CH. 31
After teaching the parents of a child with central precocious puberty about medication therapy, which statement by the parents indicates successful teaching?
"Our child will start puberty again when the medication stops."
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?"
The nurse is talking with a parent of an adolescent who is newly diagnosed with type 2 diabetes mellitus and asks, "How could this happen? No one in our family has diabetes." What response would be appropriate?
"This is caused by insulin resistance from previous pancreatic injury or generalized infection."
The nurse is providing client education regarding the administration of desmopressin acetate for the client diagnosed with diabetes insipidus. Which statements by the client or parents indicate understanding of the teaching? Select all that apply.
"We will want to inspect the nares of our child to be sure the medication is not irritating the tissue." "We will need to adjust the dose based on how much our child is urinating." "I am going to have to carry a cooler with me if I am going to be gone all day or if I go on a
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 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 2-year-old client is at the office for a follow-up visit. The client has had excessive hormone levels in recent bloodwork and the parents question why this was not found sooner. What is the best response by the nurse?
"As endocrine functions become more stable throughout childhood, alterations become more apparent."
A nurse is teaching an adolescent with type 1 diabetes about the disease. Which instruction by the nurse about how to prevent hypoglycemia would be most appropriate for the adolescent?
"Carry crackers or fruit to eat before or during periods of increased activity."
A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?
Hormonal secretion
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."
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 assessing a child for signs of an endocrine disorder. Which statement by the parent would alert the nurse to further assess the child for an endocrine disorder?
"I have all of a sudden noticed my child is always thirsty...even at night."
A 7-year-old child is being followed closely for "short stature." Approximately 6 months after the child's last doctor's visit, the nurse re-measures the height and weight of the child and plots it on the growth chart. The parents ask why their child has to be measured again. Which response should the nurse give?
"I need to see if your child has grown taller since your last visit."
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."
A 6-year-old child has been diagnosed with growth hormone deficiency. The child's mother requests more information about this condition. Which statements should be included in the nurse's response? Select all that apply.
"The majority of children who have this condition are born of normal weight and length." "There are several potential causes of this condition."
The nurse is speaking with the parents of a child recently diagnosed with hypothyroidism. Which statement by a parent indicates an understanding of symptoms of this disorder?
"When they get my son's thyroid levels normal, he won't be so tired."
A 2-month-old infant is diagnosed with hypothyroidism. When educating the parents, the nurse explains which as signs suggesting hypothyroidism? Select all that apply.
"Your infant had a long period of jaundice from birth." "Your infant's motor activity has been decreased." "Your infant has had ongoing constipation."
The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which action would be the most appropriate for the school nurse to take?
Administer subcutaneous glucagon.
The nurse is caring for a 14-year-old boy with hyperpituitarism. What would be the priority treatment?
Administering octreotide acetate as ordered
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
The nurse knows that which condition is caused by excessive levels of circulating cortisol?
Cushing syndrome
A nurse on the pediatric floor is taking care of a 12-year-old child with diabetes insipidus (DI). Which fact would the nurse understand about this disease?
DI can be managed with vasopressin given as lifelong treatment.
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 newborn girl is discovered to have congenital adrenal hyperplasia. When assessing her, the nurse would expect to find which physical characteristic?
Enlarged clitoris
A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client?
Enlarged clitoris
A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dl. What would the nurse do next?
Give 10 to 15 grams of a simple carbohydrate.
After hospital discharge, the parent of a child newly diagnosed with type 1 diabetes mellitus telephones the nurse because the child is acting confused and very sleepy. Which emergency measure would the nurse suggest the parent carry out before bringing the child to see the health care provider?
Give the child a glass of orange juice.
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
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
The parents of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. What finding would lead the nurse to suspect that the child is experiencing an acute adrenal crisis?
Hyperkalemia
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
Shortly after delivery, a newborn is diagnosed with hypocalcemia. What manifestation will the nurse assess in this patient?
Jitteriness
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
Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism?
Low T4 level and high TSH level
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.
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
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
A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?
Regular insulin
The nurse is caring for a school-aged child newly diagnosed with type 1 diabetes mellitus. Which nursing action supports the 2020 National Health Goals to reduce the long-term complications from this disease process?
Schedule the child and parents to attend diabetes education classes.
The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement?
Teaching the parents how to administer the desmopressin acetate
A school-age child is diagnosed as having Cushing syndrome from long-term therapy with oral prednisone. What assessment finding is consistent with this child's diagnosis and treatment?
There are purple striae on the abdomen.
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
What finding would the nurse expect to assess in a child with hypothyroidism?
Weight gain
A nurse should recognize that which laboratory result would be most consistent with a diagnosis of diabetes mellitus?
a fasting blood glucose greater than 126 mg/dl
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
When discussing care of an infant with congenital hypothyroidism, you would stress that the infant will need:
administration of levothyroxine for a lifetime.
Assessment of a newborn reveals that the child has hypothyroidism. How does the nurse document this finding?
congenital hypothyroidism
Insulin deficiency, in association with increased levels of counter-regulatory hormones and dehydration, is the primary cause of:
diabetic ketoacidosis
Which nursing objective is most important when working with neonates who are suspected of having congenital hypothyroidism?
early identification
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 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
The nursing diagnosis most applicable to a child with growth hormone deficiency would be:
risk for situational low self-esteem related to short stature.
The nurse is assessing a child diagnosed with Cushing disease. Which statement by the parents demonstrates a need for further teaching?
"This disorder is most likely due to an infection my child had recently."
The parents of a child who was diagnosed with diabetes insipidus ask the nurse, "How does this disorder occur?" When responding to the parents, the nurse integrates knowledge that a deficiency of which hormone is involved?
Antidiuretic hormone
An infant on the pediatric floor has diabetes insipidus. Which assessment data are important for the nurse to monitor while the infant is on strict fluid precautions?
Urine output
When collecting data on a child diagnosed with diabetes mellitus, the nurse notes that the child has had weight loss and other symptoms of the disease. The nurse would anticipate which finding in the child's fasting glucose levels?
180 mg/dl
The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. In caring for a child that has issues with the anterior pituitary, the nurse knows that this child has issues with which hormone?
growth hormone
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."
An elementary school child takes metformin three times each day. Which disorder would the school nurse expect the child to have?
Type 2 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 child is diagnosed with hypoparathyroidism. Which electrolyte imbalance would the nurse most likely expect to address?
hypocalcemia
