1.
The 6-year-old son of Mr. and Mrs. Peters is admitted to the healthcare facility with the diagnosis of idiopathic hypopituitarism. His height is measured below the third percentile and weight at the 40th percentile. Which of the following would be the first action of his attending nurse?
Correct Answer
B. Collaborate with a dietician to access his caloric needs.
Explanation
Because the child’s weight is excessive for his height. he needs dietary assessment and a weight-loss program.A: An underdeveloped jaw is not usually a problem with hypopituitarism.C: Providing a tutor to educate him is an appropriate action. but the rationale is incorrect. Although children with hypopituitarism generally appear intellectually precocious because of the disparity between their size and their cognitive ability. they are usually of normal intelligence.D: Placing the child in a room with a toddler could contribute to poor self-esteem.
2.
Katie is admitted to the intensive care unit of Nurseslabs Medical Center for diabetic ketoacidosis; which of the following is of primary importance when caring for the child?
Correct Answer
B. Evaluating the child for cardiac abnormalities
Explanation
As the fluid volume deficit is improved. total body potassium deficiency may occur. leaving the child vulnerable to hypokalemia and. afterward. cardiac arrest. The nurse should monitor the cardiac cycle for prolonged QT interval. low T wave. and depressed ST segment. which indicate weakened heart muscle and potential irregular heartbeat.A: Regular insulin is the only insulin that can be given I.V. NPH is an intermediate-acting insulin; continuous low-dose infusion of a rapid-acting insulin is preferred.C: I.V. fluids should be given to correct dehydration.D: Hypertension is more likely to happen secondary to dehydration.
3.
Nurse Angelo is attending for a child with Cushing’s syndrome; which of the following nursing interventions would be most necessary?
Correct Answer
B. Handling the child carefully to prevent bruising
Explanation
The nurse should handle the child carefully because Cushing’s syndrome causes capillary fragility. resulting in easy bruising and calcium excretion. resulting in osteoporosis. A and C: Cushing’s syndrome causes increased excretion of potassium and hydrogen ions. resulting in alkalosis and increased water and sodium retention. and hypokalemia. resulting in a sluggish and irregular heartbeat.D: Cushing’s syndrome causes hyperglycemia. not hypoglycemia.
4.
While Andres is being assessed at the clinic. Nurse Shiela observed that the child appears to be small. with an immature face and chubby body build. Her parents stated that their child’s rate of growth of all body parts is somewhat slow. but her proportions and intelligence remain normal. As a knowledgeable nurse. you know that the child has a deficiency of which of the following?
Correct Answer
C. Growth hormone (GH)
Explanation
GH stimulates protein anabolism. promoting bone and soft-tissue growth. A lack of GH would lead to decreased synthesis of somatomedin. resulting in decreased linear growth and decreased fat catabolism and increased glucose uptake in muscles. resulting in excessive subcutaneous fat hypoglycemia.A: A deficiency in ADH results in diabetes insipidus. marked by dehydration and hypernatremia.B: Deficiency of PTH causes hypocalcemia. marked by tetany. convulsions. and muscle spasms.D: Deficiency of MSH causes diminished or absent skin pigmentation.
5.
Justine is admitted to the pediatric unit due to the occurrence of diabetic ketoacidosis signaling a new diagnosis of diabetes. The diabetes team explores the cause of the episode and take steps to prevent a recurrence. Diabetic ketoacidosis (DKA) results from an excessive accumulation of which of the following?
Correct Answer
D. Ketone bodies from fat metabolism
Explanation
Inability to use glucose causes lipolysis. fatty acid oxidation. and release of ketones. resulting in metabolic acidosis and coma.A: Sodium bicarbonate administration is a treatment for DKA. not a cause.B: Potassium depletion. not potassium excess. occurs in DKA.C: Inability to use glucose. not impaired carbohydrate metabolism. is the primary mechanism is diabetes mellitus.
6.
Nurse Aries entered the room of a child with hypopituitarism and was asked by the couple about the condition of their child. Which of the following phrases if stated by the nurse best describes the condition?
Correct Answer
A. Linear growth retardation with skeletal proportions normal for chronologic age
Explanation
Although linear growth retardation occurs in hypopituitarism. delayed epiphyseal maturation allows for normal skeletal proportions.B: The child with hypopituitarism commonly experiences delayed sexual maturation.C: Normal growth may occur for the first year. followed by linear growth thereafter.D: Height is affected more profoundly than weight. contributing to obesity.
7.
In growing children. growth hormone deficiency results in short stature and very slow growth rates. Short stature may result from which of the following?
Correct Answer
A. Anterior pituitary gland hypofunction
Explanation
Short stature usually results from diminished or deficient growth hormone. which is released from the anterior pituitary gland.B: Posterior pituitary hyperfunction results in increased secretion of antidiuretic hormone or oxytocin. leading to a syndrome of inappropriate antidiuretic hormone secretion. marked by fluid retention and hyponatremia.C: Parathyroid hypofunction leads to hypocalcemia.D: Thyroid hyperfunction causes increased secretion of thyroxine. triiodothyronine. and thyrocalcitonin. resulting in Graves’ disease. marked by accelerated linear growth and early epiphyseal closure.
8.
Tara is an 11-year-old girl diagnosed with type 1 diabetes mellitus (DM). She asks her attending nurse why she can’t take a pill rather than shots like her grandmother does. Which of the following would be the nurse’s best reply?
Correct Answer
C. “Your body does not make insulin. so the insulin injections help to replace it.”
Explanation
The child has type 1 DM. indicating a lack of functioning pancreatic beta cells and an absolute insulin deficiency.A: Oral antidiabetics are indicated only for those with some functioning beta cells. as in those with type 2 DM. Therefore. injections are indicated to supply insulin that is lacking in type 1 diabetes.B: Oral antidiabetics do not correct metabolism.D: A child with type 1 DM cannot substitute an oral antidiabetic for insulin. regardless of age.
9.
Which type of diabetes mellitus (DM) most likely results from heterogenous risk factors. making it preventable?
Correct Answer
B. Type 2
Explanation
Type 2 DM is a complex disorder of various causes with social. behavioral. and environmental risk factors. The disorder may be prevented by encouraging lifestyle modification for children at risk.
10.
Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares to the nurse the desire of his son to play ball games. However. his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents. the nurse should keep in mind which of the following?
Correct Answer
A. The child should be allowed to play because doing so can foster healthy self-esteem.
Explanation
Engaging in peer-group activities can aid foster a sense of belonging and a positive self-concept. T-ball is a good sport to choose because physical stature is not an important consideration in the ability to participate. unlike some other sports. such as basketball and football.B: Hypopituitarism does not affect calcium and phosphorus homeostasis and demineralization of bone. So the risk for fractures is not increased.C: Although rare. physical activity without adequate carbohydrate intake can cause hypoglycemia.D: Moderate physical activity increases caloric use and reduces weight without undue strain on weight-bearing joints.