NURS 535 Practice Exam Questions with
Verified Answers
Growth Hormone Deficiency - ✔✔Absence or deficiency of growth hormone produced by the
pituitary gland to stimulate the body to grow
Etiology of GH deficiency - ✔✔Infections, trauma, brain tumors
Clinical manifestations of GH - ✔✔Short height for child's age
Increased amount of fat around waist and in face
Emotional feelings about height or weight
Younger appearance than children of same age
Decreased muscle mass
Delayed skeletal maturation Delayed onset of puberty Delayed tooth development
Hypoglycemia
GH Diagnostics - ✔✔Thyroid panel
Evaluate renal and liver function
Insulin like growth factors (will be low)
Growth Hormone Stimulant test
Bone density scan
Brain CT or MRI
Karotyping
GH Treatment - ✔✔Most children receive subcutaneous injections
Injections can be daily or three to four times per week and have increased growth velocity at
bedtime
,GH must be refrigerated
Close monitoring of growth with endocrinology visits every 3 to 6 months
Treatment stops when growth plates fuse
Precocious puberty - ✔✔The very early onset and rapid progression of puberty
Before age 8 in girls
Before age 9 in boys
Etiology of Precocious Puberty - ✔✔Hormone-secreting tumors
Brain injury caused by head trauma
Infection
Thyroid dysfunction
Ovarian dysfunction
Idiopathic (most cases)
Clinical manifestations of precocious puberty - ✔✔Female: Breast development, axillary hair,
pubic hair, body odor, onset of menses, acne
Male: Testicular/Penile enlargement, axillary and chest hair, deepening voice, acne
Diagnostic evaluation of precocious puberty - ✔✔Computed tomographic scan or magnetic
resonance imaging
Bone density scan
Pelvic and adrenal ultrasound
Gonadotropin-releasing hormone stimulation test
Blood work: Testosterone, estrogen, LH, FSH
Treatment involves the suppression of puberty
,congenital hypothyroidism - ✔✔Condition present at birth that results in lack of thyroid
hormones; results in poor physical and mental development; formerly called cretinism
Clinical manifestations of hypothyroidism - ✔✔Lethargy
Weakness
Dry skin
Cold intolerance
Weight gain
Constipation
Coarse hair
Diagnostic evaluation for hypothyroidism - ✔✔State-required screening: TSH and T4
Low T4, elevated TSH, or both indicate hypothyroidism
Positive test results may be followed by scan for bone age
Blood tests before 48 hours after birth may be falsely interpreted because of the rise in TSH
immediately after birth
Hyperthyroidism - ✔✔Excessive production of thyroid hormones
Signs and symptoms of hyperthyroidism - ✔✔Weakness, insomnia, tachycardia, palpitations,
dyspnea, emotional of people and extremes, "everything speeds up"
Causes of hyperthyroidism - ✔✔Graves Disease
Pituitary and thyroid tumors, thyroiditis, congenital due to transfer of immunoglobulins from
thyrotoxic mothers
Treatment of hyperthyroidism - ✔✔PTU or methimazole to control the gland
, Radioactive iodine to ablate the gland
Propranolol to treat sympathetic sxs such as tremors/palpitations, etc.
Thyroidectomy
congenital adrenal hyperplasia - ✔✔Genetic disease in which the adrenal gland is
overdeveloped, resulting in a deficiency of certain hormones and an overproduction of others
Salt losing form CAH - ✔✔No cortisol = hypoglycemia
No aldosterone = salt and water loss
Increased cortisol precursors
-17-hydroxyprogesterone = salt losing tendency
Increased androgens masculinization
Excess androgen production during fetal life is associated with salt-losing and simple virilizing
CAH and masculinizes the external genitalia of female infants
Clinical manifestations of CAH - ✔✔Males-precocious genital development
Females-may be born with varying degrees of ambiguous genitalia
-Enlarged clitoris appears as a small phallus
-Fused labia produce sac-like structure without testes
-Internal female sex organs are intact
Diagnostic evaluation CAH - ✔✔Hormonal studies
Serum electrolyte
US to visualize pelvic organs
Chromosomal typing for positive sex determination and to rule out other genetic anomalies
Verified Answers
Growth Hormone Deficiency - ✔✔Absence or deficiency of growth hormone produced by the
pituitary gland to stimulate the body to grow
Etiology of GH deficiency - ✔✔Infections, trauma, brain tumors
Clinical manifestations of GH - ✔✔Short height for child's age
Increased amount of fat around waist and in face
Emotional feelings about height or weight
Younger appearance than children of same age
Decreased muscle mass
Delayed skeletal maturation Delayed onset of puberty Delayed tooth development
Hypoglycemia
GH Diagnostics - ✔✔Thyroid panel
Evaluate renal and liver function
Insulin like growth factors (will be low)
Growth Hormone Stimulant test
Bone density scan
Brain CT or MRI
Karotyping
GH Treatment - ✔✔Most children receive subcutaneous injections
Injections can be daily or three to four times per week and have increased growth velocity at
bedtime
,GH must be refrigerated
Close monitoring of growth with endocrinology visits every 3 to 6 months
Treatment stops when growth plates fuse
Precocious puberty - ✔✔The very early onset and rapid progression of puberty
Before age 8 in girls
Before age 9 in boys
Etiology of Precocious Puberty - ✔✔Hormone-secreting tumors
Brain injury caused by head trauma
Infection
Thyroid dysfunction
Ovarian dysfunction
Idiopathic (most cases)
Clinical manifestations of precocious puberty - ✔✔Female: Breast development, axillary hair,
pubic hair, body odor, onset of menses, acne
Male: Testicular/Penile enlargement, axillary and chest hair, deepening voice, acne
Diagnostic evaluation of precocious puberty - ✔✔Computed tomographic scan or magnetic
resonance imaging
Bone density scan
Pelvic and adrenal ultrasound
Gonadotropin-releasing hormone stimulation test
Blood work: Testosterone, estrogen, LH, FSH
Treatment involves the suppression of puberty
,congenital hypothyroidism - ✔✔Condition present at birth that results in lack of thyroid
hormones; results in poor physical and mental development; formerly called cretinism
Clinical manifestations of hypothyroidism - ✔✔Lethargy
Weakness
Dry skin
Cold intolerance
Weight gain
Constipation
Coarse hair
Diagnostic evaluation for hypothyroidism - ✔✔State-required screening: TSH and T4
Low T4, elevated TSH, or both indicate hypothyroidism
Positive test results may be followed by scan for bone age
Blood tests before 48 hours after birth may be falsely interpreted because of the rise in TSH
immediately after birth
Hyperthyroidism - ✔✔Excessive production of thyroid hormones
Signs and symptoms of hyperthyroidism - ✔✔Weakness, insomnia, tachycardia, palpitations,
dyspnea, emotional of people and extremes, "everything speeds up"
Causes of hyperthyroidism - ✔✔Graves Disease
Pituitary and thyroid tumors, thyroiditis, congenital due to transfer of immunoglobulins from
thyrotoxic mothers
Treatment of hyperthyroidism - ✔✔PTU or methimazole to control the gland
, Radioactive iodine to ablate the gland
Propranolol to treat sympathetic sxs such as tremors/palpitations, etc.
Thyroidectomy
congenital adrenal hyperplasia - ✔✔Genetic disease in which the adrenal gland is
overdeveloped, resulting in a deficiency of certain hormones and an overproduction of others
Salt losing form CAH - ✔✔No cortisol = hypoglycemia
No aldosterone = salt and water loss
Increased cortisol precursors
-17-hydroxyprogesterone = salt losing tendency
Increased androgens masculinization
Excess androgen production during fetal life is associated with salt-losing and simple virilizing
CAH and masculinizes the external genitalia of female infants
Clinical manifestations of CAH - ✔✔Males-precocious genital development
Females-may be born with varying degrees of ambiguous genitalia
-Enlarged clitoris appears as a small phallus
-Fused labia produce sac-like structure without testes
-Internal female sex organs are intact
Diagnostic evaluation CAH - ✔✔Hormonal studies
Serum electrolyte
US to visualize pelvic organs
Chromosomal typing for positive sex determination and to rule out other genetic anomalies
