Chapter 51: The Child with an Endocrine or Metabolic Alteration My Nursing Test Banks

Chapter 51: The Child with an Endocrine or Metabolic Alteration

Test Bank

MULTIPLE CHOICE

1. New parents ask the nurse, Why is it necessary for our baby to have the newborn blood test? The nurse explains that the priority outcome of mandatory newborn screening for inborn errors of metabolism is

a.

Appropriate community referral for affected infants

b.

Parental education about raising a special needs child

c.

Early identification of serious genetically transmitted metabolic diseases

d.

Early identification of electrolyte imbalances

ANS: C

Feedback

A

Community referral is appropriate after a diagnosis is made.

B

With early identification and treatment, serious complications such as intellectual impairment are prevented.

C

Early identification of hypothyroidism is basic to the prevention of intellectual impairment in the child.

D

Although electrolyte imbalances could occur with some of the inborn errors of metabolism, this is not the priority outcome, nor would the newborn screen detect electrolyte imbalances.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1381

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

2. What is the priority nursing goal for a 14-year-old with Graves disease?

a.

Relieving constipation

b.

Allowing the adolescent to make decisions about whether or not to take medication

c.

Verbalizing the importance of adherence to the medication regimen

d.

Developing alternative educational goals

ANS: C

Feedback

A

The adolescent with Graves disease is not constipated.

B

Adherence to the medication schedule is important to ensure optimal health and wellness. Medications should not be skipped and dose regimens should not be tapered by the child without consultation with the childs medical provider.

C

To adhere to the medication schedule, children need to understand that the medication must be taken two or three times per day.

D

The management of Graves disease does not interfere with school attendance and does not require alternative educational plans.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1387

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

3. What information provided by the nurse would be helpful to a 15-year-old adolescent taking methimazole three times a day?

a.

Pill dispensers and alarms on her watch can remind her to take the medication as ordered.

b.

She can take the medication when she is nervous and feels she needs it.

c.

She can take two pills before school and one pill at dinner, which will be easier for her to remember.

d.

Her mother can be responsible for reminding her when it is time to take her medication.

ANS: A

Feedback

A

Methimazole is an antithyroid medication that should be taken three times a day. Reminders will facilitate taking medication as ordered.

B

This medication needs to be taken regularly, not on an as-needed basis.

C

The dosage cannot be combined to reduce the frequency of administration.

D

Because of the adolescents school schedule and activities, she, rather than her mother, needs to be responsible for her medication.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1386

OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance

4. Diabetes insipidus is a disorder of the

a.

Anterior pituitary

b.

Posterior pituitary

c.

Adrenal cortex

d.

Adrenal medulla

ANS: B

Feedback

A

The anterior pituitary produces hormones such as growth hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, gonadotropin, prolactin, and melanocyte-stimulating hormone.

B

The principal disorder of posterior pituitary hypofunction is diabetes insipidus.

C

The adrenal cortex produces aldosterone, sex hormones, and glucocorticoids.

D

The adrenal medulla produces catecholamines.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1389

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

5. Which sign, when exhibited by a hospitalized child, should the nurse recognize as a characteristic of diabetes insipidus?

a.

Weight gain

b.

Increased urine specific gravity

c.

Increased urination

d.

Serum sodium level of 130 mEq/L

ANS: C

Feedback

A

Weight gain results from retention of water when there is an excessive production of antidiuretic hormone; in diabetes insipidus there is a decreased production of antidiuretic hormone.

B

Concentrated urine is a sign of the syndrome of inappropriate antidiuretic hormone (SIADH), in which there is an excessive production of antidiuretic hormone.

C

The deficiency of antidiuretic hormone associated with diabetes insipidus causes the body to excrete large volumes of dilute urine.

D

A deficiency of antidiuretic hormone, as with diabetes insipidus, results in an increased serum sodium concentration (greater than 145 mEq/L).

PTS: 1 DIF: Cognitive Level: Application REF: p. 1388

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

6. What should the nurse include in the teaching plan for parents of a child with diabetes insipidus who is receiving DDAVP?

a.

Increase the dosage of DDAVP as the urine specific gravity (SG) increases.

b.

Give DDAVP only if urine output decreases.

c.

The child should have free access to water and toilet facilities at school.

d.

Cleanse skin before administering the transdermal patch.

ANS: C

Feedback

A

DDAVP needs to be given as ordered by the physician. If the parents are monitoring urine SG at home, they would not increase the medication dose for increased SG; the physician may order an increased dosage for very dilute urine with decreased SG.

B

DDAVP needs to be given continuously as ordered by the physician.

C

The childs teachers should be aware of the diagnosis, and the child should have free access to water and toilet facilities at school.

D

DDAVP is typically given intranasally or by subcutaneous injection. For nocturnal enuresis, it may be given orally.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1389

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

7. A child with GH deficiency is receiving GH therapy. What is the best time for the GH to be administered?

a.

At bedtime

b.

After meals

c.

Before meals

d.

On arising in the morning

ANS: A

Feedback

A

Injections are best given at bedtime to more closely approximate the physiologic release of GH.

B

This time does not mimic the physiologic release of the hormone.

C

This time does not mimic the physiologic release of the hormone.

D

This time does not mimic the physiologic release of the hormone.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1394

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

8. A nurse is explaining growth hormone deficiency to parents of a child admitted to rule out this problem. Which metabolic alteration that is related to growth hormone deficiency should the nurse explain to the parent?

a.

Hypocalcemia

b.

Hypoglycemia

c.

Diabetes insipidus.

d.

Hyperglycemia

ANS: B

Feedback

A

Symptoms of hypocalcemia are associated with hypoparathyroidism.

B

Growth hormone helps maintain blood sugar at normal levels.

C

Diabetes insipidus is a disorder of the posterior pituitary. Growth hormone is produced by the anterior pituitary.

D

Hyperglycemia results from an insufficiency of insulin, which is produced by the beta cells in the islets of Langerhans in the pancreas.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1393

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

9. At what age is sexual development in boys and girls considered to be precocious?

a.

Boys, 11 years; girls, 9 years

b.

Boys, 12 years; girls, 10 years

c.

Boys, 9 years; girls, 8 years

d.

Boys, 10 years; girls, 9 1/2 years

ANS: C

Feedback

A

These ages fall within the expected range of pubertal onset.

B

These ages fall within the expected range of pubertal onset.

C

Manifestations of sexual development before age 9 in boys and age 8 in girls is considered precocious and should be investigated.

D

These ages fall within the expected range of pubertal onset.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1390

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

10. What is the most appropriate intervention for the parents of a 6-year-old child with precocious puberty?

a.

Advise the parents to consider birth control for their daughter.

b.

Explain the importance of having the child foster relationships with same-age peers.

c.

Assure the childs parents that there is no increased risk for sexual abuse because of her appearance.

d.

Counsel parents that there is no treatment currently available for this disorder.

ANS: B

Feedback

A

Advising the parents of a 6-year-old to put their daughter on birth control is not appropriate and will not reverse the effects of precocious puberty.

B

Despite the childs appearance, the child needs to be treated according to her chronologic age and to interact with children in the same age-group. An expected outcome is that the child will adjust socially by exhibiting age-appropriate behaviors and social interactions.

C

Parents need to be aware that there is an increased risk of sexual abuse for a child with precocious puberty.

D

Treatment for precocious puberty is the administration of gonadotropin-releasing hormone blocker, which slows or reverses the development of secondary sexual characteristics and slows rapid growth and bone aging.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1393

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

11. A neonate is displaying mottled skin, has a large fontanel and tongue, is lethargic, and is having difficulty feeding. The nurse recognizes that this is most suggestive of

a.

Hypocalcemia

b.

Hypothyroidism

c.

Hypoglycemia

d.

Phenylketonuria (PKU)

ANS: B

Feedback

A

When hypocalcemia is present, neonates may display twitching, tremors, irritability, jitteriness, electrocardiographic changes, and, rarely, seizures.

B

An infant with hypothyroidism may exhibit skin mottling, a large fontanel, a large tongue, hypotonia, slow reflexes, a distended abdomen, prolonged jaundice, lethargy, constipation, feeding problems, and coldness to touch.

C

Hypoglycemia causes the neonate to exhibit jitteriness, poor feeding, lethargy, seizures, respiratory alterations including apnea, hypotonia, high-pitched cry, bradycardia, cyanosis, and temperature instability.

D

Infants with PKU may initially have digestive problems with vomiting, and they may have a musty or mousy odor to the urine, infantile eczema, hypertonia, and hyperactive behavior.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1383

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

12. A common clinical manifestation of juvenile hypothyroidism is

a.

Insomnia

b.

Diarrhea

c.

Dry skin

d.

Accelerated growth

ANS: C

Feedback

A

Children with hypothyroidism are usually sleepy.

B

Constipation is associated with hypothyroidism.

C

Thick, dry skin, mental decline, cold intolerance, and weight gain are associated with juvenile hypothyroidism.

D

Decelerated growth is common in juvenile hypothyroidism.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1385

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

13. A goiter is an enlargement or hypertrophy of which gland?

a.

Thyroid

b.

Adrenal

c.

Anterior pituitary

d.

Posterior pituitary

ANS: A

Feedback

A

A goiter is an enlargement or hypertrophy of the thyroid gland.

B

Goiter is not associated with this secretory organ.

C

Goiter is not associated with this secretory organ.

D

Goiter is not associated with this secretory organ.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1386

OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity

14. Exophthalmos (protruding eyeballs) may occur in children with which condition?

a.

Hypothyroidism

b.

Hyperthyroidism

c.

Hypoparathyroidism

d.

Hyperparathyroidism

ANS: B

Feedback

A

Hypothyroidism is not associated with exophthalmos.

B

Exophthalmos is a clinical manifestation of hyperthyroidism.

C

Hypoparathyroidism is not associated with exophthalmos.

D

Hyperparathyroidism is not associated with exophthalmos.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1385 | Box 51-1

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

15. A neonate born with ambiguous genitalia is diagnosed with congenital adrenogenital hyperplasia. Therapeutic management includes administration of

a.

Vitamin D

b.

Cortisone

c.

Stool softeners

d.

Calcium carbonate

ANS: B

Feedback

A

Vitamin D has no role in the therapy of adrenogenital hyperplasia.

B

The most common biochemical defect with congenital adrenal hyperplasia is partial or complete 21-hydroxylase deficiency. With complete deficiency, insufficient amounts of aldosterone and cortisol are produced so that circulatory collapse occurs without immediate replacement.

C

Stool softeners have no role in the therapy of adrenogenital hyperplasia.

D

Calcium carbonate has no role in the therapy of adrenogenital hyperplasia.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1382

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

16. Type 1 diabetes mellitus is suspected in an adolescent. Which clinical manifestation may be present?

a.

Moist skin

b.

Weight gain

c.

Fluid overload

d.

Blurred vision

ANS: D

Feedback

A

Dry skin, weight loss, and dehydration are clinical manifestations of type 1 diabetes mellitus.

B

Dry skin, weight loss, and dehydration are clinical manifestations of type 1 diabetes mellitus.

C

Dry skin, weight loss, and dehydration are clinical manifestations of type 1 diabetes mellitus.

D

Fatigue and blurred vision are clinical manifestations of type 1 diabetes mellitus.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1395

OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity

17. A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes. The nurse should base the explanation on the knowledge that

a.

It is a less expensive method of testing.

b.

It is not as accurate as laboratory testing.

c.

Children are better able to manage the diabetes.

d.

The parents are better able to manage the disease.

ANS: C

Feedback

A

Blood glucose monitoring is more expensive but provides improved management.

B

It is as accurate as equivalent testing done in laboratories.

C

Blood glucose self-management has improved diabetes management and can be used successfully by children from the time of diagnosis. Insulin dosages can be adjusted based on blood sugar results.

D

The ability to self-test allows the child to balance diet, exercise, and insulin. The parents are partners in the process, but the child should be taught how to manage the disease.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1400

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

18. What is the best time for the nurse to assess the peak effectiveness of subcutaneously administered Regular insulin?

a.

Two hours after administration

b.

Four hours after administration

c.

Immediately after administration

d.

Thirty minutes after administration

ANS: A

Feedback

A

The peak action for Regular (short-acting) insulin is 2 to 3 hours after subcutaneous administration.

B

The duration of Regular (short-acting) insulin is only 3 to 6 hours. Peak action occurs 2 to 3 hours after the insulin is administered.

C

Subcutaneously administered Regular (short-acting) insulin has an onset of action of 30 to 60 minutes after injection. The effectiveness of subcutaneously administered, short-acting insulin cannot be assessed immediately after administration.

D

Thirty minutes corresponds to the onset of action for Regular (short-acting) insulin.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1398 | Table 51-4

OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity

19. What is the primary concern for a 7-year-old child with type 1 diabetes mellitus who asks his mother not to tell anyone at school that he has diabetes?

a.

The childs safety

b.

The privacy of the child

c.

Development of a sense of industry

d.

Peer group acceptance

ANS: A

Feedback

A

Safety is the primary issue. School personnel need to be aware of the signs and symptoms of hypoglycemia and hyperglycemia and the appropriate interventions.

B

Privacy is not a life-threatening concern.

C

The treatment of type 1 diabetes should not interfere with the school-age childs development of a sense of industry.

D

Peer group acceptance, along with body image, are issues for the early adolescent with type 1 diabetes. This is not of greater priority than the childs safety.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1400

OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance

20. What is the best nursing action when a child with type 1 diabetes mellitus is sweating, trembling, and pale?

a.

Offer the child a glass of water.

b.

Give the child 5 units of regular insulin subcutaneously.

c.

Give the child a glass of orange juice.

d.

Give the child glucagon subcutaneously.

ANS: C

Feedback

A

A glass of water is not indicated in this situation. An easily digested carbohydrate is indicated when a child exhibits symptoms of hypoglycemia.

B

Insulin would lower blood glucose and is contraindicated for a child with hypoglycemia.

C

Four ounces of orange juice is an appropriate treatment for the conscious child who is exhibiting signs of hypoglycemia.

D

Subcutaneous injection of glucagon is used to treat hypoglycemia when the child is unconscious.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1402

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

21. Which sign is the nurse most likely to assess in a child with hypoglycemia?

a.

Urine positive for ketones and serum glucose greater than 300 mg/dL

b.

Normal sensorium and serum glucose greater than 160 mg/dL

c.

Irritability and serum glucose less than 60 mg/dL

d.

Increased urination and serum glucose less than 120 mg/dL

ANS: C

Feedback

A

Serum glucose greater than 300 mg/dL and urine positive for ketones are indicative of diabetic ketoacidosis.

B

Normal sensorium and serum glucose greater than 160 mg/dL are associated with hyperglycemia.

C

Irritability and serum glucose less than 60 mg/dL are neuroglycopenic manifestations of hypoglycemia.

D

Increased urination is an indicator of hyperglycemia. A serum glucose level less than 120 mg/dL is within normal limits.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1396 | Table 51-3

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

22. When would a child diagnosed with type 1 diabetes mellitus most likely demonstrate a decreased need for insulin?

a.

During the honeymoon phase

b.

During adolescence

c.

During growth spurts

d.

During minor illnesses

ANS: A

Feedback

A

During the honeymoon phase, which may last from a few weeks to a year or longer, the child is likely to need less insulin.

B

During adolescence, physical growth and hormonal changes contribute to an increase in insulin requirements.

C

Insulin requirements are typically increased during growth spurts.

D

Stress either from illness or from events in the environment can cause hyperglycemia. Insulin requirements are increased during periods of minor illness.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1396

OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity

23. What should a nurse advise the parents of a child with type 1 diabetes mellitus who is not eating as a result of a minor illness?

a.

Give the child half his regular morning dose of insulin.

b.

Substitute simple carbohydrates or calorie-containing liquids for solid foods.

c.

Give the child plenty of unsweetened, clear liquids to prevent dehydration.

d.

Take the child directly to the emergency department.

ANS: B

Feedback

A

The child should receive his regular dose of insulin even if he does not have an appetite.

B

A sick-day diet of simple carbohydrates or calorie-containing liquids will maintain normal serum glucose levels and decrease the risk of hypoglycemia.

C

If the child is not eating as usual, he needs calories to prevent hypoglycemia.

D

During periods of minor illness, the child with type 1 diabetes mellitus can be managed safely at home.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1405 | Box 51-4

OBJ: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance

24. Which is the nurses best response to the parents of a 10-year-old child newly diagnosed with type 1 diabetes mellitus who are concerned about the childs continued participation in soccer?

a.

Consider the swim team as an alternative to soccer.

b.

Encourage intellectual activity rather than participation in sports.

c.

It is okay to play sports such as soccer unless the weather is too hot.

d.

Give the child an extra 15 to 30 g of carbohydrate snack before soccer practice.

ANS: D

Feedback

A

Soccer is an appropriate sport for a child with type 1 diabetes as long as the child prevents hypoglycemia by eating a snack.

B

Participation in sports is not contraindicated for a child with type 1 diabetes.

C

The child with type 1 diabetes may participate in sports activities regardless of climate.

D

Exercise lowers blood glucose levels. A snack with 15 to 30 g of carbohydrates before exercise will decrease the risk of hypoglycemia.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1400

OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance

25. Which comment by a 12-year-old child with type 1 diabetes indicates deficient knowledge?

a.

I rotate my insulin injection sites every time I give myself an injection.

b.

I keep records of my glucose levels and insulin sites and amounts.

c.

Ill be glad when I can take a pill for my diabetes like my uncle does.

d.

I keep Lifesavers in my school bag in case I have a low-sugar reaction.

ANS: C

Feedback

A

Rotating injection sites is appropriate because insulin absorption varies at different sites.

B

Keeping records of serum glucose and insulin sites and amounts is appropriate.

C

Children with type 1 diabetes will require life-long insulin therapy.

D

Prompt treatment of hypoglycemia reduces the possibility of a severe reaction. Keeping hard candy on hand is an appropriate action.

PTS: 1 DIF: Cognitive Level: Analysis REF: pp. 1396-1398

OBJ: Nursing Process: Evaluation MSC: Client Needs: Health Promotion and Maintenance

26. Which laboratory finding confirms that a child with type 1 diabetes is experiencing diabetic ketoacidosis?

a.

No urinary ketones

b.

Low arterial pH

c.

Elevated serum carbon dioxide

d.

Elevated serum phosphorus

ANS: B

Feedback

A

Urinary ketones, often in large amounts, are present when a child is in diabetic ketoacidosis.

B

Severe insulin deficiency produces metabolic acidosis, which is indicated by a low arterial pH.

C

Serum carbon dioxide is decreased in diabetic ketoacidosis.

D

Serum phosphorus is decreased in diabetic ketoacidosis.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1405

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

MULTIPLE RESPONSE

1. Which nursing intervention is appropriate for a child with type 1 diabetes who is experiencing deficient fluid volume related to abnormal fluid losses through diuresis and emesis? Select all that apply.

a.

Initiate IV access.

b.

Begin IV fluid replacement with normal saline.

c.

Begin IV fluid replacement with D51/2NS.

d.

Weigh on arrival to the unit and then every other day.

e.

Maintain strict intake and output monitoring.

ANS: A, B, E

Feedback

Correct

IV access should always be obtained on a hospitalized child with dehydration and a history of type 1 diabetes. Maintaining circulation is a priority nursing intervention. If the child is vomiting and unable to maintain adequate hydration, fluid volume replacement/rehydration is needed. Normal saline is the initial IV rehydration fluid, followed by half-normal saline. Maintaining strict intake and output is essential in calculating rehydration status.

Incorrect

D51/2NS is not the recommended fluid for rehydration of this patient.Weighing the patient on arrival is important, but following the initial weight, the child needs to be weighed more frequently than every other day. Comparison of admission weight and a weight every 8 hours provides an indication of hydration status.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1405

OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

2. Which children admitted to the pediatric unit would the nurse monitor closely for development of SIADH? Select all who apply.

a.

A newly diagnosed preschooler with type 1 diabetes

b.

A school-age child returning from surgery for removal of a brain tumor

c.

An infant with suspected meningitis

d.

An adolescent with blunt abdominal trauma following a car accident

e.

A school-age child with head trauma

ANS: B, C, E

Feedback

Correct

Childhood SIADH usually is caused by disorders affecting the central nervous system, such as infections (meningitis), head trauma, and brain tumors.

Incorrect

These conditions do not usually cause SIADH.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1390

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

3. A child is diagnosed with hypothyroidism. The nurse should expect to assess which symptoms associated with hypothyroidism? Select all that apply.

a.

Weight loss

b.

Fatigue

c.

Diarrhea

d.

Dry, thick skin

e.

Cold intolerance

ANS: B, D, E

Feedback

Correct

A child with hypothyroidism will display fatigue, dry, thick skin, and cold intolerance.

Incorrect

Weight loss and diarrhea are signs of hyperthyroidism.

PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1383

OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity

COMPLETION

1. The rise in the incidence of both overweight and obese children is directly related to the increase in the number of children diagnosed with _______________.

ANS:

type 2 diabetes

Type 2 diabetes is an emerging problem in the pediatric population. At the time of diagnoses, approximately 50% of the beta cells and the pancreas of type 2 diabetic children are still producing insulin. Education regarding healthy dietary choices and exercise are essential in managing these children.

PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1407

OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance

TRUE/FALSE

1. Type 1 diabetes, the most common childhood endocrine disease, presents challenges to the nurse in the areas of teaching, management, and adherence. Due to recent changes in health care delivery systems, meeting the needs of a type 1 diabetic child has become even more complicated. Unless the newly diagnosed child is in diabetic ketoacidosis, the child may not be hospitalized. Is this statement true or false?

ANS: T

This statement is correct. Therefore the nurse must develop a plan of care that involves child and family education and supports them in either an inpatient or in outpatient setting.

PTS: 1 DIF: Cognitive Level: Application REF: p. 1396

OBJ: Nursing Process: Planning

MSC: Client Needs: Safe and Effective Care Environment

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