Nclex-Rn Practice Questions-Care Of The Child - Endocrine Disorders Part 3
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Question 1 |
The mother of a child diagnosed with hypopituitarism states to the nurse that she feels guilty because she should have recognized this disorder. What is the best response by the nurse about children with hypopituitarism?
A | “They’re usually large for gestational age at birth.” |
B | “They’re usually small for gestational age at birth.” |
C | “They usually exhibit signs of this disorder soon after birth.” |
D | “They’re usually of normal size for gestational age at birth.” |
Question 2 |
In an infant receiving inadequate treatment for congenital hypothyroidism, the nurse should expect to observe which symptom(s)?
A | Irritability and jitteriness |
B | Fatigue and sleepiness |
C | Increased appetite |
D | Diarrhea |
Question 3 |
The nurse instructs the parents of an infant diagnosed with hypothyroidism on how to count the infant’s pulse. The parents ask the nurse what they should do if the pulse rate is above the provided parameters. What is the best response by the nurse?
A | “Allow the infant to take a nap and then give the medication.” |
B | “Withhold the medication and give a double dose the next day.” |
C | “Hold the medication and call the physician.” |
D | “Give the medication and then consult the physician.” |
Question 4 |
Which nursing objective is most important when working with neonates who are suspected of having congenital hypothyroidism?
A | Identifying the disorder early |
B | Promoting bonding |
C | Allowing rooming in |
D | Encouraging fluid intake |
Question 5 |
A nurse is caring for a neonate with congenital hypothyroidism. The nurse observes the client for which finding?
A | Hyperreflexia |
B | Long forehead |
C | Puffy eyelids |
D | Small tongue |
Question 6 |
A client newly diagnosed with diabetes insipidus asks the nurse about what method is best to monitor the condition. What is the best response by the nurse?
A | Measuring abdominal girths every day |
B | Measuring intake, output, and urine specific gravity |
C | Checking daily weights and measuring intake |
D | Checking for pitting edema in the lower extremities |
Question 7 |
A child with diabetes insipidus will be receiving injectable vasopressin when discharged from the hospital. What is the most important information for the nurse to provide when teaching injection techniques?
A | Teach injection techniques to the primary caregiver. |
B | Teach injection techniques to anyone who will provide care for the child. |
C | Teach injection techniques to anyone who will provide care for the child as well as to the child if he’s old enough to understand. |
D | Provide information about the nearest home health agency so the parents can arrange for the home health nurse to come and give the injection. |
Question 8 |
When providing care for a school-age client with diabetes insipidus, the nurse understands that which behavior might be difficult related to this child’s growth and development?
A | Taking desmopressin acetate (DDAVP) at school |
B | Taking DDAVP before bedtime |
C | Letting his mother administer the vasopressin injection |
D | Giving himself a vasopressin injection before school starts |
Question 9 |
When reviewing the results of radiographic examinations of a child with hypopituitarism, which characteristic should the nurse expect to observe?
A | Bone age near normal |
B | Epiphyseal maturation normal |
C | Epiphyseal maturation retarded |
D | Bone maturation greatly retarded |
Question 10 |
When caring for a neonate diagnosed with diabetes insipidus, the nurse determines further intervention is necessary when the assessment identifies:
A | edema. |
B | increased head circumference. |
C | weight gain. |
D | weight loss. |
Question 11 |
When providing information to the parents of a child who’s receiving growth hormone replacement therapy for hypopituitarism, the nurse should include which intervention?
A | Explaining that growth in height and weight won’t begin until puberty |
B | Teaching how to perform venipuncture for administration of the growth hormone |
C | Helping parents recognize the importance of interacting with the child according to age rather than size |
D | Advising parents to hold the child back in school until linear growth begins to approximate the normal patterns |
Question 12 |
Which metabolic alteration characteristic might be associated with growth hormone deficiency?
A | Galactosemia |
B | Homocystinuria |
C | Hyperglycemia |
D | Hypoglycemia |
Question 13 |
A child has been brought to a pediatrician’s office for concerns about growth. The physician suspects hypopituitarism. The mother asks the nurse which test will be done to determine the diagnosis. Which response by the nurse would be appropriate?
A | Hypersecretion of thyroid hormone |
B | Increased reserves of growth hormone |
C | Hyposecretion of antidiuretic hormone (ADH) |
D | Decreased reserves of growth hormone |
Question 14 |
Which statement made by a parent of a child with short stature would indicate to the nurse the need for further teaching?
A | “Obtaining blood studies won’t aid in proper diagnosis.” |
B | “A history of my child’s growth patterns should be discussed.” |
C | “X-rays should be included in my child’s diagnostic procedures.” |
D | “A family history is important information for me to share with my child’s physician.” |
Question 15 |
The nurse is educating parents of a child with hypopituitarism about realistic expectations of height for their child who is successfully responding to growth hormone replacement. What is the best information for the nurse to include?
A | “Your child will never reach a normal adult height.” |
B | “Your child will attain his eventual adult height at a faster rate.” |
C | “Your child will attain his eventual adult height at a slower rate.” |
D | “The rate of your child’s growth will be the same as children without this disorder.” |
Question 16 |
The nurse is providing teaching for parents who are planning to administer prescribed growth hormone to their child at home. The parents ask the nurse what the best time is to give the medication. What is the best response by the nurse?
A | At bedtime |
B | After dinner |
C | In the middle of the day |
D | First thing in the morning |
Question 17 |
The nurse is obtaining the health history of a child with diabetes insipidus. The nurse expects the history to include which findings?
A | Delayed closure of the fontanels, coarse hair, and hypoglycemia in the morning |
B | Gradual onset of personality changes, lethargy, and blurred vision |
C | Vomiting early in the morning, headache, and decreased thirst |
D | Abrupt onset of polyuria, nocturia, and polydipsia |
Question 18 |
Which method is considered the definitive treatment for hypopituitarism due to growth hormone deficiency?
A | Treatment with desmopressin acetate (DDAVP) |
B | Replacement of antidiuretic hormone (ADH) |
C | Treatment with testosterone or estrogen |
D | Replacement with biosynthetic growth hormone |
Question 19 |
A child with diabetes insipidus has a viral illness that includes congestion, nausea, and vomiting. What is the most important information for the nurse to tell the parents?
A | Make no changes in the medication regimen. |
B | Give medications only once per day. |
C | Obtain an alternate route for desmopressin acetate (DDAVP) administration. |
D | Give medication 1 hour after vomiting has occurred. |
Question 20 |
An adolescent with type 1 diabetes tells the nurse he will be playing football for his school this year. He asks the nurse what he can do to prevent hypoglycemia. What is the best response by the nurse?
A | Limit participation in planned exercise activities that involve competition. |
B | Carry crackers or fruit to eat before or during periods of increased activity. |
C | Increase the insulin dosage before planned or unplanned strenuous exercise. |
D | Check blood sugar before exercising and eat a protein snack if the level is elevated. |
Question 21 |
An adolescent female client is admitted to the hospital with type 1 diabetes and unstable blood glucose levels. What is the most important question for the nurse to include in the health history?
A | Does she play any team sports? |
B | Does she refrigerate her insulin? |
C | Is she satisfied with her weight? |
D | Does she use recreational drugs? |
Question 22 |
When obtaining information about a child, which comment made by a parent to the nurse would indicate the possibility of hypopituitarism in a child?
A | “I can pass down my child’s clothes to his younger brother.” |
B | “Usually, my child wears out his clothes before his size changes.” |
C | “I have to buy bigger size clothes for my child about every 2 months.” |
D | “I have to buy larger shirts more frequently than larger pants for my child.” |
Question 23 |
The nurse is reviewing assessment data of a client on fluid restriction for diabetes insipidus diagnostic testing. The nurse determines further intervention is necessary when the assessment identifies which finding?
A | Weight gain of 3% to 5% |
B | Weight loss of 3% to 5% |
C | Increase in urine output |
D | Generalized edema |
Question 24 |
Which observation when plotting height and weight on a growth chart would indicate that a 4-year-old child has a growth hormone deficiency?
A | Upward shift of 1 percentile or more |
B | Upward shift of 5 percentiles or more |
C | Downward shift of 2 percentiles or more |
D | Downward shift of 5 percentiles or more |
Question 25 |
A nurse is collecting a health history from the parents of a 12-month-old infant being evaluated for possible hypopituitarism. What is the most important question for the nurse to ask?
A | Did the mother drink alcohol while pregnant? |
B | Does the infant receive multivitamins? |
C | What’s the infant’s growth pattern? |
D | Was the infant premature? |
Question 26 |
A 14-year-old male client with type 1 diabetes mellitus plans to join the basketball team at his school. The practices are twice a week with games on Saturdays. He calls the nurse at his clinic for advice. The nurse should respond with which statement?
A | “Delay eating a meal until after practice or a game.” |
B | “Time your insulin to peak at the time of practice and games.” |
C | “Monitor your blood sugar before, during, and after exercise.” |
D | “Increase your daily calorie intake by 10% and up your insulin dose by 10%.” |
Question 27 |
The parents of a child who’s going through testing for hypopituitarism ask the nurse what type of test results they should expect. The nurse’s response should be based on which factor?
A | Measurement of growth hormone will occur only one time. |
B | Growth hormone levels are decreased after strenuous exercise. |
C | There will be increased overnight urine growth hormone concentration. |
D | Growth hormone levels are elevated 45 to 90 minutes following the onset of sleep. |
Question 28 |
A child is admitted with complaints of weight loss and lack of energy. The child’s ears and cheeks are flushed, and the nurse observes an acetone odor to the child’s breath. The child’s blood glucose level is 325 mg/dl, his blood pressure is 104/60 mm Hg, his pulse is 88 beats/minute, and respirations are 16 breaths/minute. Which does the nurse expect the physician to order first?
A | Subcutaneous administration of glucagon |
B | Administration of I.V. regular insulin by continuous infusion pump |
C | Administration of regular insulin subcutaneously every 4 hours as needed by sliding scale insulin |
D | Administration of I.V. fluids in boluses of 20 ml/kg |
Question 29 |
A child with diabetic ketoacidosis is to receive a continuous infusion of insulin for a blood glucose level of 780 mg/dl. The nurse reviews the orders and would administer which solution?
A | Normal saline with regular insulin |
B | Normal saline with Ultralente insulin |
C | 5% dextrose in water with NPH insulin |
D | 5% dextrose in water with PZI insulin |
Question 30 |
In a client with diabetes insipidus, a nurse could expect which characteristics of the urine?
A | Pale in color; specific gravity less than 1.006 |
B | Concentrated; specific gravity less than 1.006 |
C | Concentrated; specific gravity less than 1.03 |
D | Pale in color; specific gravity more than 1.03 |
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