogen Progesterone Human chorionic gonadotropin

Human chorionic gonadotropin

An adolescent client has a blood pressure of 210/110 mm Hg and is experiencing tachycardia, palpitations, and weight loss. Which health problem should be ruled out before treatment for pheochromocytoma is started? Hypothyroidism Hyperthyroidism Adrenal insufficiency Congenital adrenal hyperplasia

Hyperthyroidism

During a routine wellness assessment the nurse notes that a 10-year-old client has an area of dark pigmentation on the axilla and arms. Which additional measurement should the nurse complete to determine if type 2 diabetes mellitus is present? Weight Blood pressure Oxygenation level Capillary blood glucose level

Capillary blood glucose level

The nurse is planning care for a pre-adolescent client newly diagnosed with type 1 diabetes mellitus. Which should be the focus when providing nutrition teaching to this client? Fat reduction Weight reduction Protein restriction Carbohydrate exchanges

Carbohydrate exchanges

The parent of a 12-year-old client taking steroids for asthma is concerned about the child's weight gain and mood swings. Which should the nurse consider is occurring with this client? Depression Cushing syndrome Oxygen deprivation Type 2 diabetes mellitus

Cushing syndrome

A 6-year-old child develops hair loss, constipation, and extreme fatigue. For which health problem should the nurse assess this client? Hypothyroidism Hyperthyroidism Myxedema Hypoparathyroidism

Hypothyroidism

A 7-year-old client receiving somatropin (Genotropin) is experiencing knee and ankle pain. Which should the nurse expect to be prescribed for this client? Discontinue the medication Increase the dose of medication Decrease the dose of medication Change the route to administer the medication

Decrease the dose of medication

The nurse suspects that an adolescent with type 1 diabetes mellitus is experiencing diabetic ketoacidosis (DKA). Which finding caused the nurse to make this clinical determination? Slow heart rate Extreme hunger Deep and laborious respirations Slightly elevated blood pressure

Deep and laborious respirations

A 7-year-old female client is diagnosed with premature adrenarche. Which should the nurse expect to assess in this client? Onset of menstruation Increased growth velocity Development of pubic, axillary, and body hair Unilateral breast development with areolae maturation

Development of pubic, axillary, and body hair

The nurse is concerned that a 3-year-old client is experiencing nephrogenic diabetes insipidus (DI). Which finding caused the nurse to have this concern? Diarrhea Itchy skin Dilute urine Constipation

Dilute urine

The nurse is concerned that an adolescent client is experiencing hypoglycemia. Which finding caused the nurse to make this clinical determination? Dizziness Stomach pain Extreme thirst Frequent urination

Dizziness

A school-age client with type 1 diabetes mellitus has little league baseball games at 1700 hours several times a week. Which should the parents and client be instructed to do before games? Drink 16 ounces of water before starting the game Withhold providing the routine insulin dose until after the game is over Eat a complex carbohydrate and protein between 1600 and 1630 hours Ingest a serving of a rapid acting glucose source immediately before the game begins

Eat a complex carbohydrate and protein between 1600 and 1630 hours

The nurse is concerned about a family with a 5-year-old child with hypopituitarism. Which observation caused the nurse to have this concern? Putting on knee pads before roller skating Feeding the child a snack at the kitchen table Helping apply a helmet before riding a bicycle Holding the child's hand when crossing the street

Feeding the child a snack at the kitchen table

An 8-year-old child with tanned-appearing skin and intense salt cravings has a serum cortisol level of 4.5 mg/dL. Which should the nurse expect to be prescribed for this client? Fluid restriction Intravenous fluids Glucose replacements Further diagnostic tests

Further diagnostic tests

A 6-month-old client is recovering from meningitis. Which hormone level should the nurse expect to be assessed in this client? Growth hormone Luteinizing hormone Thyroid-stimulating hormone Adrenocorticotrophic hormone

Growth hormone

A 3-year-old male client is diagnosed with congenital adrenal hyperplasia. For which health problem should the nurse plan care for this client? Pheochromocytoma Adrenal insufficiency True precocious puberty Incomplete precocious puberty

Incomplete precocious puberty

A 10-day-old infant with hypothyroidism is beginning treatment. Which should the nurse expect when assessing this client? Jaundice Weight loss Tachycardia Elevated blood pressure

Jaundice

A school-age child is newly diagnosed with type 1 diabetes mellitus. Which should the nurse instruct the client and parents to do in preparation for an upcoming endocrinologist appointment? Restrict the intake of fluids Keep a log of blood glucose measurements Withhold taking the prescribed insulin dose Eat several additional servings of a carbohydrate

Keep a log of blood glucose measurements

The nurse is reviewing laboratory results for a school-age client. For which finding should the nurse prepare teaching about hypothyroidism? Low serum T3 Low serum T4 Elevated serum T3 Elevated serum T4

Low serum T4

A 4-year-old child with an edematous face and swollen tongue is brought to the community clinic for health care. Which action should the nurse take first to validate if the client is experiencing myxedema? Determine blood oxygen level Evaluate level of consciousness Evaluate current height and weight Measure capillary blood glucose level

Measure capillary blood glucose level

A spasm occurs when the nurse taps the facial nerve of a 3-month-old client. Which should the nurse use when documenting this finding? Pain level 10 Absence of pain Positive Chvostek sign Negative Chvostek sign

Positive Chvostek sign

A 15-year-old female client is diagnosed with kidney stones. Which teaching should the nurse prepare for this client and the family? Actions to prevent infection Preoperative parathyroidectomy Dietary changes to reduce diarrhea Supplementation with calcium and vitamin D

Preoperative parathyroidectomy

An adolescent client is recovering from surgery to remove a pheochromocytoma. Which room assignment would be the most beneficial for this client? Private room near the nurse's station Semi-private room with a school-age child Semi-private room with an adolescent with a wound infection Semi-private room with a young adult experiencing severe pain

Private room near the nurse's station

A client with type 1 diabetes mellitus is flushed with dry skin and reports eating a large serving of pasta for lunch. Which action should the nurse take? Instruct to lie down Provide with a large glass of water Measure blood pressure and heart rate Prepare an additional dose of prescribed insulin

Provide with a large glass of water

A school-age client has a blood glucose level of 60 mg/dL. Which direction should the nurse provide the parent after giving the client 6 ounces of regular soda? Provide a protein Seek immediate medical attention Encourage to drink several glasses of water Recheck the blood glucose level in 15 minutes

Recheck the blood glucose level in 15 minutes

A 2-month-old client has a low level of insulin-like growth factor 1 (IGF-1). Which should the nurse expect to be prescribed for this client? Growth hormone replacements Repeat the laboratory measurement MRI of the thyroid and adrenal glands Intravenous infusion of a glucose solution

Repeat the laboratory measurement

The nurse is reviewing the endocrine system with the parents of a toddler. Which should the nurse explain as the role of mineralocorticoids? Retain sodium Secrete insulin Aid in stress reduction Suppress the immune system

Retain sodium

A parent asks what can be done for a 13-year-old client who has developed a swollen neck, "bugging out" eyes, and can't seem to eat enough food but is still losing weight. Which should the nurse suggest to this parent? Seek immediate medical attention Encourage the client to rest in bed Provide activities to distract the client Increase the number of meals the client eats each day

Seek immediate medical attention

An adolescent client recovering from an adrenalectomy is experiencing confusion, nausea and vomiting, and a fever. Which should the nurse recommend to the parents? Increase oral fluid intake Seek immediate medical attention Offer ginger ale and soda crackers Provide an over-the-counter antipyretic medication

Seek immediate medical attention

A 6-year-old client is being tested for syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory test value should the nurse identify that confirms this health problem? Serum sodium 120 mEq/L Urine specific gravity 1.020 Blood urea nitrogen 12 mg/dL Serum osmolarity 320 mOsmol/kg

Serum sodium 120 mEq/L

An adolescent client is demonstrating signs of diabetic ketoacidosis (DKA). For which precipitating factor should the nurse assess this client? Date of last immunization Outcome of last ophthalmologic examination Average number of calories ingested each day Type of insulin and time when last injection occurred

Type of insulin and time when last injection occurred

A school-age client reports hating to receive a daily insulin injection because of the pain. Which recommendation should the nurse provide to the parent? Reuse a syringe and needle Keep the insulin refrigerated Use the syringe like a dart to pierce the skin Cleanse the skin with soap and water before the injection

Use the syringe like a dart to pierce the skin

A school-age client is diagnosed with severe diabetic ketoacidosis (DKA). Which laboratory value should the nurse expect to confirm this diagnosis? Venous blood pH 6.8 +4 ketones in the urine Blood glucose 220 mg/dL Bicarbonate level 15 mEq/L

Venous blood pH 6.8

A 7-month-old infant with muscle rigidity and abdominal distention has a low serum calcium level. Which additional diagnostic test should the nurse expect to be prescribed to diagnose this client's health problem? Muscle biopsy X-ray of a long bone Water deprivation test CT scan of the abdomen

X-ray of a long bone

The nurse is instructing the parents of a toddler with type 1 diabetes mellitus. In which order should the nurse instruct the parents to prepare the client's insulin? Inject air into the insulin vial Tap on the syringe to remove air bubbles Remove syringe cap and pull air into the syringe Withdraw prescribed amount of insulin into the syringe

remove, inject, withdraw, tap