Pediatric Endocrine NCLEX quiz

You are going over insulin administration education with a patient's mother. Which statement by her raises concern? A. "When she is sick I will hold her insulin." B."I always carry sugary items in case she has a hypoglemic attack." C. "I will bring her in every 3 months for a glycosylate hemoglobin blood drawn." D. "I ordered her a Medic-Alert bracelet yesterday."

A. When a diabetic is sick, they should never hold their insulin. This is because when the body is stressed or has an infection they are at a very high risk for hyperglycemia so it is essential they monitor their blood glucose closely and administered insulin as needed. All the other options are correct.

As the nurse, taking care of the patient who has been hospitalized for 3 days with dehydration, what abnormal finding would you report to the MD? A. Weight change of 100 lbs to 92 lbs and urinary output of less than 1 ml/kg/hr B. 1-3 second skin turgor C. Weight change of 90 lbs to 93 lbs and dry mucous membranes D. Options A & C

A. The only correct option is: Weight change of 100 lbs to 92 lbs and urinary output of less than 1 ml/kg/hr. All the other answers are normal findings that do not cause concern.

Substance known to disrupt normal hormone-related growth and development of children include all the following except: A. Aloin B. Dioxins C. Oral contraceptives D. Coumestans derived from alfalfa

A. Aloin Aloin is the one of the active compounds found in aloe vera gel, and has not been found to affect childhood growth and development. Dioxins are toxic byproducts of industrial processes. Oral contraceptives contain female sex hormones that can alter normal sexual development in children based on their time of exposure. Coumestans, while natural compounds found in some plants, are considered phytoestrogens, which have been shown to affect endocrine function.

The nurse knows that diabetic teaching has been effective when parents of a newly diagnosed child state they will, during an illness, prove the child with: A. more insulin B. more calories C. less insulin D. less protein

A. more insulin Illness causes greater insulin resistance, so more is needed to achieve normal blood glucose levels. Increased calorie intake will be ineffective without more insulin to assist the body with metabolizing those calories. Restricting protein is not recommended, but during illness, fluids and light carbohydrates are usually tolerated best.

A 5 year old a has temperature of 103.6 'F and is brought into the emergency room by his mother. Which statement by the mother causes concern? A. "I've tried to encourage fluid intake every hour." B. "I administered Aspirin to help with the fever a few hours ago." C. "I re-took his temperature 30 minutes after I gave the medication and it was still high." D. "I gave him a sponge bath to help with the fever."

B. A child should never have aspirin, especially for a fever due to Reyes Syndrome.

A 7 year old has been having vomiting with diarrhea for 3 days. How do you expect the child to present clinically? A. Sunken eyeballs and bradycardia B. None of the options are correct. C. Bradycardia, dry mucous membranes, absence of tears D. Tachycardia, dry mucous membranes, weight loss

B. The child should be experiencing dehydration and would present clinically with: Tachycardia, dry mucous membranes, weight loss, sunken eyes and/or fontanles, decreased urinary output

A student with type I diabetes mellitus complains of feeling lightheaded. Her blood sugar is 60 mg/dL. Using the 15/15 rule, the nurse should: A. give 15 mL of juice, and repeat does in 15 minutes B. give 15 grams of carbohydrates and retest blood sugar in 15 minutes C. Give 15 grams of carbohydrates and 15 g of protein D. Give 15 ounces of juice and retest blood sugar in 15 minutes

B. give 15 grams of carbohydrates and retest blood sugar in 15 minutes 15/15 rule states to give 15 g of carbohydrates (approx 60 calories; roughly 4 oz of juice or a tablespoon of honey or sugar). Protein by itself will treat hypoglycemia. Only 15 mL of juice does not contain enough calories to increase the blood sugar. Fifteen oz of juice nearly 4 times the recommended amount

A mother brings her child in the office for a follow-up appointment and voices concern that her child has started urinating more than normal and is constantly thirsty & hungry. As the RN, you suspect?* A. Hypoglyemia B. Phenylkentonuria C. Diabetes Mellitus D. Tret's syndrome

C. The symptoms the mother is reports are the classic 3 P's of diabetes: polyuria, polydipsia, polyphagia

During teaching, the nurse should advise the family of a child newly-diagnosed with Graves' disease to: A. Encourage outdoor activities B. Limit bathing to prevent skin irritation C. Promote interaction with one friend instead of a group D. Set the thermostat higher than normal for comfort

C. Promote interaction with one friend instead of a group Children with Graves' disease (an autoimmune conditions that causes hyperthyriodism) tend to be more emotionally labile, and may have difficulty managing group dynamics. Sweating and feeling too warm are common complaints; showering should be encouraged. Bright light, such as sunshine, may be irritating because of disease-related ophthalmopathy.

A patient with a history is diabetes is exhibiting sweating and slurred speech. What do you suspect is the cause? A. hyponaterima B. hypernaterima C.hyperglycemia D. hypoglycemia

D These are the classic symptoms of hypoglycemia.

A child is ordered by the doctor for ketone and glucose urine testing. The patient is to collect it at home. How would you instruct the patient to collect the specimen?* A. Cleanse the area with betadine. B. Encourage the patient to consume at least 24 oz of water prior to the specimen collection. C. Demonstrate a clean catch techinque. D. Use the second voided urine for most accurate results.

D. The patient should use the second voided urine to ensure that the results are accurate. First voided urines tend to be concentrated and could effect results.

A 15 year old, who is type 1 diabetic, reports that she almost "passes out" during gym class. What information would you assess from the teenager?* A. None of the options are correct. B. What type of form she needs to have filled out so she can be excused from gym class. C. How she takes her blood glucose after exercise. D. Her eating habits prior to gym class.

D. It is very important to ask the teen when and what she eats before gym. Type 1 diabetics are encouraged to eat before physical activity to decrease the chances of hypoglycemia (which is what this teen is experiencing). She should take her blood glucose BEFORE exercise not AFTER. There is no need for her to be excused from gym class because exercise is essential for diabetics.

An adolescent with Addison's disease may need an increased dosage of glucocorticoids to which of the following situations? A. completing spring semester of school B. Gaining 7 pounds C. Death of a family member D. Undergoing a root canal

D. Undergoing a root canal Physical stress, such as infection, surgery, dental work and pregnancy, can lead to adrenal crisis in those with Addison's disease. Psychological stress has less effect than physical stress. Adrenal insufficiency leads to weight loss.

A two-year-old has been admitted with a diagnosis of Kawasaki disease. Which of the following would be a priority on the plan of care for this child? A. vital signs every 6 hours B. Hourly intake and output records C. Skin care D. Passive range-of-motion exercises

Those with Kawasaki disease are at high-risk for CHF in the initial stages. Vital signs would need to be recorded more often than every 6 hours. Skin care and ROM exercises are important, but not the priority at this time.