PEDS Ch. 31 EAQs: Endocrine Dysfunction

Calculate the estimated target height of a 10-year-old daughter if the heights of the father and mother are 177 cm and 160 cm, respectively. Record your answer as a whole number. _________ cm

162

Which clinical manifestations in children help to distinguish between hypoglycemia and hyperglycemia? Select all that apply. 1 A child with hypoglycemia has sweating. 2 A child with hypoglycemia has nausea and vomiting. 3 A child with hyperglycemia has exaggerated reflexes. 4 A child with hyperglycemia has deep, rapid breathing. 5 A child with hyperglycemia has tachycardia and palpitations.

A child with hypoglycemia has sweating. A child with hyperglycemia has deep, rapid breathing.

What are the differences between glucocorticoids and mineralocorticoids? Select all that apply. 1 Progestins are glucocorticoids rather than mineralocorticoids. 2 Aldosterone is a mineralocorticoid rather than a glucocorticoid. 3 Glucocorticoids rather than mineralocorticoids are produced by the adrenal cortex. 4 Mineralocorticoids rather than glucocorticoids are produced by the adrenal medulla. 5 Glucocorticoid rather than mineralocorticoid levels in the blood show diurnal variation.

Aldosterone is a mineralocorticoid rather than a glucocorticoid. Glucocorticoid rather than mineralocorticoid levels in the blood show diurnal variation.

An infant presents with hypospadias, micropenis, and no palpable gonads. Which term does the nurse use to document these findings? 1 Atrophy 2 Cushing syndrome 3 Ambiguous genitalia 4 Adrenal insufficiency

Ambiguous genitalia

The nurse suspects that a child has delayed growth. The nurse does not have serial height and weight records to assess the child's growth. Which action does the nurse take? 1 Asks the parents about the child's allergy status. 2 Asks about the child's height and weight at birth. 3 Asks about the child's growth as compared to siblings. 4 Asks about the child's weight as compared to the siblings.

Asks about the child's growth as compared to siblings.

What are the similarities between cortisol and aldosterone? Select all that apply. 1 Both are mineralocorticoids. 2 Both promote sodium retention. 3 Both promote potassium retention. 4 Both are produced by the adrenal cortex. 5 Both are regulated by the renin-angiotensin system.

Both promote sodium retention. Both are produced by the adrenal cortex.

Which is the most appropriate test to diagnose Cushing syndrome in a child? 1 Serum potassium level 2 Histamine stimulation test 3 Fasting blood glucose level 4 Dexamethasone suppression test

Dexamethasone suppression test

What information should the nurse include when discussing a child's precocious puberty with the parents? 1 The child is not yet fertile. 2 Sexual interest is usually advanced. 3 Dress and activities should be appropriate to the chronological age. 4 The appearance of secondary sex characteristics does not proceed in the usual order.

Dress and activities should be appropriate to the chronological age.

Which are the clinical manifestations of juvenile hypothyroidism? 1 Sleepiness, dry skin, diarrhea 2 Dry skin, sparse hair, slowed growth 3 Diarrhea, dry skin, decelerated growth 4 Constipation, dry skin, enlarged thyroid

Dry skin, sparse hair, slowed growth 3

A child is on hormone replacement therapy for panhypopituitarism. What instructions does the nurse give to the child's parents? Select all that apply. 1 Provide same age-appropriate responsibilities as the child's siblings. 2 Provide responsibilities that would be appropriate for a younger child. 3 Encourage the child to wear medical identification at all times. 4 Encourage the child to participate in group activities with peers. 5 Keep the child away from other children, because they will bully the child.

Encourage the child to wear medical identification at all times. 4 Encourage the child to participate in group activities with peers. Provide same age-appropriate responsibilities as the child's siblings.

The nurse is planning care for a child with recently diagnosed diabetes insipidus. Which nursing intervention is included? 1 Encouraging the child to wear medical identification 2 Discussing with the child and family ways to limit fluid intake 3 Teaching the child and family how to do required urine testing 4 Reassuring the child and family that diabetes insipidus is not a chronic or life-threatening illness

Encouraging the child to wear medical identification

What is the difference between epinephrine and norepinephrine? 1 Epinephrine elevates blood pressure and norepinephrine reduces blood pressure. 2 Norepinephrine increases cardiac output and epinephrine decreases cardiac output. 3 Norepinephrine affects only the beta receptors and epinephrine affects both alpha and beta receptors. 4 Epinephrine can affect both alpha and beta receptors and norepinephrine affects only the alpha receptors.

Epinephrine can affect both alpha and beta receptors and norepinephrine affects only the alpha receptors.

An infant is born with ambiguous genitalia. Tests are being performed to enable sex assignment. The parents tell the nurse that family and friends are asking what caused the baby to be this way. Which is the nurse's best response? 1 Explain the disorder so the parents can explain it to others 2 Help the parents understand that no one knows how this occurs 3 Encourage the parents not to worry while the tests are being done 4 Suggest that the parents avoid family and friends until the sex is assigned

Explain the disorder so the parents can explain it to others

Cushing syndrome is a characteristic group of manifestations caused by excessive circulation of which hormone? 1 Free cortisol 2 Thyroid hormone 3 Androgen hormones 4 Adrenocorticotropic hormone (ACTH)

Free cortisol

Which is the best method for assessing control of diabetes? 1 Urine testing 2 Patient logbooks 3 Self-monitoring of blood glucose 4 Glycosylated hemoglobin (hemoglobin A1c) testing

Glycosylated hemoglobin (hemoglobin A1c) testing

Which condition is common in a child with Turner syndrome and in one with growth hormone (GH) deficiency? 1 Growth failure 2 Normal bone age 3 Chromosomal abnormalities 4 An increase in weight/height ratio

Growth failure

How is Hashimoto disease different from Graves disease (GD)? 1 Hashimoto disease has a peak incidence during the first 3 years of life. 2 Hashimoto disease is the most common cause of hyperthyroidism in children. 3 Hashimoto disease is characterized by an increase in thyroid-stimulating hormone (TSH). 4 Hashimoto disease is adequately treated with surgical ablation of the thyroid tumor.

Hashimoto disease is characterized by an increase in thyroid-stimulating hormone (TSH).

A neonate with a goiter has just been admitted to the newborn nursery. Which is the priority nursing intervention? 1 Positioning the neonate on the left side 2 Having a tracheostomy set at the bedside 3 Suctioning the child at least every 5 to 10 minutes 4 Explaining to the parents how to place the dressing on the goiter

Having a tracheostomy set at the bedside

The child has been diagnosed with diabetic ketoacidosis (DKA). The nurse plans care based on which understanding of diabetic ketoacidosis? 1 DKA is best treated at home 2 DKA is best treated at a practitioner's office or clinic 3 Immediate treatment is required because DKA is a life-threatening situation 4 No treatment is required, because DKA is an expected outcome of type 1 diabetes mellitus

Immediate treatment is required because DKA is a life-threatening situation

Which changes in the management of the child with type 1 diabetes mellitus are expected as a result of more exercise? 1 Increased food intake 2 Decreased food intake 3 Decreased risk of insulin shock 4 Increased risk of hyperglycemia

Increased food intake

Which is the most effective treatment option for children with type 1 diabetes? 1 Diet only 2 Oral agents 3 Insulin and diet 4 Diet and oral agents

Insulin and diet

How is the delivery of insulin through an insulin infusion pump different from delivery of insulin through subcutaneous injections? 1 Insulin infusion pump delivers insulin into the thigh muscles. 2 Insulin infusion pump causes less skin infections than injections. 3 Insulin infusion pump delivers fixed amounts of insulin continuously. 4 Insulin infusion pump is less expensive than giving multiple injections.

Insulin infusion pump delivers fixed amounts of insulin continuously.

Which is a common clinical manifestation of adrenocortical insufficiency that occurs due to deficiency of glucocorticoids and mineralocorticoids? 1 Fewer pubic and axillary hairs 2 Hyperkalemia and hyponatremia 3 Irritability, apathy, and negativism 4 Hyperpigmentation in knees and elbows

Irritability, apathy, and negativism

Which statement best describes Cushing syndrome? 1 Treatment involves replacement of cortisol. 2 It is caused by excessive production of cortisol. 3 The major clinical features are exophthalmia and pigment changes. 4 Diagnosis is suspected with findings of hypotension, hyperkalemia, and polyuria.

It is caused by excessive production of cortisol.

Which are the signs and symptoms of diabetic ketoacidosis? Select all that apply. 1 Ketonuria 2 Ketonemia 3 Dehydration 4 Acetone breath 5 Shallow, slow breathing

Ketonuria 2 Ketonemia 3 Dehydration 4 Acetone breath

Which is the nurse's best action when caring for a child with diabetes who has a diminished food intake due to typhoid? 1 Restrict the child's fluid intake. 2 Omit insulin therapy during the illness. 3 Monitor blood glucose of the child every 3 hours. 4 Notify the primary health care provider if the child vomits more than three times.

Monitor blood glucose of the child every 3 hours.

What kind of activity restrictions are placed on the child with recently diagnosed type 1 diabetes? 1 Daily exercise is contraindicated. 2 The child may not participate in sports. 3 Swimming is acceptable, but soccer is too strenuous. 4 No activities are restricted unless they are contraindicated because of other health conditions.

No activities are restricted unless they are contraindicated because of other health conditions.

Which diet intervention does the nurse make for a child with diabetes mellitus? 1 Total food intake of the child should be restricted. 2 Large snacks should be avoided during afternoons. 3 Fat intake should be less than 50% of total calorie intake. 4 One slice of bread may be given if the child dislikes having one small apple.

One slice of bread may be given if the child dislikes having one small apple.

The nurse is assessing a child for pituitary hyperfunction. Which assessment findings does the nurse recognize as an effect of hyperpituitarism? Select all that apply. 1 Absence of sexual maturation 2 Overgrowth of the long bones 3 Thickened, deeply creased skin 4 Delayed dentition and tooth loss 5 Malocclusion of teeth in enlarged jaw

Overgrowth of the long bones 3 Thickened, deeply creased skin Malocclusion of teeth in enlarged jaw

The student nurse is caring for a patient with pheochromocytoma. Which action, if performed by the student nurse, would prompt the charge nurse to intervene immediately? 1 Checking the blood pressure of the patient 2 Checking the respiratory rate of the patient 3 Measuring the blood glucose levels in patient 4 Palpating the mass to note its measurements in patient

Palpating the mass to note its measurements in patient

How is the parasympathetic nervous system different from the sympathetic nervous system? 1 Parasympathetic nervous system secretes neurotransmitting substances. 2 Parasympathetic nervous system primarily regulates the digestive system. 3 Parasympathetic nervous system maintains homeostasis during times of stress. 4 Parasympathetic nervous system controls the nonvoluntary functions of the body.

Parasympathetic nervous system primarily regulates the digestive system.

Which are the cardinal signs of diabetes insipidus? 1 Vascular anomalies 2 Polyuria and polydipsia 3 Hypotension and dehydration 4 Dehydration and diminished urine output

Polyuria and polydipsia

An infant is born with a goiter. Which is the priority nursing consideration for this infant? 1 Institution of seizure precautions 2 Preparation for fluid administration 3 Preparation for emergency ventilation 4 Flexion of the neck to facilitate breathing

Preparation for emergency ventilation

Which manifestation helps the nurse to identify hyperglycemia in a child with diabetes mellitus (DM)? 1 Excessive sweating 2 Presence of acetone breath 3 Shallow normal respirations 4 Presence of paleness or pallor

Presence of acetone breath

The parents of a child who is receiving growth hormone replacement therapy are not satisfied with the outcome of the treatment, because the child's height is not increasing. The child is still shorter than school peers. Which is the most appropriate action of the nurse? 1 Increase the dose of growth hormone to the child. 2 Reassure the parents and set realistic expectations. 3 Change the route of administration of growth hormone. 4 Advise the parents to feed the child with high protein diet.

Reassure the parents and set realistic expectations.

Which manifestation of type 2 diabetes helps the nurse to distinguish it from type 1 diabetes? 1 Rapid, deep breathing 2 Absence of serum insulin 3 Relative insulin deficiency 4 Excessive thirst and hunger

Relative insulin deficiency

Which is a common clinical manifestation of hypopituitarism that occurs due to deficiency of growth hormone (GH) or a deficiency of thyroid-stimulating hormone (TSH)? 1 Short stature 2 Delayed dentition 3 Increased insulin sensitivity 4 Delayed epiphyseal closure

Short stature

What is the difference between type 1 and type 2 diabetes mellitus (DM)? 1 Twin concordance is less in type 1 DM than in type 2 DM. 2 Most diabetic people have type 1 DM rather than type 2 DM. 3 Insulin therapy is required in more cases of type 2 DM than in type 1 DM. 4 Islet-cell antibodies are found more often in type 2 DM than in type 1 DM.

Twin concordance is less in type 1 DM than in type 2 DM.

A nurse is caring for a 15-year-old girl who is experiencing polyuria, polydipsia, and polyphagia. The girl is underweight and reports being extremely fatigued over the past 3 days. The nurse anticipates testing will confirm which diagnosis? 1 Type 1 diabetes 2 Type 2 diabetes 3 Pheochromocytoma 4 Congenital adrenal hyperplasia

Type 1 diabetes

How is type 2 diabetes mellitus (DM) different from type 1 DM in children? 1 Type 2 DM has an abrupt onset. 2 Type 2 DM occurs primarily in white people. 3 Type 2 DM is a chronic disorder of metabolism. 4 Type 2 DM is frequently associated with a family history.

Type 2 DM is frequently associated with a family history.

Which diagnostic finding helps distinguish nephrogenic diabetes insipidus (DI) from central DI? 1 Rise in urine osmolality after fluid deprivation 2 Loss of the body weight after fluid deprivation 3 Rise in urine osmolality after injection of vasopressin 4 Unresponsiveness to administration of exogenous vasopressin

Unresponsiveness to administration of exogenous vasopressin

What levels of thyroid hormone (TH) and thyroid-stimulating hormone (TSH) characterize primary congenital hypothyroidism? 1 Low level of circulating TH, low level of TSH at birth 2 Low level of circulating TH, normal level of TSH at birth 3 Low level of circulating TH, elevated level of TSH at birth 4 High level of circulating TH, elevated level of TSH at birth

Low level of circulating TH, elevated level of TSH at birth

Which physiologic alteration is characterized by destruction of pancreatic beta cells that produce insulin? 1 Type 1 diabetes 2 Type 2 diabetes 3 Gestational diabetes 4 Impaired glucose tolerance

Type 1 diabetes

A child with generalized tuberculosis is diagnosed with total adrenal insufficiency and is prescribed cortisol and antitubercular drugs for long-term use. Which statement does the nurse include in parent teaching? 1 "Give antibiotics regularly to avoid adrenal crisis." 2 "Always have a prefilled syringe of hydrocortisone at home." 3 "Give a high-fat and high-protein diet to prevent malnutrition." 4 "Do not give cortisol injection when the child vomits the food and the tablet."

"Always have a prefilled syringe of hydrocortisone at home."

The nurse is assessing a child with delayed growth. Which questions does the nurse include in the assessment while interviewing the parents? Select all that apply. 1 "Tell me about diseases in your family." 2 "What kind of medications does the child take?" 3 "Have there been changes in the child's appetite?" 4 "What kind of developmental issues did the child have?" 5 "What behavioral therapies is the child undergoing now?"

"Tell me about diseases in your family." 2 "What kind of medications does the child take?" 3 "Have there been changes in the child's appetite?" 4 "What kind of developmental issues did the child have?"

When does rapid-acting insulin peak? 1 2 hours after injection 2 5 hours after injection 3 15 to 30 minutes after injection 4 30 to 90 minutes after injection

30 to 90 minutes after injection