Chapter 30 My Nursing Test Banks

Ball/Bindler/Cowen, Principles of Pediatric Nursing: Caring for Children 6th Edition Test Bank
Chapter 30

Question 1

Type: MCSA

A school-age client diagnosed with diabetes insipidus (DI) is admitted to the pediatric unit. Which laboratory value does the nurse anticipate for this client based on the diagnosis?

1. Hyperglycemia

2. Hypernatremia

3. Hypercalcemia

4. Hypoglycemia

Correct Answer: 2

Rationale 1: In all forms of diabetes insipidus, serum sodium can increase to pathologic levels, so hypernatremia can occur and should be treated. The glucose level is not affected, so hypoglycemia or hyperglycemia is not caused by the diabetes insipidus. Hypercalcemia (high calcium) does not occur with this endocrine disorder.

Rationale 2: In all forms of diabetes insipidus, serum sodium can increase to pathologic levels, so hypernatremia can occur and should be treated. The glucose level is not affected, so hypoglycemia or hyperglycemia is not caused by the diabetes insipidus. Hypercalcemia (high calcium) does not occur with this endocrine disorder.

Rationale 3: In all forms of diabetes insipidus, serum sodium can increase to pathologic levels, so hypernatremia can occur and should be treated. The glucose level is not affected, so hypoglycemia or hyperglycemia is not caused by the diabetes insipidus. Hypercalcemia (high calcium) does not occur with this endocrine disorder.

Rationale 4: In all forms of diabetes insipidus, serum sodium can increase to pathologic levels, so hypernatremia can occur and should be treated. The glucose level is not affected, so hypoglycemia or hyperglycemia is not caused by the diabetes insipidus. Hypercalcemia (high calcium) does not occur with this endocrine disorder.

Global Rationale: In all forms of diabetes insipidus, serum sodium can increase to pathologic levels, so hypernatremia can occur and should be treated. The glucose level is not affected, so hypoglycemia or hyperglycemia is not caused by the diabetes insipidus. Hypercalcemia (high calcium) does not occur with this endocrine disorder.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 30.3 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

Question 2

Type: MCSA

A nurse is conducting a daily weight on a pediatric client diagnosed with diabetes insipidus and notes the child has lost two pounds in 24 hours. Which action by the nurse is the most appropriate?

1. Continue to monitor the child.

2. Notify the healthcare provider regarding the weight loss.

3. Chart the weight and report the loss to the next shift.

4. Do nothing more than chart the weight, as this would be a normal finding.

Correct Answer: 2

Rationale 1: With diabetes insipidus, the child may have severe fluid-volume deficit. A weight loss of two pounds indicates a loss of one liter of fluid, so the healthcare provider should be notified and fluids replaced either orally or intravenously. This is a significant loss in a 24-hour period, so continuing to monitor, charting the weight and reporting to the next shift, and doing nothing would prolong treatment.

Rationale 2: With diabetes insipidus, the child may have severe fluid-volume deficit. A weight loss of two pounds indicates a loss of one liter of fluid, so the healthcare provider should be notified and fluids replaced either orally or intravenously. This is a significant loss in a 24-hour period, so continuing to monitor, charting the weight and reporting to the next shift, and doing nothing would prolong treatment.

Rationale 3: With diabetes insipidus, the child may have severe fluid-volume deficit. A weight loss of two pounds indicates a loss of one liter of fluid, so the healthcare provider should be notified and fluids replaced either orally or intravenously. This is a significant loss in a 24-hour period, so continuing to monitor, charting the weight and reporting to the next shift, and doing nothing would prolong treatment.

Rationale 4: With diabetes insipidus, the child may have severe fluid-volume deficit. A weight loss of two pounds indicates a loss of one liter of fluid, so the healthcare provider should be notified and fluids replaced either orally or intravenously. This is a significant loss in a 24-hour period, so continuing to monitor, charting the weight and reporting to the next shift, and doing nothing would prolong treatment.

Global Rationale: With diabetes insipidus, the child may have severe fluid-volume deficit. A weight loss of two pounds indicates a loss of one liter of fluid, so the healthcare provider should be notified and fluids replaced either orally or intravenously. This is a significant loss in a 24-hour period, so continuing to monitor, charting the weight and reporting to the next shift, and doing nothing would prolong treatment.

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 30.5 Prioritize nursing care for each type of acquired metabolic disorder.

Question 3

Type: MCMA

The nurse is caring for a pediatric client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) disorder. Which interventions should the nurse implement for this child?

Standard Text: Select all that apply.

1. Encouragement of fluids

2. Strict intake and output

3. Administration of ordered diuretics

4. Specific gravity of urine

5. Weight only on admission but not daily

Correct Answer: 2,3,4

Rationale 1: SIADH results from an excessive amount of serum antidiuretic hormone, causing water intoxication and hyponatremia. Intake and output should be monitored strictly. Diuretics such as furosemide (Lasix) are administered to eliminate excess body fluid, and urine specific gravity is monitored. Fluids are restricted to prevent further hemodilution. Daily weights should be obtained to monitor fluid balance.

Rationale 2: SIADH results from an excessive amount of serum antidiuretic hormone, causing water intoxication and hyponatremia. Intake and output should be monitored strictly. Diuretics such as furosemide (Lasix) are administered to eliminate excess body fluid, and urine specific gravity is monitored. Fluids are restricted to prevent further hemodilution. Daily weights should be obtained to monitor fluid balance.

Rationale 3: SIADH results from an excessive amount of serum antidiuretic hormone, causing water intoxication and hyponatremia. Intake and output should be monitored strictly. Diuretics such as furosemide (Lasix) are administered to eliminate excess body fluid, and urine specific gravity is monitored. Fluids are restricted to prevent further hemodilution. Daily weights should be obtained to monitor fluid balance.

Rationale 4: SIADH results from an excessive amount of serum antidiuretic hormone, causing water intoxication and hyponatremia. Intake and output should be monitored strictly. Diuretics such as furosemide (Lasix) are administered to eliminate excess body fluid, and urine specific gravity is monitored. Fluids are restricted to prevent further hemodilution. Daily weights should be obtained to monitor fluid balance.

Rationale 5: SIADH results from an excessive amount of serum antidiuretic hormone, causing water intoxication and hyponatremia. Intake and output should be monitored strictly. Diuretics such as furosemide (Lasix) are administered to eliminate excess body fluid, and urine specific gravity is monitored. Fluids are restricted to prevent further hemodilution. Daily weights should be obtained to monitor fluid balance.

Global Rationale: SIADH results from an excessive amount of serum antidiuretic hormone, causing water intoxication and hyponatremia. Intake and output should be monitored strictly. Diuretics such as furosemide (Lasix) are administered to eliminate excess body fluid, and urine specific gravity is monitored. Fluids are restricted to prevent further hemodilution. Daily weights should be obtained to monitor fluid balance.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 30.5 Prioritize nursing care for each type of acquired metabolic disorder.

Question 4

Type: MCSA

An adolescent client diagnosed with Graves disease is admitted to the hospital. Which clinical manifestations would the nurse expect on assessment?

1. Weight gain, hirsutism, and muscle weakness

2. Dehydration, metabolic acidosis, and hypertension

3. Tachycardia, fatigue, and heat intolerance

4. Hyperglycemia, ketonuria, and glucosuria

Correct Answer: 3

Rationale 1: Graves disease occurs when thyroid hormone levels are increased, resulting in excessive levels of circulating thyroid hormones. Clinical manifestations include tachycardia, fatigue, and heat intolerance. Weight gain, hirsutism, and muscle weakness are signs of Cushing syndrome. Dehydration, metabolic acidosis, and hypertension are signs of congenital adrenal hyperplasia. Hyperglycemia, ketonuria, and glucosuria are signs of diabetes.

Rationale 2: Graves disease occurs when thyroid hormone levels are increased, resulting in excessive levels of circulating thyroid hormones. Clinical manifestations include tachycardia, fatigue, and heat intolerance. Weight gain, hirsutism, and muscle weakness are signs of Cushing syndrome. Dehydration, metabolic acidosis, and hypertension are signs of congenital adrenal hyperplasia. Hyperglycemia, ketonuria, and glucosuria are signs of diabetes.

Rationale 3: Graves disease occurs when thyroid hormone levels are increased, resulting in excessive levels of circulating thyroid hormones. Clinical manifestations include tachycardia, fatigue, and heat intolerance. Weight gain, hirsutism, and muscle weakness are signs of Cushing syndrome. Dehydration, metabolic acidosis, and hypertension are signs of congenital adrenal hyperplasia. Hyperglycemia, ketonuria, and glucosuria are signs of diabetes.

Rationale 4: Graves disease occurs when thyroid hormone levels are increased, resulting in excessive levels of circulating thyroid hormones. Clinical manifestations include tachycardia, fatigue, and heat intolerance. Weight gain, hirsutism, and muscle weakness are signs of Cushing syndrome. Dehydration, metabolic acidosis, and hypertension are signs of congenital adrenal hyperplasia. Hyperglycemia, ketonuria, and glucosuria are signs of diabetes.

Global Rationale: Graves disease occurs when thyroid hormone levels are increased, resulting in excessive levels of circulating thyroid hormones. Clinical manifestations include tachycardia, fatigue, and heat intolerance. Weight gain, hirsutism, and muscle weakness are signs of Cushing syndrome. Dehydration, metabolic acidosis, and hypertension are signs of congenital adrenal hyperplasia. Hyperglycemia, ketonuria, and glucosuria are signs of diabetes.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Phyiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 30.3 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

Question 5

Type: MCSA

A nurse is planning care for a pediatric client diagnosed with adrenal insufficiency (Addison disease). Which nursing diagnosis is the priority for this client?

1. Risk for Deficient Fluid Volume

2. Risk for Injury Secondary to Hypertension

3. Acute Pain

4. Imbalanced Nutrition: More than Body Requirements

Correct Answer: 1

Rationale 1: Adrenal insufficiency can cause fluid deficit. The goal of care is to maintain fluid and electrolyte balance while normal levels of corticosteroids and mineral corticoids are established. Therefore, Acute Pain and Imbalanced Nutrition: More than Body Requirements are not priority nursing diagnoses. A symptom of adrenal insufficiency is hypotension, not hypertension.

Rationale 2: Adrenal insufficiency can cause fluid deficit. The goal of care is to maintain fluid and electrolyte balance while normal levels of corticosteroids and mineral corticoids are established. Therefore, Acute Pain and Imbalanced Nutrition: More than Body Requirements are not priority nursing diagnoses. A symptom of adrenal insufficiency is hypotension, not hypertension.

Rationale 3: Adrenal insufficiency can cause fluid deficit. The goal of care is to maintain fluid and electrolyte balance while normal levels of corticosteroids and mineral corticoids are established. Therefore, Acute Pain and Imbalanced Nutrition: More than Body Requirements are not priority nursing diagnoses. A symptom of adrenal insufficiency is hypotension, not hypertension.

Rationale 4: Adrenal insufficiency can cause fluid deficit. The goal of care is to maintain fluid and electrolyte balance while normal levels of corticosteroids and mineral corticoids are established. Therefore, Acute Pain and Imbalanced Nutrition: More than Body Requirements are not priority nursing diagnoses. A symptom of adrenal insufficiency is hypotension, not hypertension.

Global Rationale: Adrenal insufficiency can cause fluid deficit. The goal of care is to maintain fluid and electrolyte balance while normal levels of corticosteroids and mineral corticoids are established. Therefore, Acute Pain and Imbalanced Nutrition: More than Body Requirements are not priority nursing diagnoses. A symptom of adrenal insufficiency is hypotension, not hypertension.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 30.5 Prioritize nursing care for each type of acquired metabolic disorder.

Question 6

Type: MCSA

A pediatric client is admitted to the hospital unconscious. The client has a history of type 1 diabetes, and according to the clients mother, has been to two birthday parties in the last few days and has resisted taking the prescribed insulin. At school the client had two more pieces of birthday cake and some ice cream at a class birthday party. What is the likely reason for this clients unconscious state?

1. Metabolic alkalosis

2. Metabolic ketoacidosis

3. Insulin shock

4. Insulin reaction

Correct Answer: 2

Rationale 1: Metabolic acidosis or ketoacidosis could have occurred because of the excessive intake of sugar with no additional insulin. The body burns fat and protein stores for energy when no insulin is available to metabolize glucose. Altered consciousness occurs as symptoms progress. Metabolic alkalosis, insulin shock, or insulin reaction would not be happening in this case.

Rationale 2: Metabolic acidosis or ketoacidosis could have occurred because of the excessive intake of sugar with no additional insulin. The body burns fat and protein stores for energy when no insulin is available to metabolize glucose. Altered consciousness occurs as symptoms progress. Metabolic alkalosis, insulin shock, or insulin reaction would not be happening in this case.

Rationale 3: Metabolic acidosis or ketoacidosis could have occurred because of the excessive intake of sugar with no additional insulin. The body burns fat and protein stores for energy when no insulin is available to metabolize glucose. Altered consciousness occurs as symptoms progress. Metabolic alkalosis, insulin shock, or insulin reaction would not be happening in this case.

Rationale 4: Metabolic acidosis or ketoacidosis could have occurred because of the excessive intake of sugar with no additional insulin. The body burns fat and protein stores for energy when no insulin is available to metabolize glucose. Altered consciousness occurs as symptoms progress. Metabolic alkalosis, insulin shock, or insulin reaction would not be happening in this case.

Global Rationale: Metabolic acidosis or ketoacidosis could have occurred because of the excessive intake of sugar with no additional insulin. The body burns fat and protein stores for energy when no insulin is available to metabolize glucose. Altered consciousness occurs as symptoms progress. Metabolic alkalosis, insulin shock, or insulin reaction would not be happening in this case.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 30.7 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

Question 7

Type: MCSA

A pediatric client is diagnosed with type 1 diabetes. The nurse teaches the client the difference between insulin shock and diabetic hyperglycemia. The nurse evaluates that the client understands the teaching when the client states which characteristics of diabetic hyperglycemia?

1. Tremors and lethargy

2. Hunger and hypertension

3. Thirst and flushed skin

4. Shakiness and pallor

Correct Answer: 3

Rationale 1: Thirst and flushed skin are characteristic of diabetic hyperglycemia. Tremors, lethargy, hunger, shakiness, and pallor are characteristic of hypoglycemia. Hypertension is not a sign associated with hyperglycemia or hypoglycemia.

Rationale 2: Thirst and flushed skin are characteristic of diabetic hyperglycemia. Tremors, lethargy, hunger, shakiness, and pallor are characteristic of hypoglycemia. Hypertension is not a sign associated with hyperglycemia or hypoglycemia.

Rationale 3: Thirst and flushed skin are characteristic of diabetic hyperglycemia. Tremors, lethargy, hunger, shakiness, and pallor are characteristic of hypoglycemia. Hypertension is not a sign associated with hyperglycemia or hypoglycemia.

Rationale 4: Thirst and flushed skin are characteristic of diabetic hyperglycemia. Tremors, lethargy, hunger, shakiness, and pallor are characteristic of hypoglycemia. Hypertension is not a sign associated with hyperglycemia or hypoglycemia.

Global Rationale: Thirst and flushed skin are characteristic of diabetic hyperglycemia. Tremors, lethargy, hunger, shakiness, and pallor are characteristic of hypoglycemia. Hypertension is not a sign associated with hyperglycemia or hypoglycemia.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 30.7 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

Question 8

Type: MCSA

The nurse is providing education to a pediatric client diagnosed with diabetes. The client will be playing soccer over the summer. Which change in the clients management will the nurse explore during this education session?

1. Increased food intake

2. Decreased food intake

3. Increased need for insulin

4. Decreased risk of insulin reaction

Correct Answer: 1

Rationale 1: Increased physical activity requires adequate caloric intake to prevent hypoglycemia, so food intake should be increased. Increased activity would not require decreased food intake, and it would not result in a decreased risk of insulin reaction. Exercise causes the insulin to be used more efficiently, so increased insulin would not be needed.

Rationale 2: Increased physical activity requires adequate caloric intake to prevent hypoglycemia, so food intake should be increased. Increased activity would not require decreased food intake, and it would not result in a decreased risk of insulin reaction. Exercise causes the insulin to be used more efficiently, so increased insulin would not be needed.

Rationale 3: Increased physical activity requires adequate caloric intake to prevent hypoglycemia, so food intake should be increased. Increased activity would not require decreased food intake, and it would not result in a decreased risk of insulin reaction. Exercise causes the insulin to be used more efficiently, so increased insulin would not be needed.

Rationale 4: Increased physical activity requires adequate caloric intake to prevent hypoglycemia, so food intake should be increased. Increased activity would not require decreased food intake, and it would not result in a decreased risk of insulin reaction. Exercise causes the insulin to be used more efficiently, so increased insulin would not be needed.

Global Rationale: Increased physical activity requires adequate caloric intake to prevent hypoglycemia, so food intake should be increased. Increased activity would not require decreased food intake, and it would not result in a decreased risk of insulin reaction. Exercise causes the insulin to be used more efficiently, so increased insulin would not be needed.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Reduction of Risk Potential

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 30.7 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

Question 9

Type: MCSA

The nurse is teaching the parent of a type 1 diabetic preschool-age client about management of the disease. Which teaching point is appropriate for the nurse to include in this session?

1. Allowing the client to administer all the insulin injections

2. Allowing the client to choose which finger to stick for glucose testing

3. Allowing the client to draw up the insulin dose

4. Allowing the client to test blood glucose

Correct Answer: 2

Rationale 1: The preschool-age clients need for autonomy and control can be met by allowing the client to pick which finger to stick for glucose testing. Administering the insulin, drawing up the dose, and testing blood glucose should not be done by the client until he or she is middle-school age or older.

Rationale 2: The preschool-age clients need for autonomy and control can be met by allowing the client to pick which finger to stick for glucose testing. Administering the insulin, drawing up the dose, and testing blood glucose should not be done by the client until he or she is middle-school age or older.

Rationale 3: The preschool-age clients need for autonomy and control can be met by allowing the client to pick which finger to stick for glucose testing. Administering the insulin, drawing up the dose, and testing blood glucose should not be done by the client until he or she is middle-school age or older.

Rationale 4: The preschool-age clients need for autonomy and control can be met by allowing the client to pick which finger to stick for glucose testing. Administering the insulin, drawing up the dose, and testing blood glucose should not be done by the client until he or she is middle-school age or older.

Global Rationale: The preschool-age clients need for autonomy and control can be met by allowing the client to pick which finger to stick for glucose testing. Administering the insulin, drawing up the dose, and testing blood glucose should not be done by the client until he or she is middle-school age or older.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 30.7 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

Question 10

Type: MCSA

A pediatric client is seen in the clinic with a possible diagnosis of type 2 diabetes. The mother asks what the healthcare provider uses to make the diagnosis. The nurse explains that type 2 diabetes is suspected if the child has obesity, acanthosis nigricans, and two non-fasting blood-glucose levels above which level?

1. 120

2. 80

3. 200

4. 50

Correct Answer: 3

Rationale 1: Blood-glucose levels at or above 200 mg/dL without fasting is diagnostic of type 2 diabetes.

Rationale 2: Blood-glucose levels at or above 200 mg/dL without fasting is diagnostic of type 2 diabetes.

Rationale 3: Blood-glucose levels at or above 200 mg/dL without fasting is diagnostic of type 2 diabetes.

Rationale 4: Blood-glucose levels at or above 200 mg/dL without fasting is diagnostic of type 2 diabetes.

Global Rationale: Blood-glucose levels at or above 200 mg/dL without fasting is diagnostic of type 2 diabetes.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 30.3 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

Question 11

Type: MCSA

A pediatric client diagnosed with Turner syndrome tells the nurse, I feel different from my peers. Which response by the nurse is the most appropriate?

1. Tell me more about the feelings you are experiencing.

2. These feelings are not unusual and should pass soon.

3. Youll start to grow soon, so dont worry.

4. You seem to be upset about your disease.

Correct Answer: 1

Rationale 1: The lack of growth and sexual development associated with Turner syndrome presents problems with psychosocial development. Self-image, self-consciousness, and self-esteem are affected by the girls perception of her body and how she differs from peers. The nurse should encourage more expression of the girls feelings. Responding that the feelings will pass, that shell start to grow, or that she is upset about the disease would not be therapeutic.

Rationale 2: The lack of growth and sexual development associated with Turner syndrome presents problems with psychosocial development. Self-image, self-consciousness, and self-esteem are affected by the girls perception of her body and how she differs from peers. The nurse should encourage more expression of the girls feelings. Responding that the feelings will pass, that shell start to grow, or that she is upset about the disease would not be therapeutic.

Rationale 3: The lack of growth and sexual development associated with Turner syndrome presents problems with psychosocial development. Self-image, self-consciousness, and self-esteem are affected by the girls perception of her body and how she differs from peers. The nurse should encourage more expression of the girls feelings. Responding that the feelings will pass, that shell start to grow, or that she is upset about the disease would not be therapeutic.

Rationale 4: The lack of growth and sexual development associated with Turner syndrome presents problems with psychosocial development. Self-image, self-consciousness, and self-esteem are affected by the girls perception of her body and how she differs from peers. The nurse should encourage more expression of the girls feelings. Responding that the feelings will pass, that shell start to grow, or that she is upset about the disease would not be therapeutic.

Global Rationale: The lack of growth and sexual development associated with Turner syndrome presents problems with psychosocial development. Self-image, self-consciousness, and self-esteem are affected by the girls perception of her body and how she differs from peers. The nurse should encourage more expression of the girls feelings. Responding that the feelings will pass, that shell start to grow, or that she is upset about the disease would not be therapeutic.

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 30.8 Plan care for the child with an inherited metabolic disorder.

Question 12

Type: MCSA

A parent of a newborn asks the nurse why a heel stick is being done on the baby to test for phenylketonuria (PKU). Which response by the nurse is the most appropriate?

1. This screening is required and detection can be done before symptoms develop.

2. The infant has high-risk characteristics.

3. Because the infant was born by cesarean, this test is necessary.

4. Because the infant was born by vaginal delivery, this test is recommended.

Correct Answer: 1

Rationale 1: Screening for phenylketonuria is required by law in every state. It is not done according to high-risk characteristics or type of delivery.

Rationale 2: Screening for phenylketonuria is required by law in every state. It is not done according to high-risk characteristics or type of delivery.

Rationale 3: Screening for phenylketonuria is required by law in every state. It is not done according to high-risk characteristics or type of delivery.

Rationale 4: Screening for phenylketonuria is required by law in every state. It is not done according to high-risk characteristics or type of delivery.

Global Rationale: Screening for phenylketonuria is required by law in every state. It is not done according to high-risk characteristics or type of delivery.

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub: 

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: LO 30.3 Summarize signs and symptoms that may indicate a disorder of the endocrine system.

Question 13

Type: MCSA

The nurse is administering a dose of rapid-acting insulin at 0800 to an insulin-dependent pediatric client. Based on when the insulin peaks, when will the client be at greatest risk for a hypoglycemic episode?

1. At about noon

2. Between bedtime and breakfast the next morning

3. Between lunch and dinner

4. Around 0930

Correct Answer: 4

Rationale 1: Rapid-acting insulin peaks 3090 minutes after administration. An injection given at 0800 would peak around 0930.

Rationale 2: Rapid-acting insulin peaks 3090 minutes after administration. An injection given at 0800 would peak around 0930.

Rationale 3: Rapid-acting insulin peaks 3090 minutes after administration. An injection given at 0800 would peak around 0930.

Rationale 4: Rapid-acting insulin peaks 3090 minutes after administration. An injection given at 0800 would peak around 0930.

Global Rationale: Rapid-acting insulin peaks 3090 minutes after administration. An injection given at 0800 would peak around 0930.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 30.7 Distinguish between the nursing care of the child with type 1 and type 2 diabetes.

Question 14

Type: MCMA

Which teaching tips should be included when instructing parents on hydrocortisone administration?

Standard Text: Select all that apply.

1. Maintain prescribed administration times.

2. Never discontinue medication abruptly.

3. Injections might be necessary when unable to take by mouth.

4. Lower doses are needed during illness.

5. Keep an emergency kit with the child at all times.

Correct Answer: 1,2,3,5

Rationale 1: Maintaining prescribed administration times is important, as they follow the normal body release of cortisol. Abruptly discontinuing a steroid is not recommended. Giving injections when unable to take by mouth and during emergencies is important to maintain cortisol levels. Higher, not lower, doses are needed during illness.

Rationale 2: Maintaining prescribed administration times is important, as they follow the normal body release of cortisol. Abruptly discontinuing a steroid is not recommended. Giving injections when unable to take by mouth and during emergencies is important to maintain cortisol levels. Higher, not lower, doses are needed during illness.

Rationale 3: Maintaining prescribed administration times is important, as they follow the normal body release of cortisol. Abruptly discontinuing a steroid is not recommended. Giving injections when unable to take by mouth and during emergencies is important to maintain cortisol levels. Higher, not lower, doses are needed during illness.

Rationale 4: Maintaining prescribed administration times is important, as they follow the normal body release of cortisol. Abruptly discontinuing a steroid is not recommended. Giving injections when unable to take by mouth and during emergencies is important to maintain cortisol levels. Higher, not lower, doses are needed during illness.

Rationale 5: Maintaining prescribed administration times is important, as they follow the normal body release of cortisol. Abruptly discontinuing a steroid is not recommended. Giving injections when unable to take by mouth and during emergencies is important to maintain cortisol levels. Higher, not lower, doses are needed during illness.

Global Rationale: Maintaining prescribed administration times is important, as they follow the normal body release of cortisol. Abruptly discontinuing a steroid is not recommended. Giving injections when unable to take by mouth and during emergencies is important to maintain cortisol levels. Higher, not lower, doses are needed during illness.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 30.6 Develop a family education plan for the child who needs lifelong cortisol replacement.

Question 15

Type: MCSA

The nurse is planning care for a pediatric client diagnosed with adrenal hyperplasia. Which nursing diagnosis is most appropriate for this client?

1. Impaired Social Interaction Related to Unnatural Facial Features

2. Nutrition: Less than Body Requirements due to Nausea and Vomiting

3. Depression Related to Inability to Take in Oral Fluids

4. Risk for Deficient Fluid Volume Related to Failure of Regulatory Mechanisms

Correct Answer: 4

Rationale 1: Adrenal hyperplasia alters the regulatory mechanisms, creating a fluid volume deficit. There is no major nutritional deficit, social interaction, or depression related directly to the diagnosis of adrenal hyperplasia.

Rationale 2: Adrenal hyperplasia alters the regulatory mechanisms, creating a fluid volume deficit. There is no major nutritional deficit, social interaction, or depression related directly to the diagnosis of adrenal hyperplasia.

Rationale 3: Adrenal hyperplasia alters the regulatory mechanisms, creating a fluid volume deficit. There is no major nutritional deficit, social interaction, or depression related directly to the diagnosis of adrenal hyperplasia.

Rationale 4: Adrenal hyperplasia alters the regulatory mechanisms, creating a fluid volume deficit. There is no major nutritional deficit, social interaction, or depression related directly to the diagnosis of adrenal hyperplasia.

Global Rationale: Adrenal hyperplasia alters the regulatory mechanisms, creating a fluid volume deficit. There is no major nutritional deficit, social interaction, or depression related directly to the diagnosis of adrenal hyperplasia.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 30.8 Plan care for the child with an inherited metabolic disorder.

Question 16

Type: MCMA

The nurse is planning care for pediatric clients who have diagnoses that impact the endocrine system. Which changes occurring during the school-age and adolescence have a direct impact on the endocrine system?

Standard Text: Select all that apply.

1. Puberty

2. Adrenarche

3. Menarche

4. Sexual exploration

5. Risk-taking behavior

Correct Answer: 1,2,3

Rationale 1: Puberty, adrenarche, and menarche are all changes that occur during the school age and adolescence that have a direct impact on the endocrine system. Sexual exploration and risk-taking behaviors do not have a direct impact on the endocrine system.

Rationale 2: Puberty, adrenarche, and menarche are all changes that occur during the school age and adolescence that have a direct impact on the endocrine system. Sexual exploration and risk-taking behaviors do not have a direct impact on the endocrine system.

Rationale 3: Puberty, adrenarche, and menarche are all changes that occur during the school age and adolescence that have a direct impact on the endocrine system. Sexual exploration and risktaking behaviors do not have a direct impact on the endocrine system.

Rationale 4: Puberty, adrenarche, and menarche are all changes that occur during the school age and adolescence that have a direct impact on the endocrine system. Sexual exploration and risk-taking behaviors do not have a direct impact on the endocrine system.

Rationale 5: Puberty, adrenarche, and menarche are all changes that occur during the school age and adolescence that have a direct impact on the endocrine system. Sexual exploration and risk-taking behaviors do not have a direct impact on the endocrine system.

Global Rationale: Puberty, adrenarche, and menarche are all changes that occur during the school age and adolescence that have a direct impact on the endocrine system. Sexual exploration and risk-taking behaviors do not have a direct impact on the endocrine system.

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: LO 30.1 Describe the anatomy and physiology of the endocrine system and pediatric differences.

Question 17

Type: MCMA

The nurse educator is teaching a group of nursing students about the endocrine system. Which statements are appropriate for the educator to include in the teaching session?

Standard Text: Select all that apply.

1. Gonadotropin-releasing hormone stimulates the anterior pituitary to produce LH and FSH.

2. Growth hormone regulates linear bone growth and growth of all tissues.

3. Antidiuretic hormone regulates urine concentration by the kidneys.

4. Thyroid hormone regulates serum calcium levels and phosphorus excretion.

5. Parathyroid hormone regulates metabolism of cells and body heat production.

Correct Answer: 1,2,3

Rationale 1: All statements are correct except the statements regarding the thyroid hormone and the parathyroid hormone. The thyroid hormone regulates metabolism of the cells and body heat production, not the parathyroid hormone. The parathyroid hormone regulates serum calcium levels and phosphorus excretion.

Rationale 2: All statements are correct except the statements regarding the thyroid hormone and the parathyroid hormone. The thyroid hormone regulates metabolism of the cells and body heat production, not the parathyroid hormone. The parathyroid hormone regulates serum calcium levels and phosphorus excretion.

Rationale 3: All statements are correct except the statements regarding the thyroid hormone and the parathyroid hormone. The thyroid hormone regulates metabolism of the cells and body heat production, not the parathyroid hormone. The parathyroid hormone regulates serum calcium levels and phosphorus excretion.

 

Rationale 4: All statements are correct except the statements regarding the thyroid hormone and the parathyroid hormone. The thyroid hormone regulates metabolism of the cells and body heat production, not the parathyroid hormone. The parathyroid hormone regulates serum calcium levels and phosphorus excretion.

Rationale 5: All statements are correct except the statements regarding the thyroid hormone and the parathyroid hormone. The thyroid hormone regulates metabolism of the cells and body heat production, not the parathyroid hormone. The parathyroid hormone regulates serum calcium levels and phosphorus excretion.

Global Rationale: All statements are correct except the statements regarding the thyroid hormone and the parathyroid hormone. The thyroid hormone regulates metabolism of the cells and body heat production, not the parathyroid hormone. The parathyroid hormone regulates serum calcium levels and phosphorus excretion.

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 30.2 Identify the function of important hormones of the endocrine system.

Question 18

Type: MCMA

The nurse is providing education to a group of student nurses regarding disorders of the endocrine system that can cause short stature. Which disorders will the nurse include in the educational session?

Standard Text: Select all that apply.

1. Hypothyroidism

2. Turner syndrome

3. Type 1 diabetes mellitus

4. Diabetes insipidus

5. Cushing syndrome

Correct Answer: 1,2,5

Rationale 1: There are many disorders of the endocrine system that can cause short stature including hypothyroidism, Turner syndrome, and Cushing syndrome. Type 1 diabetes mellitus and diabetes insipidus are not endocrine disorders that cause short stature.

Rationale 2: There are many disorders of the endocrine system that can cause short stature including hypothyroidism, Turner syndrome, and Cushing syndrome. Type 1 diabetes mellitus and diabetes insipidus are not endocrine disorders that cause short stature.

Rationale 3: There are many disorders of the endocrine system that can cause short stature including hypothyroidism, Turner syndrome, and Cushing syndrome. Type 1 diabetes mellitus and diabetes insipidus are not endocrine disorders that cause short stature.

Rationale 4: There are many disorders of the endocrine system that can cause short stature including hypothyroidism, Turner syndrome, and Cushing syndrome. Type 1 diabetes mellitus and diabetes insipidus are not endocrine disorders that cause short stature.

Rationale 5: There are many disorders of the endocrine system that can cause short stature including hypothyroidism, Turner syndrome, and Cushing syndrome. Type 1 diabetes mellitus and diabetes insipidus are not endocrine disorders that cause short stature.

Global Rationale: There are many disorders of the endocrine system that can cause short stature including hypothyroidism, Turner syndrome, and Cushing syndrome. Type 1 diabetes mellitus and diabetes insipidus are not endocrine disorders that cause short stature.

Cognitive Level: Remembering

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: LO 30.4 Identify all conditions for which short stature is a sign.

Ball/Bindler/Cowen, Principles of Pediatric Nursing 6th Ed. Test Bank

Copyright 2015 by Pearson Education, Inc.

Leave a Reply