NURS 405 Exam 3

The emergency department nurse is assessing a child who has presented with a 2-day history of nausea and vomiting with pain that is isolated to the right upper quadrant of the abdomen. Which action is most appropriate? Administer antacids as ordered. Assess the child's usual urinary voiding pattern. Prepare the child for admission to the hospital. Encourage fluid intake.

Prepare the child for admission to the hospital.

Which assessment finding would suggest that a child's postoperative feeding schedule following pyloric stenosis surgery should be slowed? Flatulence Vomiting Falling asleep at each feeding Semiformed bowel movements

Vomiting

A 6-week-old infant is diagnosed with pyloric stenosis. When taking a health history from the parent, which symptom would the nurse expect to hear described? Vomiting immediately after feeding Refusal to eat Vomiting about 2 hours after feeding Chronic diarrhea

Vomiting immediately after feeding

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

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

cognitive impairment

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

cognitive impairment

The nurse is teaching the mother of an infant with a temporary ileostomy about stoma care. What is the most important instruction to emphasize to the mother to avoid an emergency situation? "You may need adhesive remover to ease pouch removal." "Gather all of your supplies before you begin." "Call the doctor immediately if the stoma is not pink/red and moist." "You must be meticulous in caring for the surrounding skin."

"Call the doctor immediately if the stoma is not pink/red and moist."

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." "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." "If our child is sick we should check blood glucose levels more often."

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

The nurse is caring for an infant recently diagnosed with oral candidiasis (thrush) who has been prescribed nystatin. Which statement by the infant's mother would suggest a need for further education? "I will watch for diaper rash." "I will add the nystatin to her bottle four times per day." "I will use a cotton tipped applicator to apply the medication to her mouth." "I will make sure to clean all of her toys before I give them to her."

"I will add the nystatin to her bottle four times per day."

The nurse is caring for a child with gastrointestinal concerns. What statement by the parent would indicate a need for the nurse to further assess the child for constipation? "My child does not have liquid stool or leak liquid stools that I am aware of." "My child only has a bowel movement about four times a week." "My child eats vegetables and fresh fruit, but does not like beans." "My child has such large bowl movements that it clogs the toilet."

"My child has such large bowl movements that it clogs the toilet."

The nurse is caring for a 4-year-old with oral vesicles and ulcers from herpangina. The child is refusing fluids due to the pain and the mother is concerned about his hydration status. Which of the suggestions would be most appropriate? "Try some Anbesol or Kank-A." "Offer him some orange juice." "Encourage him to have some soda." "Offer 'magic mouthwash' followed by a popsicle."

"Offer 'magic mouthwash' followed by a popsicle."

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask? "How long has your child been toilet trained?" "What foods has your child eaten during the last few days?" "How many times a day does your child urinate?" "Tell me about the types of stools your child has been having."

"Tell me about the types of stools your child has been having."

The adolescent has been diagnosed with gastroesophageal reflux disease (GERD). Which statement(s) by the adolescent indicates that adequate learning has occurred? Select all that apply. "I will probably need a laxative because of the omeprazole." "The omeprazole could give me a headache." "It sounds like the health care provider is reluctant to give me bisacodyl because of the side effects." "The famotidine may make me confused." "I should try to lie down right after I eat."

"The famotidine may make me confused." "The omeprazole could give me a headache." "It sounds like the health care provider is reluctant to give me bisacodyl because of the side effects."

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? "The sign occurs because my child is having increased intracranial pressure." "The sign occurs when there is muscle pain and the muscle is stimulated." "When I tap on my child's facial nerve, the reaction is a facial muscle spasm." "The sign means my child is not getting enough vitamin D."

"When I tap on my child's facial nerve, the reaction is a facial muscle spasm."

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? 7.0% 7.5 % 6.5% 8.5%

8.5%

The nurse is caring for a 2-year-old child with a gastrointestinal infection resulting in 4 to 5 liquid stools per day over the past 3 days. Based on this information, which important concern(s) will the nurse address in the child's care? Select all that apply. undernourishment risk: malnutrition fluid deficiency risk: dehydration diarrhea and loss of electrolytes availability of parents to care for the child the risk for skin maceration in the perineum

fluid deficiency risk: dehydration diarrhea and loss of electrolytes the risk for skin maceration in the perineum

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? The parents ask appropriate questions about the planned treatment goals. During follow-up visits the child demonstrates normal growth and development. The parents fill the prescription for hormone replacement therapy prior to discharge. Prior to discharge the parents state that they understand the medication regimen.

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

Which type of jaundice seen in adults is the result of increased destruction of red blood cells? Hemolytic Obstructive Hepatocellular Nonobstructive

Hemolytic

A previously healthy adult's sudden and precipitous decline in health has been attributed to fulminant hepatic failure, and the client has been admitted to the intensive care unit. The nurse should be aware that the treatment of choice for this client is what? IV administration of immune globulins Transfusion of packed red blood cells and fresh-frozen plasma (FFP) Liver transplantation Lobectomy

Liver transplantation

A physician orders spironolactone (Aldactone), 50 mg by mouth four times daily, for a client with fluid retention caused by cirrhosis. Which finding indicates that the drug is producing a therapeutic effect? Serum sodium level of 135 mEq/L Blood pH of 7.25 Loss of 2.2 lb (1 kg) in 24 hours Serum potassium level of 3.5 mEq/L

Loss of 2.2 lb (1 kg) in 24 hours

The nurse is assessing a 7-year-old girl with a headache, irritability, and vomiting. Her health history reveals she has had meningitis. Which intervention is priority? Monitoring urine volume and specific gravity. Restoring fluid balance with IV sodium. Setting up safety precautions to prevent injury. Notifying the physician of the neurologic findings.

Notifying the physician of the neurologic findings.

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

Type 2 diabetes mellitus

Which of the following diagnostic studies definitely confirms the presence of ascites? Abdominal x-ray Ultrasound of liver and abdomen Colonoscopy Computed tomography of abdomen

Ultrasound of liver and abdomen

A client with carcinoma of the head of the pancreas is scheduled for surgery. Which of the following should a nurse administer to the client before surgery? Potassium Vitamin K Vitamin B Oral bile acids

Vitamin K

A patient with severe chronic liver dysfunction comes to the clinic with bleeding of the gums and blood in the stool. What vitamin deficiency does the nurse suspect the patient may be experiencing? Vitamin A deficiency Folic acid deficiency Vitamin K deficiency Riboflavin deficiency

Vitamin K deficiency

A child with growth hormone deficiency has been receiving growth hormone for the past 11 months. What result would the nurse interpret as indicating effectiveness of this therapy? rapid weight gain reports of headaches growth plate closure height increase of 4 in (10 cm)

height increase of 4 in (10 cm)

A child is diagnosed with hypoparathyroidism. Which electrolyte imbalance would the nurse most likely expect to address? hyponatremia hypocalcemia hyperkalemia hypomagnesemia

hypocalcemia

The parents of a 5-week-old infant present to urgent care because the child is "throwing up forcefully with every feeding." What other assessment(s) will the nurse complete? Select all that apply. mucous membranes and skin feeding technique family history of lactose and gluten intolerance vomiting description and pattern current weight and weight gain since birth

mucous membranes and skin feeding technique vomiting description and pattern current weight and weight gain since birth

The nurse teaches a parent to differentiate between regurgitation and vomiting in the infant. The parent correctly states which characteristic of regurgitation? Select all that apply. forceful expulsion of stomach contents occurs with feeding no appearance of distress timing unrelated to feeding followed by dry retching

occurs with feeding no appearance of distress

A child weighing 10 kg is admitted with severe vomiting for the past 3 days. The nurse writes a nursing diagnosis of Risk for deficient fluid volume related to vomiting. When the nurse reassesses the child, which outcomes would indicate the effectiveness of the treatment plan? Select all that apply. drinks 16 ounces of milk per nursing shift urine output of 15 mL/hour tolerating sips of clear fluids urine specific gravity of 1.008 poor skin turgor on abdomen

urine specific gravity of 1.008 urine output of 15 mL/hour tolerating sips of clear fluids

The nurse is providing discharge teaching regarding oral fluid rehydration to a mother who brought her child to the clinic because of vomiting over the past 2 days. The child is mildly dehydrated. Which comments by the mother indicated learning occurred? "Oral rehydration solutions (ORS) are good sources of fluids for rehydration." "I should be sure my child receives 50 to 100 ml/kg of oral rehydration solution (ORS) over 4 hours." "I should not give my child any fluids for 1 to 2 hours after an episode of vomiting." "Solutions like Pedialyte are not necessary for mild dehydration." "My child can drink milk if he feels like it to help in rehydration."

"I should be sure my child receives 50 to 100 ml/kg of oral rehydration solution (ORS) over 4 hours." "I should not give my child any fluids for 1 to 2 hours after an episode of vomiting." "Oral rehydration solutions (ORS) are good sources of fluids for rehydration."

The parent of a 3-week-old infant brings the infant in for an evaluation. During the visit, the parent tells the nurse that the infant is spitting up after feedings. Which response by the nurse would be most appropriate? "Thicken the formula by adding oat cereal." "Do not worry; you are just feeding your infant too much." "Your child might have an allergy." "Infants this age commonly spit up."

"Infants this age commonly spit up."

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? "You are lucky that you did not have to learn how to give yourself a shot." "Kids can usually be managed with an oral agent, meal planning, and exercise." "This will rectify itself if you follow all of the doctor's directions." "A weight-loss program should be implemented and maintained."

"Kids can usually be managed with an oral agent, meal planning, and exercise."

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? "We and our child need to learn to identify carbohydrate, protein, and fat foods." "When our child is sick, we may need to check glucose levels more frequently." "Our child should not participate in sports or physical activity." "Our child should eat three meals and midafternoon and bedtime snacks each day."

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

A 10-year-old child has been diagnosed with type 1 diabetes. 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." "The pancreas inside your belly makes enough chemical called insulin, but your body does not want to use it to keep your blood sugar level normal." "The alpha and beta cells in your pancreas are fighting against each other; that is why your blood sugar stays high and you need insulin injection." "The part of your body called the pancreas is broken and produces too much chemical called glucagon, which makes you really thirsty and have to go to the bathroom a lot."

"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."

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." "This medication will make me urinate more, so I need to plan for that when I am at school." "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 long hike." "It is important that I keep a close watch on my blood glucose levels to determine if the medication is working." "We will need to adjust the dose based on how much our child is urinating."

"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 long hike."

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? "Heat intolerance is a caused by low thyroid levels." "When they get my son's thyroid levels normal, he won't be so tired." "Most people with hypothyroidism have smooth, velvety skin." "My son's nervousness may be a symptom of his hypothyroidism."

"When they get my son's thyroid levels normal, he won't be so tired."

A 16-year-old adolescent is at the office for a checkup. The parent states, "My child keeps forgetting to take insulin. What can we do to make sure my child takes it?" Which is the best response by the nurse? "You can offer your child prizes for taking the medication." "You can remind your child that the medication is in the cabinet, and that the child should take it when needed." "You can set a medication time that allows your child to have a normal routine that does not interrupt school or sleep." "You can make sure that you are the only one who understands and is able to administer the medication."

"You can set a medication time that allows your child to have a normal routine that does not interrupt school or sleep."

The nurse is talking with a woman in her second trimester of pregnancy who has been diagnosed with polyhydramnios. The physician has ordered an ultrasound be performed to check for the presence of esophageal atresia. Which statement by the woman indicates an understanding of the relationship between these conditions? "Babies with esophageal atresia have an inability to swallow amniotic fluid causing the excess buildup." "Enzymes in amniotic fluid can cause the development of esophageal atresia." "Reductions in amniotic fluid are associated with the development of esophageal atresia." "Babies with esophageal atresia produce an excessive amount of amniotic fluid."

"Babies with esophageal atresia have an inability to swallow amniotic fluid causing the excess buildup."

A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate? "Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." "Do not give the child anything to drink for 4 hours. If the fever goes down and the loose stools stop, you can resume breastfeeding." "Continue breastfeeding as you have been doing. The fluid from the breast milk is important to maintain fluid balance." "Give a clear pediatric electrolyte replacement for the next few hours, then call back to report on how your child is doing."

"Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment."

A 15-year-old adolescent is scheduled for a pelvic ultrasound to evaluate for a possible ovarian cyst. Which instruction by the nurse would be most appropriate? "Drink plenty of fluids because you need to have a full bladder." "Limit your level of physical activity for one-half hour before the test." "You need to remain very still for the entire test." "You won't be able to drink any water before or during the test."

"Drink plenty of fluids because you need to have a full bladder."

The nurse is assessing a toddler and palpates a sausage-shaped mass in the upper mid abdomen. When taking the toddler's history, what question would the nurse ask the parent first? "How is your toddler's appetite?" "Has your toddler been having different colored stools?" "Has your toddler been around anyone who has been sick?" "Can you describe any pain your toddler is having?"

"Has your toddler been having different colored stools?"

A 10-year-old child has been diagnosed with precocious puberty. When talking with the child, what statements are appropriate? Select all that apply. "Would talking with someone about your feelings help?" "Tell me about your feelings about what is happening to your body." "Do you like boys yet?" "Developing is normal but your development is happening early." "How are you doing in school?"

"How are you doing in school?" "Developing is normal but your development is happening early." "Would talking with someone about your feelings help?" "Tell me about your feelings about what is happening to your body."

A nurse caring for an infant born with a cleft palate notices that the parents rarely interact with their child. The nurse overhears the mother telling her spouse that she "feels like crying" every time she looks at their infant. What would be the best response from the nurse? "Your infant needs you right now. You should put your negative feelings about the condition aside for your infant's sake." "I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" "Many infants are born with this condition. Your infant's palate is not nearly as bad as some cases." "Keep in mind that your infant's condition is not life-threatening and can be corrected eventually."

"I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?"

The nurse is teaching the mother of a 5-year-old boy with a history of impaction how to administer enemas at home. Which response from the mother indicates a need for further teaching? "He will require 250 to 500 mL of enema solution." "He should retain the solution for 5 to 10 minutes." "I should position him on his abdomen with knees bent." "I should wash my hands and then wear gloves."

"I should position him on his abdomen with knees bent."

The nurse is performing discharge teaching for an adolescent diagnosed with peptic ulcer disease. Which statement(s) by the adolescent demonstrates learning has occurred? Select all that apply. "I can eat whatever I want to as long as I take my medications." "My proton pump inhibitor should be taken when I feel discomfort." "I can use ibuprofen for pain." "I will need to make sure to take all of the antibiotic prescribed." "I will be starting yoga soon to help with the stress."

"I will be starting yoga soon to help with the stress." "I will need to make sure to take all of the antibiotic prescribed."

The student nurse is caring for a child with the nursing diagnosis "Risk for fluid volume deficit related to inadequate oral intake." Which statement by the student would indicate a need for further education by the nursing instructor? "I will monitor her IV line to help maintain her fluid volume." "I will teach her mother to give her small drinks frequently." "I will make sure there is plenty of orange juice available. It's her favorite juice." "I will weigh her every morning at the same time."

"I will make sure there is plenty of orange juice available. It's her favorite juice."

The nurse is speaking with the parents of a school-aged child recently diagnosed with diabetes regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching? "When my son's breath smells fruity, it almost always indicates high blood sugar." "If I notice changes in my son like tearfulness or irritability, his blood sugar may be high." "Dry flushed skin may be a sign if high blood sugar." "If my son says he feels shaky, his blood sugar may be low."

"If I notice changes in my son like tearfulness or irritability, his blood sugar may be high."

The nurse is caring for a child recently diagnosed with growth hormone deficiency. After providing education regarding this disorder, which statement by the parent demonstrates a need for further teaching? "This early diagnosis and treatment will lead to a better prognosis that my child will reach normal adult height." "If growth hormone therapy is used, it will continue for the rest of my child's life." "My child will follow up with an endocrinologist every 3 to 6 months to monitor growth." "It is important I treat my child according to the child's age not based on the child's size."

"If growth hormone therapy is used, it will continue for the rest of my child's life."

The mother of a young child who has been treated for a bacterial urinary tract infection tells the nurse her daughter has a white thick covering over her tongue. The mother states that she "has tried everything to get it off my child's tongue." How should the nurse respond? "Have you tried using a toothbrush to get it off?" "That is a common side effect after taking an antibiotic. It will go away after the antibiotic is out of the system." "It is likely an infection was caused by the antibiotic for the urinary tract infection. I am sure a different antibiotic will help it." "It's not unusual for a fungal infection to occur while taking an antibiotic for an infection. I will let your primary care provider know so we can get it treated."

"It's not unusual for a fungal infection to occur while taking an antibiotic for an infection. I will let your primary care provider know so we can get it treated."

The nurse is teaching a group of caregivers of children diagnosed with diabetes. 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? "If my child eats as much as their older brother eats they could have an insulin reaction." "My child measures their own medication but sometimes doesn't administer the correct amount." "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." "My child monitors their glucose levels to keep them from going too high."

"My child measures their own medication but sometimes doesn't administer the correct amount."

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? "Give your child ibuprofen according to the instructions on the box." "Offer your child at least 8 ounces of clear fluids and call back tomorrow." "Fever and sore throat may be side effects of the medication." "Please take your child straight to the emergency department."

"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? "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?" "Are you saying that hypothyroidism is caused by a problem in the way the thyroid gland develops?" "So, hypothyroidism can be only temporary, right?"

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

The student nurse is preparing a presentation on celiac disease. What information should be included? Select all apply. "Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders." "The entire family will need to eat a gluten-free diet." "Gluten is found in most wheat products, rye, barley and possibly oats." "Most children with celiac disease are diagnosed within the first year of life." "The only treatment for celiac disease is a strict gluten-free diet."

"Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders." "Gluten is found in most wheat products, rye, barley and possibly oats." "The only treatment for celiac disease is a strict gluten-free diet."

The nurse is discussing the treatment of congenital agaterm-20nglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis? "We will give enemas until clear and then teach you how to do these at home." "Your child will be treated with oral iron preparations to correct the anemia." "The treatment for the disorder will be a surgical procedure." "Your child will receive counseling so the underlying concerns will be addressed."

"The treatment for the disorder will be a surgical procedure."

The nurse is assessing a child diagnosed with Cushing syndrome. Which statement by the parents demonstrates a need for further teaching? "This disorder is most likely due to an infection my child had recently." "My child may experience excessive weight gain." "My child's round, full face appearance is reversible with appropriate treatment." "We need to pay close attention to any wounds our child gets to monitor for adequate healing."

"This disorder is most likely due to an infection my child had recently."

The nurse is preparing a client for surgery and the client asks, "What does it mean when they say they are going to reduce my abdominal hernia?" Which response by the nurse is most appropriate? "All this means is that the herniated intestines are twisted and edematous, which is why you need surgery." "If you do not understand this, I need to cancel your surgery and have the health care provider come back." "The health care provider will remove about half of the herniated contents during the procedure." "This means the hernia contents will be manipulated back into your peritoneal cavity during surgery."

"This means the hernia contents will be manipulated back into your peritoneal cavity during surgery."

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor? "You must have the second one in 2 weeks and the third in 1 month." "You must have the second one in 1 month and the third in 6 months." "You must have the second one in 1 year and the third the following year." "You must have the second one in 6 months and the third in 1 year."

"You must have the second one in 1 month and the third in 6 months."

A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful? "We might notice some of the medication in her stool." "She might lose some weight initially." "We should not stop this medication abruptly." "This drug helps to control the abdominal cramping."

"We should not stop this medication abruptly."

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? "What time each day does your child take his growth hormone?" "Is your child taking vasopressin IM or SC?" "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?"

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? "If you think you want testosterone shots, then I will get them scheduled for you." "It really doesn't matter how tall your dad is. The physician just looks at your height to make this diagnosis." "I would be worried about your short stature too and get a second opinion." "You will not need medication because your hormone levels are normal. I would be glad to discuss these findings with you."

"You will not need medication because your hormone levels are normal. I would be glad to discuss these findings with you."

The nurse is reviewing the recommended diet with the parents and child who was diagnosed with type 2 diabetes. The nurse determines that the parents and child understand the information when they identify that they will restrict carbohydrate intake to which amount at each of the three main meals? 15 grams 60 grams 30 grams 45 grams

45 grams

The nurse is providing care to a child who has had an appendectomy for a perforated appendix. The nurse would anticipate intravenous antibiotic therapy for how long? 5 to 7 days 7 to 14 days 1 to 3 days 3 to 5 days

7 to 14 days

A client is suspected of having cirrhosis of the liver. What diagnostic procedure will the nurse prepare the client for in order to obtain a confirmed diagnosis? A CT scan Platelet count A liver biopsy A prothrombin time

A liver biopsy

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of congenital aganglionic megacolon? A partial or complete intestinal obstruction occurs. In this disorder the sphincter that leads into the stomach is relaxed. A thickened, elongated muscle causes an obstruction at the end of the stomach. There are recurrent paroxysmal bouts of abdominal pain.

A partial or complete intestinal obstruction occurs.

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? The newborn is already severely impaired at birth, and this suggests the diagnosis. Hypothyroidism is usually detected at birth by the newborn's physical appearance. A simple blood test to diagnose hypothyroidism is required in most states. 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 nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurately related to the diagnosis of pyloric stenosis? A thickened, elongated muscle causes an obstruction at the end of the stomach. A partial or complete intestinal obstruction occurs. In this disorder the sphincter that leads into the stomach is relaxed. There are recurrent paroxysmal bouts of abdominal pain.

A thickened, elongated muscle causes an obstruction at the end of the stomach.

The nurse observes the interactions of parents with their infant who was born with a cleft lip. The mother is attempting to feed the baby, but does not make eye contact. The father is watching television with his back turned to the mother and baby. What psychosocial nursing intervention would be most helpful to this family? Ask the parents if they have any questions regarding the care of their child. Refer the family to a social worker or mental health practitioner. Explain to the parents that surgical intervention will fix the defect in the baby's lip. Teach the mother the appropriate technique for breastfeeding an infant with cleft lip.

Ask the parents if they have any questions regarding the care of their child.

The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed? Upper endoscopy Abdominal CT scan Thoracentesis Abdominal paracentesis

Abdominal paracentesis

An important message for any nurse to communicate is that drug-induced hepatitis is a major cause of acute liver failure. The medication that is the leading cause is: Dextromethorphan Ibuprofen Acetaminophen Benadryl

Acetaminophen

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

Administer subcutaneous glucagon.

Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward? Vitamin K administration until school age An increased intake of calcium beginning immediately Administration of vitamin C until after growth is complete Administration of levothyroxine indefinitely

Administration of levothyroxine indefinitely

A client reporting shortness of breath is admitted with a diagnosis of cirrhosis. A nursing assessment reveals an enlarged abdomen with striae, an umbilical hernia, and 4+ pitting edema of the feet and legs. What is the most important data for the nurse to monitor? Hemoglobin Albumin Bilirubin Temperature

Albumin

What intervention does the nurse anticipate providing for the patient with ascites that will help correct the decrease in effective arterial blood volume that leads to sodium retention? Albumin infusion Platelet infusions Therapeutic paracentesis Diuretic therapy

Albumin infusion

The single modality of pharmacologic therapy for chronic type B viral hepatitis is: Epivir Hepsera Baraclude Alpha-interferon

Alpha-interferon

The nurse is assessing a client with hepatic cirrhosis for mental deterioration. For what clinical manifestations will the nurse monitor? Select all that apply. Insomnia Agitation Alterations in mood Report of headache Decreased deep tendon reflexes

Alterations in mood Agitation Insomnia

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? Growth hormone Antidiuretic hormone Insulin Thyroxine

Antidiuretic hormone

Diabetes insipidus is a disorder of the posterior pituitary that results in deficient secretion of which hormone? Adrenocorticotropic hormone (ACTH) Antidiuretic hormone (ADH) Luteinizing hormone (LH) Thyroid stimulating hormone (TSH)

Antidiuretic hormone (ADH)

The nurse is caring for a pediatric client with idiopathic celiac disease. Which meal will the nurse select for this client? Meatloaf, green beans, peanut butter cookie, and fat-free milk Ham and cheese sandwich, orange slices, chips, and whole milk Whole wheat pasta, meatballs, carrot sticks, apple, and water Baked salmon, potato slices, vanilla ice cream, and apple juice

Baked salmon, potato slices, vanilla ice cream, and apple juice

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition? Barium enema Upper endoscopy Endoscopic retrograde cholangiopancreatography Surgery

Barium enema

A woman in her first trimester of pregnancy has just been diagnosed with acquired hypothyroidism. The nurse is alarmed because this condition can lead to which pregnancy complication? Gestational diabetes in the mother Congenital heart defects in the fetus Decreased cognitive development of the fetus Spina bifida in the fetus

Decreased cognitive development of the fetus

A 6-year-old child is being evaluated for growth hormone dysfunction. Which tests will be employed in the diagnostic workup? Select all that apply. CT scan erythrocyte sedimentation rate pituitary function test complete blood count MRI

CT scan MRI pituitary function test

When caring for a client with advanced cirrhosis and hepatic encephalopathy, which assessment finding should the nurse report immediately? Weight loss of 2 pounds in 3 days Anorexia for more than 3 days Constipation for more than 2 days Change in the client's handwriting and/or cognitive performance

Change in the client's handwriting and/or cognitive performance

A new mother is concerned about the need to provide medication to a newborn every day for an indefinite period of time. What should the nurse encourage the mother to do to help ensure medication compliance? Select all that apply. Schedule prescription refills at least 1 day before the current amount is used up. Check the expiration dates on all medications. Build medication administration into the general home routine. Plan times for medications that fit in with the daily routine. Make medication administration pleasant such as including it during mealtimes.

Check the expiration dates on all medications. Plan times for medications that fit in with the daily routine. Build medication administration into the general home routine.

A nurse is caring for a client with cholelithiasis. Which sign indicates obstructive jaundice? Clay-colored stools Straw-colored urine Reduced hematocrit Elevated urobilinogen in the urine

Clay-colored stools

A child presents with intermittent abdominal pain, severe anorexia, and diarrhea. The child's height and weight are significantly behind standards for age. There is skin breakdown in the anal region. The nurse explains that this presentation is consistent with which diagnosis? ulcerative colitis Hirschsprung disease Crohn disease food poisoning

Crohn disease

The nurse knows that which condition is caused by excessive levels of circulating cortisol? Turner syndrome Addison disease Cushing syndrome Graves disease

Cushing syndrome

Which is an age-related change of the hepatobiliary system? Decreased blood flow Enlarged liver Increased drug clearance capability Decreased prevalence of gallstones

Decreased blood flow

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

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 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 works on your pancreas to stimulate insulin production.

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

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? Explain the preparation for an 8-hour fasting blood glucose test. Explain why the child might need to schedule an eye exam. Discuss preparing for a thyroid function test. Prepare the parent for a neurology consult.

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. 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.

A child is admitted with a temperature, 101.2°F (38.4°C); pulse rate 100 beats/min; respirations 24 breaths/min. On admission the pain is localized in right lower quadrant. Legs are drawn up against the abdomen. Bowel sounds are sluggish. Rebound tenderness is present. White blood cell count of 17,000/mm3. Ultrasound confirms appendicitis. Which instruction would the nurse give to the child and the parent? Use a heating pad to decrease the abdominal discomfort. Do not rub or put pressure on the abdomen. Drink cool fluids to reduce the temperature. Place an ice pack over the place of the discomfort.

Do not rub or put pressure on the abdomen.

A nurse is caring for a patient with cancer of the liver whose condition has required the insertion of a percutaneous biliary drainage system. The nurse's most recent assessment reveals the presence of dark green fluid in the collection container. What is the nurse's best response to this assessment finding? Document the presence of normal bile output. Aspirate a sample of the drainage for culture. Promptly report this assessment finding to the primary provider. Irrigate the drainage system with normal saline as prescribed.

Document the presence of normal bile output.

The mother of a newborn with a cleft lip reports she is having a hard time looking her baby. What is the best action by the nurse? Tell the mother that while this is difficult it will get easier. Encourage the mother to provide care for her infant. Explain that surgery will make this better in the future. Encourage the child's mother to hold her infant against her shoulder to provide closeness while not looking at the defect.

Encourage the mother to provide care for her infant.

A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client? Divergent vision Abnormal facial features Enlarged clitoris Small for gestational age

Enlarged clitoris

The mode of transmission of hepatitis A virus (HAV) includes which of the following? Semen Fecal-oral Blood Saliva

Fecal-oral

Which type of deficiency results in macrocytic anemia? Folic acid Vitamin C Vitamin A Vitamin K

Folic acid

The nurse is administering medications to a client that has elevated ammonia due to cirrhosis of the liver. What medication will the nurse give to detoxify ammonium and to act as an osmotic agent? Cholestyramine Spironolactone Lactulose Kanamycin

Lactulose

A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect? Appendicitis Gastroenteritis Hirschsprung disease Pancreatitis

Gastroenteritis

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 hypothyroidism Cushing syndrome hypertension

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? Graves disease syndrome of inappropriate antidiuretic hormone secretion (SIADH) diabetes Cushing disease

Graves disease

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

Heat intolerance

The nurse identifies which type of jaundice in an adult experiencing a transfusion reaction? Hemolytic Nonobstructive Hepatocellular Obstructive

Hemolytic

A nurse prepares a menu for a client with Crohn disease. What is the focus of dietary management for this disease? High calorie, high fiber Low calorie, high carbohydrate Low fiber, low calorie High carbohydrate, high protein

High carbohydrate, high protein

A client has developed drug-induced hepatitis from a drug reaction to antidepressants. What treatment does the nurse anticipate the client will receive to treat the reaction? High-dose corticosteroids Paracentesis Azathioprine Liver transplantation

High-dose corticosteroids

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time? Improving hydration Maintaining skin integrity Promoting comfort Preparing family for home care

Improving hydration

The assessment of a client admitted with increased ascites related to cirrhosis reveals the following: pulse 86 beats per minute and weak, respirations 28 breaths per minute, blood pressure 130/88 mm Hg, and pulse oximetry 90%. Which nursing diagnosis should receive top priority? Excess fluid volume Imbalanced nutrition: less than body requirements Fatigue Ineffective breathing pattern

Ineffective breathing pattern

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case? Necrotizing enterocolitis Volvulus with malrotation Short-bowel/short-gut syndrome Intussusception

Intussusception

The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess? It is difficult to keep the child awake. The child is active and playful. The child has above-normal growth for his age. The skin is pink and healthy looking.

It is difficult to keep the child awake.

While conducting a physical examination of a client, which of the following skin findings would alert the nurse to the liklihood of liver problems? Select all that apply. Cyanosis of the lips Aphthous stomatitis Ecchymoses Petechiae Jaundice

Jaundice Petechiae Ecchymoses

A client is being prepared to undergo laboratory and diagnostic testing to confirm the diagnosis of cirrhosis. Which test would the nurse expect to be used to provide definitive confirmation of the disorder? Coagulation studies Magnetic resonance imaging Radioisotope liver scan Liver biopsy

Liver biopsy

A client with right upper quadrant pain and weight loss is diagnosed with liver cancer. For which treatment will the nurse prepare the client when it is determined that the disease is confined to one lobe of the liver? Laser hyperthermia Radiation Liver resection Chemotherapy

Liver resection

Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism? High thyroxine (T4) level and low thyroid stimulating hormone (TSH) level Low T4 level and high TSH level Normal TSH level and high T4 level Normal T4 level and low TSH level

Low T4 level and high TSH level

A client with cirrhosis has a massive hemorrhage from esophageal varices. Balloon tamponade is used temporarily to control hemorrhage and stabilize the client. In planning care, the nurse gives the highest priority to which goal? Maintaining fluid volume Maintaining the airway Controlling bleeding Relieving the client's anxiety

Maintaining the airway

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? Correct nausea and vomiting. Monitor the child's weight daily. Monitor intake and output. Monitor sodium levels.

Monitor sodium levels.

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 intake and output. Educating family about side effects. Providing a wet washcloth to suck. Monitoring blood glucose levels.

Monitoring blood glucose levels.

A 3-month-old girl is found to have an umbilical hernia at a well visit. On examination, the nurse discovers that the fascial ring through which the intestine protrudes is about 1 cm in diameter. Which statement by the nurse to the girl's father would indicate the likely intervention required to correct this condition? Taping a silver dollar over the area will help reduce the hernia. Wrapping an elastic band around the child's waist should correct the problem. Surgery at age 1 to 2 years will likely be needed to repair the condition. No intervention is needed, as the opening will most likely close spontaneously.

No intervention is needed, as the opening will most likely close spontaneously.

A client has undergone a liver biopsy. After the procedure, the nurse should place the client in which position? High Fowler On the left side On the right side Trendelenburg

On the right side

The nurse is caring for a teenager diagnosed with acute pancreatitis. Which order would the nurse question? PO pain management NPO nasogastric tube placed to suction serum amylase levels

PO pain management

The nurse is caring for an 11-year-old child who has type 2 diabetes mellitus. The child has been vomiting for 48 hours and the breath has a fruity odor. The nurse notes that respirations are deep and rapid with a temperature of 102°F (38.9°C). Which intervention would be most appropriate? Give the child 25 g of carbohydrates. Prepare for IV insertion. Test the child's urine to detect the presence of ketones. Give the child 8 ounces of clear liquid.

Prepare for IV insertion.

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 Abrupt onset of symptoms Marked weight loss Polydipsia Polyphagia

Polyuria Polydipsia Polyphagia

In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention? Change the infant's diet to one that is lactose-free. Assist in insertion of a nasogastric (NG) tube. Assist in doing a barium enema procedure on the infant. Prepare the infant for surgery.

Prepare the infant for surgery.

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis? Projectile vomiting Frequent urination Severe abdominal pain Explosive diarrhea

Projectile vomiting

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? Lispro Regular insulin NPH Detemir

Regular insulin

The nurse is providing care to a patient with gross ascites who is maintaining a position of comfort in the high semi-Fowler's position. What is the nurse's priority assessment of this patient? Skin assessment related to increase in bile salts Urinary output related to increased sodium retention Peripheral vascular assessment related to immobility Respiratory assessment related to increased thoracic pressure

Respiratory assessment related to increased thoracic pressure

In what location would the nurse palpate for the liver? Left lower quadrant Right lower quadrant Right upper quadrant Left upper quadrant

Right lower quadrant

The nurse is caring for a 6-month-old infant with diarrhea and dehydration. The parent is concerned because the infant has some patches on the tongue. Which feature indicates a geographic tongue? The patches are thick, white plaques on the tongue. Some patches are light in color and other patches are dark in color. There are also white patches on the erupted teeth. There are also plaques on the buccal mucosa.

Some patches are light in color and other patches are dark in color.

A client with liver cirrhosis develops ascites. Which medication will the nurse prepare teaching for this client? Acetazolamide Furosemide Ammonium chloride Spironolactone

Spironolactone

Gynecomastia is a common side effect of which of the following diuretics? Nitroglycerin (IV) Vasopressin Furosemide Spironolactone

Spironolactone

The nurse is caring for a 6-month-old infant who was admitted to the emergency department 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104°F (40°C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which is the priority nursing intervention? Administer antibiotic therapy Administer IV potassium Take a stool culture Feed the child a cracker

Take a stool culture

The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration? Soft and flat fontanels (fontanelles) Blood pressure of 80/42 mm Hg Tenting of skin Pale and slightly dry mucosa

Tenting of skin

An adolescent is diagnosed with hepatitis A. Which problem should be considered when planning care? The adolescent's urine will be dark and infectious. The adolescent will become fatigued easily. The adolescent will be very irritable and perhaps require sedation. Hypothermia is common.

The adolescent will become fatigued easily.

Ammonia, the major etiologic factor in the development of encephalopathy, inhibits neurotransmission. Increased levels of ammonia are damaging to the body. The largest source of ammonia is from: Severe infections and high fevers. Excessive diuresis and dehydration. Excess potassium loss subsequent to prolonged use of diuretics. The digestion of dietary and blood proteins.

The digestion of dietary and blood proteins.

The nurse is caring for a child who is suspected to have a growth hormone deficiency. Which finding after further testing supports this diagnosis? Computed tomography identifies a tumor on the child's kidney. Magnetic resonance imaging shows a brain tumor. Physical examination finds excessive foot and finger growth for age. The bone age is found to be two or more deviations below normal.

The bone age is found to be two or more deviations below normal.

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 needs to be started on an antibiotic drug. The child may not be taking the medication. The child may have developed leukopenia. The child must be participating in sports.

The child may have developed leukopenia.

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? Oral cavity assessment shows two of the 6-year molars. The mother reports that the boy is always thirsty. The child states that the exam room is cold. The child has a faint rash on the trunk of the body.

The child states that the exam room is cold.

The nurse is completing a morning assessment of a client with cirrhosis. Which information obtained by the nurse will be of most concern? The skin on the client's abdomen has multiple spider-shaped blood vessels. The client's hands flap back and forth when the arms are extended. The client has gained 2 kg from the previous day. The client reports nausea and anorexia.

The client's hands flap back and forth when the arms are extended.

A nurse is caring for a client with cirrhosis. The nurse assesses the client at noon and discovers that the client is difficult to arouse and has an elevated serum ammonia level. The nurse should suspect which situation? The client is avoiding the nurse. The client didn't take his morning dose of lactulose (Cephulac). The client is relaxed and not in pain. The client's hepatic function is decreasing.

The client's hepatic function is decreasing.

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.

What occurs in the gastrointestinal system of the child with Hirschsprung disease? There is a severe narrowing of the lumen of the pylorus. There is an invagination or telescoping of one portion of the bowel into a distal portion. There is a relaxed sphincter in the lower portion of the esophagus. There is a partial or complete mechanical obstruction in the intestine.

There is a partial or complete mechanical obstruction in the intestine.

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 does not interact with any other types of medication. This medication must be given in the morning before school. This medication must be given by injection. Hip or knee pain is an expected adverse effect of this 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 Type 1 diabetes mellitus Diabetes insipidus Hypothyroidism

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? Oral intake Oral mucosa Urine output Vital signs

Urine output

A child with inflammatory bowel disease is started on an anti-inflammatory medication. Which item(s) would the nurse teach the child and parents about being on this type of medication? Select all that apply. Take the medication between meals to increase absorption. Increase folic acid intake. Administer the medication just after meals to avoid gastrointestinal irritation. Drink adequate fluids to avoid crystallization of sulfa in urine. Use sunscreen and protective clothing while outside.

Use sunscreen and protective clothing while outside. Increase folic acid intake. Drink adequate fluids to avoid crystallization of sulfa in urine. Administer the medication just after meals to avoid gastrointestinal irritation.

Which of the following is the most effective strategy to prevent hepatitis B infection? Vaccine Barrier protection during intercourse Covering open sores Avoid sharing toothbrushes

Vaccine

Which medication is used to decrease portal pressure, halting bleeding of esophageal varices? Cimetidine Vasopressin Nitroglycerin Spironolactone

Vasopressin

A client with severe and chronic liver disease is showing manifestations related to inadequate vitamin intake and metabolism. He reports difficulty driving at night because he cannot see well. Which of the following vitamins is most likely deficient for this client? Vitamin A Thiamine Riboflavin Vitamin K

Vitamin A

The nurse is administering Cephulac (lactulose) to decrease the ammonia level in a patient who has hepatic encephalopathy. What should the nurse carefully monitor for that may indicate a medication overdose? Asterixis Ringing in the ears Vomiting Watery diarrhea

Watery diarrhea

Which condition indicates an overdose of lactulose? Watery diarrhea Hypoactive bowel sounds Fecal impaction Constipation

Watery diarrhea

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 proteinuria a fasting blood glucose less than 126 mg/dl glucose in the urine

a fasting blood glucose less than 126 mg/dl

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which foods would be permitted in the diet of the child with celiac syndrome? Select all that apply. applesauce bananas skim milk rye bread wheat bread

applesauce bananas skim milk

A child with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. Which action would be the priority? encouraging increased fluid intake weighing the client measuring urine output checking vital signs

checking vital signs

A child with growth hormone deficiency is prescribed growth hormone (GH) by subcutaneous injection. When teaching the child's parents about this drug, the nurse would instruct the parents to administer the drug at which frequency? monthly every 3 days daily, 6 to 7 days a week weekly

daily, 6 to 7 days a week

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason? evaluate gastric pH confirm pancreatitis determine esophageal contractility detect Helicobacter pylori

detect Helicobacter pylori

After teaching a group of students about endocrine disorders, the instructor determines that the teaching was successful when the students identify insulin deficiency, increased levels of counterregulatory hormones, and dehydration as the primary cause of which condition? ketonuria glucosuria ketone bodies diabetic ketoacidosis

diabetic ketoacidosis

Insulin deficiency, in association with increased levels of counter-regulatory hormones and dehydration, is the primary cause of: ketone bodies. ketonuria. glucosuria. diabetic ketoacidosis.

diabetic ketoacidosis.

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 warm, moist skin tachycardia

enlarged tongue

The labor and delivery nurse is caring for a mother who has demonstrated polyhydramnios upon delivery. The newborn displays copious, frothy bubbles of mucus in the mouth and nose, as well as drooling. The nurse is concerned that the infant has what disorder? hiatal hernia gastroschisis omphalocele esophageal atresia

esophageal atresia

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate? esophageal atresia (EA) cleft palate hernia pyloric stenosis

esophageal atresia (EA)

A 14-year-old client has just been diagnosed with Graves disease. Which symptom(s) is likely to be noted in the assessment? Select all that apply. lethargy moist skin nervousness increased basal metabolic rate obesity exophthalmos

exophthalmos moist skin nervousness increased basal metabolic rate

The nurse is caring for a 12-year-old child with Crohn disease. What assessment finding will the nurse report to the health care provider when caring for the child? no joint swelling fever clear lung sounds report of a headache

fever

A pediatric client has just been diagnosed with diabetes insipidus. What is the primary consideration for this client? weight loss fluid replacement polydipsia headache

fluid replacement

A child with type 1 diabetes is brought to the emergency department. The nurse suspects diabetic ketoacidosis (DKA) based on which assessment findings? Select all that apply. increased urine output fruity odor on the breath poor skin turgor decreased level of consciousness quick capillary refill

fruity odor on the breath decreased level of consciousness poor skin turgor

An 18-month-old infant is brought to the emergency department with flu-like symptoms. The infant is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: Hirschsprung disease. inflammatory bowel disease. gastroesophageal reflux disease. cystic fibrosis.

gastroesophageal reflux disease.

The nurse caring for a child who has issues with the anterior pituitary gland would expect the child to have issues with which hormone? oxytocin growth hormone antidiuretic hormone vasopressin

growth hormone

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 vasopressin antidiuretic hormone oxytocin

growth hormone

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? hard, moveable "olive-like mass" in the upper right quadrant abdominal pain and irritability sausage-shaped mass in the upper mid abdomen perianal fissures and skin tags

hard, moveable "olive-like mass" in the upper right quadrant

The parent reports that the health care provider said that the infant had a hernia but cannot remember which type. When recalling what the health care provider said, the parent said that a surgeon will repair it soon and there is no problem with the testes. Which hernia type is anticipated? umbilical hernia diaphragmatic hernia hiatal hernia inguinal hernia

inguinal hernia

The nurse is interpreting the negative feedback system that controls endocrine function. What secretion will the nurse correlate as decreasing while blood glucose levels decrease? glycogen insulin adrenocorticotropic hormone glucagon

insulin

A nurse educator is providing an in-service to a group of nurses working on a medical floor that specializes in liver disorders. What is an important education topic regarding ingestion of medications? medications becoming ineffective in clients with liver disease need for increased drug dosages need for more frequently divided doses metabolism of medications

metabolism of medications

A child is hospitalized with dehydration as a result of rotavirus. When reviewing the plan of treatment, what can the nurse anticipate will be included? Select all that apply. monitor of intake and output antibiotic therapy daily weight assessment IV fluid administration antidiarrheal agents

monitor of intake and output daily weight assessment IV fluid administration

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition? maternal use of acetaminophen in third trimester history of hypoxia at birth mother age 42 with pregnancy preterm birth

mother age 42 with pregnancy

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

oral calcium

The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is: dehydration. ischemia. painless rectal bleeding. respiratory distress.

painless rectal bleeding.

A parent brings a 10-year-old child to the emergency room with reports of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which disease would the nurse suspect? Crohn disease appendicitis pancreatitis ulcerative colitis

pancreatitis

An 8-year-old child is seen for moodiness and irritability. The child has begun to develop breast and pubic hair and the parents are concerned that these changes are occurring at too early an age. Which would the nurse suspect? adrenal hyperplasia precocious puberty pseudopuberty neurofibromatosis

precocious puberty

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? pseudopuberty neurofibromatosis precocious puberty adrenal hyperplasia

precocious puberty

A 3-month-old is admitted with severe diarrhea. Yesterday, the infant weighed 11 pounds (5 kg). Today, this infant weighs 9 pounds, 8 ounces (4.3 kg). Based on this information the nurse documents that the infant has: failure to thrive. malabsorption syndrome. risk for fluid volume deficit. severe dehydration.

severe dehydration.

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? situational low self-esteem risk associated with short stature altered skin integrity associated with overproduction of melanin altered tissue perfusion associated with infantile blood vessels self-directed violence risk associated with oversecretion of epinephrine

situational low self-esteem risk associated with short stature

A 12-year-old client arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. The client is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder is most associated with these symptoms? syndrome of inappropriate antidiuretic hormone (SIADH) hypersecretion of growth hormone hyposecretion of somatotropin diabetes insipidus (DI)

syndrome of inappropriate antidiuretic hormone (SIADH)

The nurse working with the child diagnosed with type 2 diabetes recognizes the disorder can be managed by: 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.

taking oral hypoglycemic agents.

A client with viral hepatitis A is being treated in an acute care facility. Because the client requires enteric precautions, the nurse should: place the client in a private room. wear a mask when handling the client's bedpan. wear a gown when providing personal care for the client. wash her hands after touching the client.

wash her hands after touching the client.

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 150 mg/dl. How soon should the nurse ensure that the client eats breakfast after receiving insulin? within 5 minutes within 2 hours within 15 to 30 minutes within 60 to 90 minutes

within 15 to 30 minutes

A child with liver cirrhosis is admitted to the acute care facility in preparation for a liver transplant. What finding(s) would the nurse document after completing this child's assessment? Select all that apply. yellow skin and sclera palms of hands reddened liver palpable fatty, foul-smelling stool confused mental status

yellow skin and sclera palms of hands reddened liver palpable confused mental status