NURS 535 Final Exam 2026 Questions
and Answers
gh deficiency - Correct answer-When GH is absent or produced in inadequate
amounts
Manifestations: short height for child's age, Increased fat around waist & face.
Decreased muscle mass. Delayed skeletal maturation, tooth development, and
delayed puberty. Hypoglycemia.
Diagnostics: Thyroid panel, renal/liver function, insulin like growth factor, bone
density scan, GH stimulant test, brain CT or MRI.
Treatment: SQ injections daily or 3-4 times a week, must be refrigerated.
Monitored by endocrine every 3 to 6 months. Tx stops when growth plates fuse.
Precocious puberty - Correct answer-Onset of puberty usually occurring before age
8 in girls and before age 9 in boys
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,etiology: idiopathic
Manifestation: advanced growth rate & bone maturation
Diagnostics: CT/MRI, bone density scan, pelvic adrenal US, testosterone, estrogen,
LH, FSH
Treatment: suppress puberty, provide support
congenital hypothyroidism - Correct answer-Thyroid gland does not produce
enough thyroid hormone (most common in girls)
etiology: gene mutation, failure of feedback mechanism, untreated leads to
developmental delay.
Manifestations: High TSH or either low T3 & T4
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,Large for age, puffy face, swollen tongue, hoarse cry, cold extremities,
constipation, appears tired.
Management: monitor growth & development of the infant (height, weight, head
circumference, & developmental milestones)
** never put medication in a whole bottle of formula in case infant does not finish
bottle**
Hyperthyroidism - Correct answer-Thyroid hormone levels are increased
Etiology: usually due to Graves' disease which is autoimmune disorder
Dx: Low TSH, elevated T3 & T4
S/S: tachycardia, excessive perspiration, irritability, weight loss, diarrhea,
increased appetite, muscle weakness, fatigue, goiter, exophthalmos.
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, Treatment: anithyroid medications such as propythiouracil (PTU) & methimazole
(MTZ, tapazole) SE include sore throat , skin rashes, itching, GI symptoms, and
jaundice.
**ablation with radiodine is not recommended in children**
Congenital Adrenal Hyperplasia (CAH) - Correct answer-Caused by a decrease in
enzyme activity required for cortisol production in adrenal cortex.
Can manifest pre and post natal.
Due to 21-hydroxylase deficiency (salt wasting) and 11-hydroxylase deficiency.
*over production of adrenal androgens results in virilization of female fetus
(ambiguous genitalia)**
Manifestations in males is dehydration, electrolyte imbalances, hypoglycemia.
Diagnostics: hormonal studies, serum electrolytes, US for pelvic organs.
Treatment: cortisol or prednisolone. Children with salt-loosing form require
aldosterone replacement, reconstructive surgery in females.
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and Answers
gh deficiency - Correct answer-When GH is absent or produced in inadequate
amounts
Manifestations: short height for child's age, Increased fat around waist & face.
Decreased muscle mass. Delayed skeletal maturation, tooth development, and
delayed puberty. Hypoglycemia.
Diagnostics: Thyroid panel, renal/liver function, insulin like growth factor, bone
density scan, GH stimulant test, brain CT or MRI.
Treatment: SQ injections daily or 3-4 times a week, must be refrigerated.
Monitored by endocrine every 3 to 6 months. Tx stops when growth plates fuse.
Precocious puberty - Correct answer-Onset of puberty usually occurring before age
8 in girls and before age 9 in boys
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,etiology: idiopathic
Manifestation: advanced growth rate & bone maturation
Diagnostics: CT/MRI, bone density scan, pelvic adrenal US, testosterone, estrogen,
LH, FSH
Treatment: suppress puberty, provide support
congenital hypothyroidism - Correct answer-Thyroid gland does not produce
enough thyroid hormone (most common in girls)
etiology: gene mutation, failure of feedback mechanism, untreated leads to
developmental delay.
Manifestations: High TSH or either low T3 & T4
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,Large for age, puffy face, swollen tongue, hoarse cry, cold extremities,
constipation, appears tired.
Management: monitor growth & development of the infant (height, weight, head
circumference, & developmental milestones)
** never put medication in a whole bottle of formula in case infant does not finish
bottle**
Hyperthyroidism - Correct answer-Thyroid hormone levels are increased
Etiology: usually due to Graves' disease which is autoimmune disorder
Dx: Low TSH, elevated T3 & T4
S/S: tachycardia, excessive perspiration, irritability, weight loss, diarrhea,
increased appetite, muscle weakness, fatigue, goiter, exophthalmos.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, Treatment: anithyroid medications such as propythiouracil (PTU) & methimazole
(MTZ, tapazole) SE include sore throat , skin rashes, itching, GI symptoms, and
jaundice.
**ablation with radiodine is not recommended in children**
Congenital Adrenal Hyperplasia (CAH) - Correct answer-Caused by a decrease in
enzyme activity required for cortisol production in adrenal cortex.
Can manifest pre and post natal.
Due to 21-hydroxylase deficiency (salt wasting) and 11-hydroxylase deficiency.
*over production of adrenal androgens results in virilization of female fetus
(ambiguous genitalia)**
Manifestations in males is dehydration, electrolyte imbalances, hypoglycemia.
Diagnostics: hormonal studies, serum electrolytes, US for pelvic organs.
Treatment: cortisol or prednisolone. Children with salt-loosing form require
aldosterone replacement, reconstructive surgery in females.
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
