Nclex-Rn Practice Questions-Care Of The Child - Endocrine Disorders Part 2
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Question 1 |
In the neonatal intensive care unit, the nurse is assessing the neonate of a mother with poorly controlled diabetes. The nurse would assess the neonate for which condition?
A | Cataracts |
B | Low-set ears |
C | Cardiac malformations |
D | Cleft lip and palate deformities |
Question 2 |
A nurse is providing in-home management instruction for a child who is receiving desmopressin acetate (DDAVP) for symptomatic control of diabetes insipidus. What is the most important instruction the nurse to include?
A | Give DDAVP only when urine output begins to decrease. |
B | Cleanse skin with alcohol before application of the DDAVP dermal patch. |
C | Increase the DDAVP dose if polyuria occurs just before the next scheduled dose. |
D | Call the physician for an alternate route of DDAVP when the child has an upper respiratory infection (URI) or allergic rhinitis. |
Question 3 |
A nurse is assessing a client with suspected hypopituitarism. The nurse would observe the client for which of the following?
A | Sleep disturbance |
B | Polyuria |
C | Polydipsia |
D | Short stature |
Question 4 |
Which statement made to a nurse by the parents of a child with idiopathic growth hormone deficiency would indicate the need for further teaching?
A | “This disorder may be familial.” |
B | “There’s no genetic basis for this disorder.” |
C | “This disorder might be secondary to hypothalamic deficiency.” |
D | “There may be other disorders related to pituitary hormone deficiencies.” |
Question 5 |
A nurse is teaching health to a class of fifth graders. Which information is most important for the nurse to include?
A | “There’s nothing that you can do to influence your growth.” |
B | “Excessive physical activity that begins before puberty might stunt growth.” |
C | “All children who are short in stature also have parents who are short in stature.” |
D | “Because this is a time of tremendous growth, being concerned about calorie intake isn’t important.” |
Question 6 |
While teaching the parents of a child with short stature, the nurse discusses familial short stature. What is the most appropriate information for the nurse to include in the discussion?
A | “It occurs in children who are members of a very large family with limited resources.” |
B | “It occurs in children who have no siblings and who moved a great deal during their early childhood.” |
C | “It occurs in children with delayed linear growth and skeletal and sexual maturation that’s behind that of age mates.” |
D | “It occurs in children who have ancestors with adult height in the lower percentiles and whose height during childhood is appropriate.” |
Question 7 |
A nurse is assessing a child with growth hormone deficiency. The nurse documents the assessment data as:
A | decreased weight with no change in height. |
B | decreased weight with increased height. |
C | increased weight with decreased height. |
D | increased weight with increased height. |
Question 8 |
During the assessment of a child with growth hormone deficiency, the nurse would expect to observe which finding?
A | Normal skeletal proportions |
B | Abnormal skeletal proportions |
C | Child appearing older than his age |
D | Longer than normal upper extremities |
Question 9 |
The parents of a child with growth hormone deficiency ask the nurse what sport would be best for their child to participate in. What is the most appropriate response by the nurse?
A | Basketball |
B | Field hockey |
C | Football |
D | Gymnastics |
Question 10 |
The nurse is explaining to parents the social behavior of children with hypopituitarism. The nurse determines further teaching is necessary when a parent makes which statement?
A | “I realize that my child might have school anxiety and a low self-esteem.” |
B | “Because my child is short in stature, people expect less of him than his peers.” |
C | “Because of my child’s short stature, he may not be pushed to perform at his chronological age by others.” |
D | “My child’s vocabulary is very well developed, so even though he’s short in stature, no one will treat him differently.” |
Question 11 |
Which assessment finding would alert a nurse to change the intranasal route for vasopressin administration that has been prescribed for a client?
A | Mucous membrane irritation |
B | Severe coughing |
C | Nosebleeds |
D | Pneumonia |
Question 12 |
After a nurse has explained the causes of diabetes insipidus to the parents, which statement made by a parent indicates the need for further teaching?
A | “This condition could be familial or congenital.” |
B | “Drinking alcohol during my pregnancy caused this condition.” |
C | “My child might have a tumor that’s causing these symptoms.” |
D | “An infection such as meningitis may be the reason my child has diabetes insipidus.” |
Question 13 |
When teaching parents of an infant newly diagnosed with diabetes insipidus, which statement by a parent indicates an understanding of this condition?
A | “When my infant stabilizes, I won’t have to worry about giving hormone medication.” |
B | “I don’t have to measure the amount of fluid intake that I give my infant.” |
C | “I realize that treatment for diabetes insipidus is lifelong.” |
D | “My infant will outgrow this condition.” |
Question 14 |
A client with diabetes mellitus asks the nurse what condition could possibly cause hypoglycemia. What is the best response by the nurse?
A | Too little insulin |
B | Mild illness with fever |
C | Excessive exercise without a carbohydrate snack |
D | Eating ice cream and cake to celebrate a birthday |
Question 15 |
A client is learning to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, would indicate the need for further teaching?
A | Withdrawing the NPH insulin first |
B | Injecting air into the NPH insulin bottle first |
C | After drawing up first insulin, removing air bubbles |
D | Injecting an amount of air equal to the desired dose of insulin |
Question 16 |
When assessing a neonate for signs of diabetes insipidus, a nurse should recognize which symptom as a sign of this disorder?
A | Hyponatremia |
B | Jaundice |
C | Polyuria |
D | Hypochloremia |
Question 17 |
A child is admitted with diabetes insipidus. The nurse asks the parents if they know about this condition. Which statement tells the nurse that the parents understand the condition?
A | “We know that our child’s thyroid is working too much.” |
B | “We know that our child’s pituitary gland is not working hard enough.” |
C | “Our child’s pituitary gland is working overtime.” |
D | “Our child’s parathyroid gland is not doing a good job. It is acting very lazy.” |
Question 18 |
The nurse is assessing an infant with diabetes insipidus. What initial observation would the nurse would expect?
A | Dehydration |
B | Inability to be aroused |
C | Extreme hunger relieved by frequent feedings of milk |
D | Irritability relieved with feedings of water but not milk |
Question 19 |
An infant has a positive test result for diabetes insipidus. The nurse should anticipate the physician ordering a test dose of which medication?
A | Antidiuretic hormone |
B | Biosynthetic growth hormone |
C | Adrenocorticotropic hormone |
D | Aqueous vasopressin (Pitressin Synthetic) |
Question 20 |
The nurse is teaching the parents of an infant diagnosed with diabetes insipidus. What is the most important treatment for the nurse to include in teaching?
A | Antihypertensive medications |
B | The need for blood products |
C | Hormone replacement |
D | Fluid restrictions |
Question 21 |
A nurse should anticipate which physiological response in an infant being tested for diabetes insipidus?
A | Increase in urine output |
B | Decrease in urine output |
C | No effect on urine output |
D | Increase in urine specific gravity |
Question 22 |
A nurse is helping parents understand when treatments of growth hormone replacement will end. What is the most important statement for the nurse to include?
A | The dosage of growth hormone will decrease as the child’s age increases. |
B | The dosage of growth hormone will increase as the time of epiphyseal closure nears. |
C | After giving growth hormone replacement for 1 year, the dose will be tapered down. |
D | Growth hormone replacement can’t be abruptly stopped; it must be spread out over several months. |
Question 23 |
A client is diagnosed with diabetes type 1. The nurse reviews the prescribed insulin regimen of regular insulin and NPH insulin with the client to be administered subcutaneously each morning. The nurse determines that teaching was effective when the client states that the onset of regular insulin begins at what point after administration?
A | Within 5 minutes |
B | ½ to 1 hour |
C | 1 to 1½ hours |
D | 4 to 8 hours |
Question 24 |
A client has received diet instruction as part of his treatment plan for diabetes type 1. Which statement by the client indicates to the nurse that he needs additional instructions?
A | “I’ll need a bedtime snack because I take an evening dose of NPH insulin.” |
B | “I can eat whatever I want as long as I cover the calories with sufficient insulin.” |
C | “I can have an occasional low-calorie drink as long as I include it in my meal plan.” |
D | “I should eat meals as scheduled, even if I’m not hungry, to prevent hypoglycemia.” |
Question 25 |
The nurse is assessing a 2-year-old toddler during a routine well-child visit. The nurse suspects the possibility of growth hormone deficiency when the assessment shows which finding?
A | The child had normal growth during the first year of life but showed a slowed growth curve below the 3rd percentile for the second year of life. |
B | The child fell below the 5th percentile for growth during the first year of life but, at this check-up, falls below only the 50th percentile. |
C | There has been a steady decline in growth over the 2 years of this toddler’s life that has accelerated during the past 6 months. |
D | There was delayed growth below the 5th percentile for the first and second years of life. |
Question 26 |
A nurse is explaining diabetes insipidus to the parents of an infant with the disease. When explaining the diagnostic test that’s used, which comment by a parent would indicate an understanding of the diagnostic test?
A | “Fluids will be offered every 2 hours.” |
B | “My infant’s fluid intake will be restricted.” |
C | “I won’t change anything about my infant’s intake.” |
D | “Formula will be restricted, but glucose water is okay.” |
Question 27 |
A client tells the nurse that he has not been following his prescribed diabetes management program and is concerned because he is visiting his doctor for his routine 3-month assessment. He asks if the doctor will be able to determine his lack of compliance from the blood work. The nurse is aware that the best indicator of a client’s diabetic control over the past 2 or 3 months is which measure?
A | Fasting glucose level |
B | Oral glucose tolerance level |
C | Glycosylated hemoglobin test |
D | A client’s record of glucose monitoring |
Question 28 |
When providing information about treatments for diabetes insipidus to parents, a nurse explains the use of nasal spray and injections. Which indication might deter a parent from choosing nasal spray treatment?
A | Applications must be repeated every 8 to 12 hours. |
B | Applications must be repeated every 2 to 4 hours. |
C | Nasal sprays can’t be used in infants. |
D | Measurements are too difficult. |
Question 29 |
The nurse suspects that a 10-year-old client with diabetes is hyperglycemic. What symptom would indicate hyperglycemia?
A | Rapid heart rate |
B | Headache |
C | Hunger |
D | Thirst |
Question 30 |
A nurse is teaching the parents of an infant with diabetes insipidus about an injectable drug used to treat the disorder. Which statement made by a parent would indicate the need for further teaching?
A | “I must hold the medication under warm running water for 10 to 15 minutes before administering it.” |
B | “The medication must be shaken vigorously before being drawn up into the syringe.” |
C | “Small brown particles must be seen in the suspension.” |
D | “I will store this medication in the refrigerator.” |
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