Chapter 31: The Child with a Metabolic
Condition
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The
nurse recognizes these signs are characteristic of what?
a. Hypothyroidism
b. Hyperthyroidism
c. Type 1 diabetes mellitus
d. Tay-Sachs disease
ANS: A
The infant with hypothyroidism will appear sluggish, and the tongue will be enlarged,
causing noisy respiration.
DIF: Cognitive Level: Analysis REF: p. 726 OBJ: 3
TOP: Hypothyroidism KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
2. What is an important consideration for the school-age child taking DDAVP for diabetes
insipidus?
a. Observe for signs of water deprivation.
b. Restrict his physical education program.
c. Arrange for the child to use the bathroom when needed.
d. Limit fluid intake other than during the lunch period.
ANS: C
The child with diabetes insipidus needs liberal access to bathrooms and water fountains.
Arrangements may have to be made with the school to allow access.
, DIF: Cognitive Level: Application REF: pp. 726-727 OBJ: 4
TOP: Diabetes Insipidus KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
3. What condition does the nurse suspect when a child with type 1 diabetes mellitus has
hyperglycemia, diaphoresis, and headaches in the morning?
a. Dawn phenomenon
b. Somogyi phenomenon
c. Honeymoon effect
d. Ketoacidosis
ANS: B
The Somogyi phenomenon (rebound hyperglycemia) occurs when the blood glucose level is
lowered to the point at which the body‘s counter-regulatory hormones are released, producing
the symptoms described.
DIF: Cognitive Level: Analysis REF: p. 736 OBJ: 11
TOP: Somogyi Phenomenon KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity
4. What would be the most appropriate nursing response to a woman who says, “My sister had a
child with Tay-Sachs disease, and I want to know if I could have a child with this condition”?
a. “The disease is rare. It is unlikely that you would have a child with Tay-Sachs disease.”
b. “A screening test can be done to determine if you are a carrier of the gene.”
c. “The gene for Tay-Sachs disease is transmitted by the father.”
d. “The cause of Tay-Sachs disease is thought to be an autoimmune response to a virus.”
ANS: B
Carriers can be identified by screening tests. Tay-Sachs disease has an autosomal recessive
pattern of transmission.
DIF: Cognitive Level: Comprehension REF: p. 725 OBJ: 2
TOP: Tay-Sachs Disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
Condition
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The
nurse recognizes these signs are characteristic of what?
a. Hypothyroidism
b. Hyperthyroidism
c. Type 1 diabetes mellitus
d. Tay-Sachs disease
ANS: A
The infant with hypothyroidism will appear sluggish, and the tongue will be enlarged,
causing noisy respiration.
DIF: Cognitive Level: Analysis REF: p. 726 OBJ: 3
TOP: Hypothyroidism KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
2. What is an important consideration for the school-age child taking DDAVP for diabetes
insipidus?
a. Observe for signs of water deprivation.
b. Restrict his physical education program.
c. Arrange for the child to use the bathroom when needed.
d. Limit fluid intake other than during the lunch period.
ANS: C
The child with diabetes insipidus needs liberal access to bathrooms and water fountains.
Arrangements may have to be made with the school to allow access.
, DIF: Cognitive Level: Application REF: pp. 726-727 OBJ: 4
TOP: Diabetes Insipidus KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
3. What condition does the nurse suspect when a child with type 1 diabetes mellitus has
hyperglycemia, diaphoresis, and headaches in the morning?
a. Dawn phenomenon
b. Somogyi phenomenon
c. Honeymoon effect
d. Ketoacidosis
ANS: B
The Somogyi phenomenon (rebound hyperglycemia) occurs when the blood glucose level is
lowered to the point at which the body‘s counter-regulatory hormones are released, producing
the symptoms described.
DIF: Cognitive Level: Analysis REF: p. 736 OBJ: 11
TOP: Somogyi Phenomenon KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity
4. What would be the most appropriate nursing response to a woman who says, “My sister had a
child with Tay-Sachs disease, and I want to know if I could have a child with this condition”?
a. “The disease is rare. It is unlikely that you would have a child with Tay-Sachs disease.”
b. “A screening test can be done to determine if you are a carrier of the gene.”
c. “The gene for Tay-Sachs disease is transmitted by the father.”
d. “The cause of Tay-Sachs disease is thought to be an autoimmune response to a virus.”
ANS: B
Carriers can be identified by screening tests. Tay-Sachs disease has an autosomal recessive
pattern of transmission.
DIF: Cognitive Level: Comprehension REF: p. 725 OBJ: 2
TOP: Tay-Sachs Disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
