Endocrine - 31
The primary health care provider has ordered a thyroid scan to confirm the diagnosis of hyperthyroidism. Which would the nurse do before the scan? a. Tell the client he or she will be asleep. b. Assess the client for allergies. c. Insert a urinary catheter. d. Give the client a bolus of fluids
b
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. a. Marked weight loss b. Polydipsia c. Polyuria d. Polyphagia e. Abrupt onset of symptoms
b, c, d
A 12-year-old child has hyperthyroidism. The nurse understands that the most common cause of hyperthyroidism in children is: a. Cushing syndrome. b. Addison disease. c. Graves disease. d. Plummer disease.
c
A 7-year-old child who has type 1 diabetes mellitus is at school reporting a headache and dizziness. The school nurse notices sweat on the child's face. What should the nurse do first? a. Give rapid-acting insulin b. Give glucagon IM c. Offer the child 8 ounces of juice or soda d. Offer the child 8 ounces of water
c
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? a. Cushing syndrome b. hypertension c. hypothyroidism d. Graves disease
d
A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy? a. growth plate closure b. reports of headaches c. rapid weight gain d. height increase of 4 inches
d
A newborn is born with hypothyroidism. If it is not recognized and treated, what complication is likely? a. muscle spasticity b. dehydration c. blindness d. cognitive impairment
d
Insulin deficiency, in association with increased levels of counter-regulatory hormones and dehydration, is the primary cause of: a. ketonuria. b. glucosuria. c. ketone bodies. d. diabetic ketoacidosis.
d
The nurse is seeing a new client in the clinic who reports polyuria and polydipsia. These conditions are indicative of which endocrine disorder? a. Syndrome of inappropriate antidiuretic hormone (SIADH) secretion b. Diabetes insipidus (DI) c. Hypopituitarism d. Precocious puberty
b
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? a. "I need to see if your child has grown taller since your last visit." b. "I need to make sure the last nurse measured your child right." c. "I need to calculate how tall your child will be when he/she is a grown-up." d. "I need to see how tall your child is to see how much medicine to give you."
a
A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect? a. Type 1 diabetes mellitus b. Syndrome of inappropriate diuretic hormone c. Hypothyroidism d. Diabetes insipidus
a
A newborn girl is discovered to have congenital adrenal hyperplasia. When assessing her, the nurse would expect to find which physical characteristic? a. Enlarged clitoris b. Small for gestational age c. Divergent vision d. Abnormal facial features
a
A newborn is diagnosed with the salt-losing form of congenital adrenal hyperplasia. On what should the nurse focus when assessing this client? a. Dehydration b. Bleeding tendency c. Excessive cortisone secretion d. Hypoglycemia
a
A nurse is to see a child. Assessment reveals the chief complaints of urinating "a lot" and being "really thirsty." The nurse interprets these symptoms as being associated with which condition? a. diabetes insipidus b. precocious puberty c. hypopituitarism d. syndrome of inappropriate antidiuretic hormone secretion
a
After teaching the parents of a child with central precocious puberty about medication therapy, which statement by the parents indicates successful teaching? a. "Our child will start puberty again when the medication stops." b. "Once therapy is done, our child will need surgery." c. "This medicine will reverse the symptoms and onset of puberty." d. "Our child needs to use the nasal spray once every day."
a
Diabetes insipidus is a disorder of the posterior pituitary that results in deficient secretion of which hormone? a. Antidiuretic hormone (ADH) b. Adrenocorticotropic hormone (ACTH) c. Luteinizing hormone (LH) d. Thyroid stimulating hormone (TSH)
a
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? a. "What time each day does your child take his growth hormone?" b. "How often do you test your child's blood glucose?" c. "Is your child taking vasopressin IM or SC?" d. "Does your child get upset about being taller than friends?"
a
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? a. Antidiuretic hormone b. Growth hormone c. Thyroxine d. Insulin
a
Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism? a. Low T4 level and high TSH level b. Normal T4 level and low TSH level c. High thyroxine (T4) level and low thyroid stimulating hormone (TSH) level d. Normal TSH level and high T4 level
a
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? a. adrenal hyperplasia b. precocious puberty c. neurofibromatosis d. pseudopuberty
b
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? a. Color of mucous membranes b. Urine output c. Oral intake d. Temperature and heart rate
b
The nurse is caring for a child recently diagnosed with hypoparathyroidism disorder. Which medication would the nurse expect to be ordered? a. intravenous diuretic therapy b. oral calcium c. oral potassium d. oral corticosteroids
b
The nurse is caring for a school-aged client with a chronic pediatric endocrine condition. Which client statement provides the best teaching opportunity? a. "I have to remember to take my medicine every day so I do not feel sick." b. "I have this problem because I am being punished for being bad." c. "My condition requires frequent bloodwork and that makes me sad." d. "I hope that I can outgrow the condition when I get big."
b
The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus. The caregiver states, "The teacher tells us that our child has to use the restroom many more times a day than other students do." The caregiver's statement indicates the child most likely has: a. Polyphagia b. Polyuria c. Pica d. Polydipsia
b
A child and her parents are being seen in the office after discharge from the hospital with a new diagnosis of type 2 diabetes. Which statement by the nurse is true? a. "This will rectify itself if you follow all of the doctor's directions." b. "A weight-loss program should be implemented and maintained." c. "Kids can usually be managed with an oral agent, meal planning, and exercise." d. "You are lucky that you did not have to learn how to give yourself a shot."
c
A child is diagnosed with hypoparathyroidism. Which electrolyte imbalance would the nurse most likely expect to address? a. hyperkalemia b. hypomagnesemia c. hypocalcemia d. hyponatremia
c
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? a. Addison disease b. Graves disease c. Cushing syndrome d. Turner syndrome
c
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? a. "If you think you want testosterone shots, then I will get them scheduled for you." b. "It really doesn't matter how tall your dad is. The physician just looks at your height to make this diagnosis." c. "You will not need medication because your hormone levels are normal. I would be glad to discuss these findings with you." d. "I would be worried about your short stature too and get a second opinion."
c
A nurse should recognize that which laboratory result would be most consistent with a diagnosis of diabetes mellitus? a. a fasting blood glucose less than 126 mg/dl b. glucose in the urine c. a fasting blood glucose greater than 126 mg/dl d. proteinuria
c
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? a. "Growth hormones work only if the child has short bones." b. "Will your child be able to swallow oral pills every day?" c. "Research shows that there must be a diagnosis of deficiency before growth hormones can be started at this age." d. "How tall would you like your child to be?"
c
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? a. Give the child one unit of regular insulin. b. Give the child a glass of orange juice with one unit regular insulin in it. c. Give the child a glass of orange juice. d. Give the child nothing by mouth so that a blood sugar can be drawn at the health care provider's office.
c
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? a. loose stools b. slow healing wounds c. recent weight loss d. blood pressure of 142/92 mm Hg
c
The nurse is assessing an 8-year-old boy who is performing academically at a second-grade level. The mother reports that the boy states feeling weak and tired and has had a weight increase of 6 pounds (13.2 kg) in 3 months. Which additional data would fit with a possible diagnosis of hypothyroidism? a. Oral cavity assessment shows two of the 6-year molars. b. The child has a faint rash on the trunk of the body. c. The child states that the exam room is cold. d. The mother reports that the boy is always thirsty.
c
The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. What is the priority nursing diagnosis? a. Imbalanced nutrition, more than body requirements related to excess weight b. Deficient knowledge related to fluid intake regimen c. Deficient fluid volume related to dehydration d. Excess fluid volume related to edema
c
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? a. "Our child should eat three meals and midafternoon and bedtime snacks each day." b. "When our child is sick, we may need to check glucose levels more frequently." c. "Our child should not participate in sports or physical activity." d. "We and our child need to learn to identify carbohydrate, protein, and fat foods."
c
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? a. Impaired skin integrity related to overproduction of melanin b. Risk for self-directed violence related to oversecretion of epinephrine c. Risk for situational low self-esteem related to short stature d. Ineffective tissue perfusion related to infantile blood vessels
c
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? a. "If my child eats as much as their older brother eats they could have an insulin reaction." b. "On the weekends we encourage our child to participate in lots of sports activities and stay busy so they don't have an insulin reaction." c. "My child measures their own medication but sometimes doesn't administer the correct amount." d. "My child monitors their glucose levels to keep them from going too high."
c
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? a. oxytocin b. antidiuretic hormone c. growth hormone d. vasopressin
c
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? a. "Endocrine disorders are hard to detect and you are lucky that we have found it when we did." b. "It takes time to determine the level of functioning of endocrine glands." c. "Have there been signs and symptoms that you should have reported to the doctor?" d. "As endocrine functions become more stable throughout childhood, alterations become more apparent."
d
The nurse has been teaching an adolescent about the treatment for hypothyroidism. Which outcome indicates that the teaching has been successful? a. The parents acknowledge the need for a follow-up appointment in a year. b. The parents recognize that thyroid medication be taken with food. c. The client verbalizes the requirement to restrict future athletic activities. d. The client states understanding that this is a lifetime medication.
d
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? a. Suggesting the girl speak to a counselor about her feelings b. Assisting the girl with methods to enhance her physical appearance c. Discussing ways to highlight good feelings about herself d. Exploring the girl's perception of her body image and health status
d
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? a. "Blood glucose level, food intake, and activity need to all be considered when calculating insulin dosage." b. "If our child is sick we should check blood glucose levels more often." c. "We should check our child's blood glucose levels before meals." d. "During exercise we should wait to check blood sugars until after our child completes the activity."
d
