Alterations in Endocrine Function

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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?

Cushing syndrome

A newborn girl is discovered to have congenital adrenal hyperplasia. When assessing her, the nurse would expect to find which physical characteristic?

Enlarged clitoris

Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward?

Administration of levothyroxine indefinitely

The primary health care provider has ordered a thyroid scan to confirm the diagnosis of hyperthyroidism. Which would the nurse do before the scan?

Assess the client for allergies

The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. What is the priority nursing diagnosis?

Deficient fluid volume related to dehydration

A newborn is diagnosed with the salt-losing form of congenital adrenogenital hyperplasia. On what should the nurse focus when assessing this client?

Dehydration

An adolescent is having an annual physical. The adolescent has a documented weight loss of 9 lb (4.08 kg). The parent states, "He eats constantly." Exam findings are normal overall, except that the child reports having trouble sleeping, and the child's eyeballs are noted to bulge slightly. Which interventions would the nurse perform based on these findings?

Discuss preparing for a thyroid function test

A child is prescribed glargine insulin. What information would the nurse include when teaching the child and parents about this insulin?

Do not mix this insulin with other insulins

The nurse is caring for a child admitted to the emergency center in diabetic ketoacidosis. Which clinical manifestations would the nurse most likely note in this child?

Drowsiness and fruity odor to breath

The nurse is teaching glucose monitoring and insulin administration to a child with type 1 diabetes mellitus and the parents. Which comment by a parent demonstrates a need for additional teaching?

During exercise we should wait to check blood sugars until after our child completes the activity

A nurse is reviewing with an 8-year-old how to self-administer insulin. Which of the following is the proper injection technique for insulin injections?

Elevate the subcutaneous tissue before the injection

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?

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

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?

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

The nurse is caring for a 10-year-old child with growth hormone (GH) deficiency. Which therapy would you anticipate will be prescribed for the child?

Injections of GH

The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess?

It is difficult to keep the child awake

The nurse working triage in the urgent care center notices a diabetic child may be having metabolic acidosis. Which of the following assessment data would be most indicative of this disorder?

Kussmaul respiration and drowsiness

The nurse is caring for a 4-year-old boy during a growth hormone stimulation test. Which task is priority in the care of this child?

Monitoring blood glucose levels

A 13-year-old adolescent with hyperthyroidism who takes antithyroid medication has a sore throat and a fever. The parent calls the nurse and asks what to do. Which is the best response from the nurse?

Please take your child straight to the emergency department

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 Polydipsia Polyphagia

The nurse is planning care for a school-age child diagnosed with growth hormone deficiency. Which diagnosis should the nurse select to help the child with this health problem?

Risk for situational low self-esteem related to short stature

In a child with diabetes insipidus, which characteristic would most likely be present in the child's health history?

abrupt onset of polyuria, nocturia, and polydipsia

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?

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

After teaching a group of students about endocrine disorders, the instructor determines that the teaching was successful when the students identify insulin deficiency, increased levels of counterregulatory hormones, and dehydration as the primary cause of which condition?

diabetic ketoacidosis

A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition?

Syndrome of inappropriate antidiuretic hormone (SIADH)

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 assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with this disorder?

The parents report that their son "can't drink enough water

The nurse has told the 14-year-old adolescent with diabetes that the doctor would like to have a hemoglobin A1C test performed. Which comment by the client indicates that she understands what this test is for?

This will tell my doctor what my average blood glucose level has been over the last 2 to 3 months

A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?

Type 1 diabetes mellitus

A nurse is taking care of an infant with diabetes insipidus. Which assessment data are most important for the nurse to monitor while the infant has a prescription for fluid restriction?

Urine output

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?"

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?

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

A nurse is educating a family about the Chvostek sign after their teen tested positive for Chvostek sign. Which statements by the caregivers shows the nurse that they understand the Chvostek sign?

When I tap on my child's facial nerve, the reaction is a facial muscle spasm

A nurse is reinforcing the diagnosis of constitutional delay by the health provider to a 13-year-old male adolescent. Which is the best approach for this teen?

You will not need medication because your hormone levels are normal. I would be glad to discuss these findings with you

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

The nurse is administering 10 units of NPH insulin to a child at 8 a.m. The nurse would expect this insulin to begin acting at which time?

between 9 and 11 a.m

Assessment of a newborn reveals that the child has hypothyroidism. How does the nurse document this finding?

congenital hypothyroidism

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

The nurse is assessing a 1-month-old girl who, according to the mother, doesn't eat well. Which assessment suggests the child has congenital hypothyroidism?

enlarged tongue

The nurse is reviewing the laboratory test results of a child with Addison disease. What would the nurse expect to find?

hyperkalemia

A child is diagnosed with hypoparathyroidism. Which electrolyte imbalance would the nurse most likely expect to address?

hypocalcemia

The nurse is caring for a child recently diagnosed with hypoparathyroidism disorder. Which medication would the nurse expect to be ordered?

oral calcium

An 8-year-old girl presents to the clinic for moodiness and irritability. The child has begun to develop breasts and pubic hair and the parents are concerned that the child is at too early an age for this to begin. The nurse knows that these symptoms may be indicative of what disorder?

precocious puberty

The nurse is assessing a 5-year-old child whose parent reports the child has been vomiting lately, has no appetite, and has had an extreme thirst. Laboratory work for diabetes mellitus is being completed. Which symptom would differentiate between type 1 diabetes mellitus from type 2 diabetes mellitus?

recent weight loss

A pediatric nurse is discharging a 1-month-old infant. The infant was diagnosed with congenital hypothyroidism on this admission and will be treated with levothyroxine. The nurse knows it is important to teach the parent about medication administration. Which process will the nurse include in the teaching?

Give the crushed medication in a syringe mixed with a small amount of formula

The nurse is educating the parents of a client newly diagnosed with type 1 diabetes. Which statement by the parents indicates additional teaching is needed?

Our child should not participate in sports or physical activity

The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus. The caregiver states, "She is hungry all the time and eats everything, but she is losing weight." The caregiver's statement indicates the child most likely has:

Polyphagia

A child is brought to the clinic experiencing symptoms of nervousness, tremors, fatigue, increased heart rate and blood pressure. Based on this assessment, the nurse would suspect a diagnosis of which condition?

Graves disease

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."


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