Ricci Chapter 48 PrepU

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? - Oral intake - Urine output - Color of mucous membranes - Temperature and heart rate

urine output

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 child is taking a vitamin supplement. - The child has had an MRI of their leg within the past 6 weeks. - The child wears a medical alert bracelet for diabetes.

The child is allergic to shellfish.

A 9-year-old child with Graves disease is seen at the pediatrician's office reporting sore throat and fever. The nurse notes in the history that the child is taking propylthiouracil. Which of the following would concern the nurse? - The child may not be taking the medication. - The child may have developed leukopenia. - The child needs to be started on an antibiotic drug. - The child must be participating in sports.

The child may have developed leukopenia.

An elementary school child takes metformin three times each day. Which disorder would the school nurse expect the child to have? - Type 1 diabetes mellitus - Gastrointestinal reflux - Inflammatory bowel disorder - Type 2 diabetes mellitus

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? - Vital signs - Oral intake - Oral mucosa - Urine output

Urine output

A newborn is born with hypothyroidism. If it is not recognized and treated, what complication is likely? - blindness - muscle spasticity - dehydration - cognitive impairment

cognitive impairment

Which nursing objective is most important when working with neonates who are suspected of having congenital hypothyroidism? - early identification - promoting bonding - allowing rooming in - encouraging fluid intake

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? - frequent diarrhea - enlarged tongue - tachycardia - warm, moist skin

enlarged tongue

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? - "It takes time to determine the level of functioning of endocrine glands." - "Have there been signs and symptoms that you should have reported to the doctor?" - "As endocrine functions become more stable throughout childhood, alterations become more apparent." - "Endocrine disorders are hard to detect and you are lucky that we have found it when we did."

"As endocrine functions become more stable throughout childhood, alterations become more apparent."

The nurse is teaching glucose monitoring and insulin administration to a child with type 1 diabetes 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." - "If our child is sick we should check blood glucose levels more often." - "We should check our child's blood glucose levels before meals." - "Blood glucose level, food intake, and activity need to all be considered when calculating insulin dosage."

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

A nurse who is caring for a 7-year-old is providing client education to the child and caregiver. Which response by the caregiver demonstrates to the nurse that the caregiver understands the diagnosis of type 1 diabetes mellitus? - "We will just have our child exercise and take medicine to cure this." - "I will just feed my child healthy foods and sign her up for more sports." - "Her body fights against the insulin." - "Her body doesn't have any insulin."

"Her body doesn't have any insulin."

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." - "Maybe you could do something to remind yourself to take the medication on a daily basis." - "As long as you are missing multiple doses it should be fine. Just as long as you take the levothyroxine at some point each day." - "If you forget a dose you can double up the next day. We just want your thyroid level to be maintained since you don't produce enough thyroid hormone."

"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 educating the parents of a client newly diagnosed with type 1 diabetes. Which statement by the parents indicates additional teaching is needed? - "When our child is sick, we may need to check glucose levels more frequently." - "Our child should eat three meals and midafternoon and bedtime snacks each day." - "We and our child need to learn to identify carbohydrate, protein, and fat foods." - "Our child should not participate in sports or physical activity."

"Our child should not participate in sports or physical activity."

A school-age child is seen in the family clinic. The parents ask the nurse if their child should start taking growth hormones to help the child grow because the parents are short. What is the best response by the nurse? - "Growth hormones work only if the child has short bones." - "Will your child be able to swallow oral pills every day?" - "Research shows that there must be a diagnosis of deficiency before growth hormones can be started at this age." - "How tall would you like your child to be?"

"Research shows that there must be a diagnosis of deficiency before growth hormones can be started at this age."

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 only temporary, right?" - "Are you saying that hypothyroidism is caused by a problem in the way the thyroid gland develops?" - "Do you mean that hypothyroidism may be caused by a problem in the way the body makes thyroxine?" - "So, hypothyroidism can be treated by exposing our baby to a special light, right?"

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

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? - "Is your child taking vasopressin IM or SC?" - "What time each day does your child take his growth hormone?" - "Does your child get upset about being taller than friends?" - "How often do you test your child's blood glucose?"

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

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. - Abrupt onset of symptoms - Marked weight loss - Polyuria - Polydipsia - Polyphagia

- Polyuria - Polydipsia - Polyphagia

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% - 6.5% - 7.5 % - 7.0%

8.5%

A newborn was diagnosed as having hypothyroidism at birth. The parent asks the nurse how the disease could be discovered this early. Which is the nurse's best answer? - Hypothyroidism is usually detected at birth by the newborn's physical appearance. - A newborn has a typical rash at birth that suggests the diagnosis. - A simple blood test to diagnose hypothyroidism is required in most states. - The newborn is already severely impaired at birth, and this suggests the diagnosis.

A simple blood test to diagnose hypothyroidism is required in most states.

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? - Request that someone call 911. - Administer subcutaneous glucagon. - Anticipate that the child will need intravenous glucose. - Dissolve a piece of candy in the child's mouth.

Administer subcutaneous glucagon.

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 - Growth hormone - Insulin - Thyroxine

Antidiuretic hormone

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. - Give the client a bolus of fluids - Tell the client he or she will be asleep. - Insert a urinary catheter.

Assess the client for allergies.

A newborn exhibits significant jittery movements, convulsions, and apnea. Hypoparathyroidism is suspected. What would the nurse expect to be administered? - Calcium gluconate - Hydrocortisone - Desmopressin - Levothyroxine

Calcium gluconate

A 15-year-old girl is brought to the clinic by her mother because the girl has been experiencing irregular and sporadic menstrual periods and excessive body hair growth. Polycystic ovary syndrome is suspected. Which additional assessment finding would help to support this suspicion? - Darkened pigmentation around the neck area - Decreased serum levels of free testosterone - Body mass index as normal - Short stature

Darkened pigmentation around the neck area

A newborn is diagnosed with the salt-losing form of congenital adrenogenital hyperplasia. On what should the nurse focus when assessing this client? - Dehydration - Hypoglycemia - Bleeding tendency - Excessive cortisone secretion

Dehydration

A child has been prescribed desmopressin acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse? - Desmopressin acetate works on your pancreas to stimulate insulin production. - Desmopressin acetate is a synthetic form of insulin used to lower your blood sugar. - Desmopressin acetate is a synthetic antidiuretic hormone that will slow down your urine output. - Desmopressin acetate works to help your kidneys work more efficiently.

Desmopressin acetate is a synthetic antidiuretic hormone that will slow down your urine output.

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. - Give the dose first thing in the morning. - Store the insulin in the refrigerator until just before giving it. - Discard any opened vials after a week.

Do not mix this insulin with other insulins.

The nurse is caring for a newborn with 21-OH enzyme deficiency congenital adrenal hyperplasia (CAH). The nurse identifies one goal of the plan of care as being the understanding of the importance of maintaining hormone supplementation. Which outcome criteron demonstrates this goal has been met? - During follow-up visits the child demonstrates normal growth and development. - Prior to discharge the parents state that they understand the medication regimen. - The parents fill the prescription for hormone replacement therapy prior to discharge. - The parents ask appropriate questions about the planned treatment goals.

During follow-up visits the child demonstrates normal growth and development.

A 12-year-old child has hyperthyroidism. The nurse understands that the most common cause of hyperthyroidism in children is: - Addison disease. - Cushing syndrome. - Graves disease. - Plummer disease.

Graves disease

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

Graves disease

During an assessment of an adolescent child, the nurse notes that the child has a protuberant tongue, fatigued appearance, poor muscle tone, and exophthalmos. What medical diagnosis would the nurse expect the child to have? - Cushing disease - Graves disease - diabetes - syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Graves disease

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: - Polyuria - Pica - Polyphagia - 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 - Lispro - NPH - Detemir

Regular insulin

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 - Ineffective tissue perfusion related to infantile blood vessels - Impaired skin integrity related to overproduction of melanin - Risk for self-directed violence related to oversecretion of epinephrine

Risk for situational low self-esteem related to short stature

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 will the nurse perform? - Take glucometer readings as ordered. - Measure intake and output. - Monitor sodium and potassium levels. - Weigh daily.

Take glucometer readings as ordered.

The nurse is caring for 1-month-old girl with thyrotoxicosis. What finding would the nurse expect to assess? - The child has a strong appetite but fails to thrive. - Observation reveals lethargy and irritability. - Skin is cool, dry, and scaly to the touch. - The child is hypoactive and hypotonic.

The child has a strong appetite but fails to thrive.

A child is admitted to the pediatric medical unit with the diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). The child experiences the typical signs and symptoms of this disorder. Which concern will the nurse include in care planning? - delayed growth and development risk - altered nutrition risk - noncompliance because of difficulty coping - excess fluid volume risk

excess fluid volume risk

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? - Child appears pale and fatigued. - There are purple striae on the abdomen. - The child is excessively tall for chronologic age. - The child is demonstrating signs of hypoglycemia.

There are purple striae on the abdomen.

The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication? - This medication must be given by injection. - This medication must be given in the morning before school. - Hip or knee pain is an expected adverse effect of this medication. - This medication does not interact with any other types of medication.

This medication must be given by injection.

A 6-year-old boy has a moon-face, stocky appearance but with thin arms and legs. His cheeks are unusually ruddy. He is diagnosed with Cushing syndrome. What is the most likely cause of this condition in this child? - Tumor of the adrenal cortex - Tumor of the thyroid - Tumor of the pancreas - Tumor of the parathyroid

Tumor of the adrenal cortex

A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect? - Syndrome of inappropriate diuretic hormone - Diabetes insipidus - Type 1 diabetes mellitus - Hypothyroidism

Type 1 diabetes mellitus

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? - vasopressin - antidiuretic hormone - oxytocin - growth hormone

growth hormone

A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess? - Heat intolerance - Constipation - Weight gain - Facial edema

heat intolerance

A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy? - rapid weight gain - reports of headaches - height increase of 4 inches - growth plate closure

height increase of 4 inches

The nurse is caring for a child recently diagnosed with hypoparathyroidism disorder. Which medication would the nurse expect to be ordered? - oral calcium - oral corticosteroids - intravenous diuretic therapy - oral potassium

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 - pseudopuberty - adrenal hyperplasia - neurofibromatosis

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 is being completed. Which symptom would differentiate between type 1 diabetes from type 2 diabetes? - recent weight loss - blood pressure of 142/92 mm Hg - slow healing wounds - loose stools

recent weight loss

The nurse working with the child diagnosed with type 2 diabetes recognizes the disorder can be managed by: - taking oral hypoglycemic agents. - increasing carbohydrates in the diet, especially in the evening. - conserving energy with rest periods during the day. - decreasing amounts of daily insulin.

taking oral hypoglycemic agents.

The nurse is caring for a child diagnosed with low functioning parathyroid. Which is a treatment goal of a child with hypoparathyroidism? - Maintain the child's calcium level at a normal level with calcium replacement as prescribed. - Assure the parents have a plan in place for periods of low glucose levels if noted. - Provide the child and parent with a referral to a pediatric gastrointestinal specialist. - Provide the parents a specific dietary plan for high-phosphorus foods to be eaten.

Maintain the child's calcium level at a normal level with calcium replacement as prescribed.

A child has been diagnosed with the syndrome of inappropriate antidiuretic hormone (SIADH) and has been admitted to the hospital. Which nursing intervention is most important for this child? - Monitor sodium levels. - Monitor the child's weight daily. - Monitor intake and output. - Correct nausea and vomiting.

Monitor sodium levels.