Peds Endocrine

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? 1. Use the second voided urine for most accurate results. 2. Demonstrate a clean catch techinque. 3. Encourage the patient to consume at least 24 oz of water prior to the specimen collection. 4. Cleanse the area with betadine.

1. Use the second voided urine for most accurate results.

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? 1. Weight change of 100 lbs to 92 lbs and urinary output of less than 1 ml/kg/hr 2. 1-3 second skin turgor 3. Weight change of 90 lbs to 93 lbs and dry mucous membranes 4. Options A & C

1. Weight change of 100 lbs to 92 lbs and urinary output of less than 1 ml/kg/hr

A parent brings a 2-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and makes which interpretation? 1. It is positive. 2. It is negative. 3. It is inconclusive. 4. It requires rescreening at age 6 weeks.

2. It is negative.

A 7 year old has been having vomiting with diarrhea for 3 days. How do you expect the child to present clinically? 1. Sunken eyeballs and bradycardia 2. Tachycardia, dry mucous membranes, weight loss 3. None of the options are correct. 4. Bradycardia, dry mucous membranes, absence of tears

2. Tachycardia, dry mucous membranes, weight loss

You check a patient's blood glucose with a glucometer and find it to read 99. How would you interpet this result? 1. This is hyperglyemia and contact the doctor. 2. This finding is normal and no further intervention is needed. 3. This is diabetic ketoacidosis and contact the doctor. 4. This is hypoglyemia and encourage the patient to eat something with sugar.

2. This finding is normal and no further intervention is needed.

The nurse would implement which interventions for a child older than 2 years with type 1 diabetes mellitus who has a blood glucose level of 60 mg/dL (3.4 mmol/L)? Select all that apply. 1. Administer regular insulin. 2. Encourage the child to ambulate. 3. Give the child a teaspoon of honey. 4. Provide electrolyte replacement therapy intravenously. 5. Wait 30 minutes and confirm the blood glucose reading. 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs.

3. Give the child a teaspoon of honey. 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs.

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? 1. None of the options are correct. 2. How she takes her blood glucose after exercise. 3. Her eating habits prior to gym class. 4. What type of form she needs to have filled out so she can be excused from gym class.

3. Her eating habits prior to gym class.

A pediatrician prescribes an intravenous (IV) solution of 5% dextrose and half-normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? 1. Obtains a weight 2. Takes the temperature 3. Takes the blood pressure 4. Checks the amount of urine output

4. Checks the amount of urine output

A school-age child with type 1 diabetes mellitus has soccer practice, and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which would the school nurse tell the child to do? 1. Eat twice the amount normally eaten at lunchtime. 2. Take half the amount of prescribed insulin on practice days. 3. Take the prescribed insulin at noontime rather than in the morning. 4. Eat a small box of raisins or drink a cup of orange juice before soccer practice

4. Eat a small box of raisins or drink a cup of orange juice before soccer practice

An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings would the nurse expect to note? 1. Sweating and tremors 2. Hunger and hypertension 3. Cold, clammy skin and irritability 4. Fruity breath odor and decreasing level of consciousness

4. Fruity breath odor and decreasing level of consciousness

A child with type 1 diabetes mellitus is brought to the emergency department by the parents, who state that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion? 1. Potassium infusion 2. NPH insulin infusion 3. 5% dextrose infusion 4. Normal saline infusion

4. Normal saline infusion

The nurse has just administered ibuprofen to a child with a temperature of 102° F (38.8° C). The nurse would also take which action? 1. Withhold oral fluids for 8 hours. 2. Sponge the child with cold water. 3. Plan to administer salicylate in 4 hours. 4. Remove excess clothing and blankets.

4. Remove excess clothing and blankets.

A patient with a history is diabetes is exhibiting sweating and slurred speech. What do you suspect is the cause? 1. hyponaterima 2. hyperglycemia 3. hypernaterima 4. hypoglycemia

4. hypoglycemia

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? 1. "I re-took his temperature 30 minutes after I gave the medication and it was still high." 2. "I've tried to encourage fluid intake every hour." 3. "I administered Aspirin to help with the fever a few hours ago." 4. "I gave him a sponge bath to help with the fever."

3. "I administered Aspirin to help with the fever a few hours ago."

You are going over insulin administration education with a patient's mother. Which statement by her raises concern? 1. "I always carry sugary items in case she has a hypoglemic attack." 2. "I will bring her in every 3 months for a glycosylate hemoglobin blood drawn." 3. "When she is sick I will hold her insulin." 4. "I ordered her a Medic-Alert bracelet yesterday."

3. "When she is sick I will hold her insulin."

A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted? 1. The child has no tears. 2. Urine specific gravity is 1.035. 3. Capillary refill is less than 2 seconds. 4. Urine output is less than 1 mL/kg/hr.

3. Capillary refill is less than 2 seconds.

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? 1. Phenylkentonuria 2. Diabetes Mellitus 3. Hypoglyemia 4. Tret's syndrome

2. Diabetes Mellitus

The parents of a 6-year-old child who has type 1 diabetes mellitus call a clinic nurse and tell the nurse that the child has been sick. The parents report that the child's urine is positive for ketones. The nurse would instruct the parents to take which action? 1. Hold the next dose of insulin. 2. Come to the clinic immediately. 3. Encourage the child to drink liquids. 4. Administer an additional dose of regular insulin.

3. Encourage the child to drink liquids.

A child with diabetic ketoacidosis requires insulin. What lab valve do you need to monitor? 1. Calcium level 2. Magnesium level 3. Potassium level 4. Sodium level

3. Potassium level