med-surge, peds exam 2 (prep-u)
A parent, distressed to learn that her school-aged child is diagnosed with type 2 diabetes mellitus, asks the nurse how this could happen because no one in the family has diabetes. What instruction is most accurate?
"This disorder is associated with being overweight and eating a diet high in fats and carbohydrates."
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 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."
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."
During a visit to the clinic the adolescent client with hypothyroidism tells the nurse that she takes her Synthroid (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."
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 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."
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?"
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."
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
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%
Diabetes insipidus is a disorder of the posterior pituitary resulting in deficient secretion of which hormone?
Antidiuretic hormone
A pediatric client has just been diagnosed with diabetes mellitus. What would the nurse do first?
Check blood glucose levels.
The nurse knows that which condition is caused by excessive levels of circulating cortisol?
Cushing syndrome
A child has been prescribed Stimate (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?
Stimate (desmopressin acetate) is a synthetic antidiuretic hormone that will slow down your urine output
A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms?
Syndrome of inappropriate antidiuretic hormone
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.
A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client?
Enlarged clitoris
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?
Graves disease
The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child who has issues with the anterior pituitary, the nurse would expect the child to have issues with which hormone?
Growth hormone
A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess?
Heat intolerance
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
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 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.
The nurse is caring for a child who is scheduled for bone scan. It is suspected that the child has a growth hormone deficiency. Which finding would support this medical diagnosis?
The bone scan would show bone age would be two or more deviations below normal.
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 child with a history of diabetes insipidus has been taking vasopressin. The parents bring the child to the clinic for an evaluation. During the visit, the parents mention that it seems like their son is hardly urinating. The nurse suspects syndrome of inappropriate antidiuretic hormone. What findings would the nurse expect to find to help confirm this condition? Select all that apply.
Urine specific gravity 1.033 Decreased serum sodium level Serum osmolality 260 mOsm/kg
The nurse measures the client's blood glucose level prior to breakfast. The measurement obtained is 130 mg/dL. The orders read to administer 2 units of Humalog insulin for a blood glucose of 100 to 150mg/dL. How soon should the nurse ensure that the client eats their breakfast after receiving their insulin?
Within 15 to 30 minutes
A newborn is born with hypothyroidism. If it is not recognized and treated, what complication is likely?
cognitive impairment
A child with a primary growth hormone deficiency is to receive biosynthetic growth hormone. The nurse would explain to the child and parents that this hormone would be given at which frequency?
daily
Insulin deficiency, in association with increased levels of counter-regulatory hormones and dehydration, is the primary cause of:
diabetic ketoacidosis.
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
A child is admitted to the pediatric medical unit with the diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Based on the typical signs and symptoms of this disorder, which nursing diagnosis will the nurse identify as relating to this client?
Excess fluid volume
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.
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
The nurse is assessing a 5-year-old boy whose mother says he has been vomiting lately, has no appetite, and has had an extreme thirst. Lab work for diabetes mellitus is being completed. Which symptom would differentiate between type 1 diabetes mellitus over type 2 diabetes mellitus?
The child has lost weight recently.
A 10-year-old client is upset and tells the school nurse. "I am the shortest one in my class. I am done with school and just want to stay home." Which response by the nurse is most appropriate?
"You seem very upset. Sit down and let's talk about what is going on."
