KAPLAN PEDIATRICS LATEST
REVIEW
A preschool-age client is diagnosed with idiopathic hypopituitarism.
Which hormone is most commonly prescribed for a preschool client
with idiopathic hypopituitarism?
a. Estrogen
b. Parathormone
c. Growth hormone
d. Insulin - ANSWERS-c. Growth hormone
The most common hormone affected in children with hypopituitarism is
growth hormone. Growth hormone promotes growth of bone and soft
tissues, affects linear growth, and conserves carbohydrate utilization.
Estrogen accelerates growth of epithelial cells in utero, promotes protein
anabolism, promotes breast development during puberty and pregnancy,
and stimulates ripening of ova. It would not be the priority hormones
prescribed for the child with hypopituitarism. Parathormone is not
affected by hypopituitarism, but is regulated by a feedback loop due to
levels of phosphorus and calcium in the blood. Parathormone promotes
calcium reabsorption from blood, bone, and intestines. It promotes
excretion of phosphorus in the kidneys. Insulin is produced by the beta
cells of the pancreas in response to elevations of blood glucose. If blood
sugar levels are affected in hypopituitarism, they are usually decreased.
Hypoglycemia is more prevalent in hypopituitarism.
END OF
PAGE
1
,KAPLAN PEDIATRICS LATEST
REVIEW
The nurse instructs a parent about the appropriate way to instill ear drops
in the right ear of a toddler client. The nurse determines teaching is
effective if the parent makes which statement?
a. "I should pull my child's ear down and back."
b. "I will have my child stand next to me."
c. "I will place a dry cotton ball in my child's ear."
d. "My child should lie on the right side after I instill the drops." -
ANSWERS-a. "I should pull my child's ear down and back."
In children younger than 3 years of age, the nurse would straighten the
ear canal by pulling the pinna down and straight back. In children older
than 3 years of age, the nurse should pull the pinna up and back. The
child should like supine with head turned to left side for the drops to be
instilled. A dry cotton ball will cause wicking and medication will be
absorbed by the cotton. It is best to moisten the cotton ball with
medication prior to inserting. After insertion of the ear drops, the child
should lie with head turned to left side to keep the drops in the correct
position.
END OF
PAGE
2
,KAPLAN PEDIATRICS LATEST
REVIEW
An infant client is able to stand holding on to objects, plays "peek-a-
boo," and is starting to say "mama" and "dada." The nurse identifies
these behaviors are characteristic of which age?
a. 5 months
b. 6 months
c. 9 months
4. 12 months - ANSWERS-c. 9 months
At 9 months of age, the infant is able to pull self up and assumes a
seated position as well as say words such as "dada," "mama," and
"baba." At 5 months of age, the infant squeals and makes cooing sounds.
The infant is also able to reach for objects with one hand, and hold the
head steady. At 6 months of age, the infant takes pleasure in hearing
own voice and begins to imitate sounds. The infant also begins to sit
unsupported and show curiosity in surroundings. At 12 months of age,
the infant comprehends the meanings of several words, recognize
objects by name, and says 3-5 words besides "dada" and "mama." The 1-
year-old is able to respond to simple spoken requests and make simple
gestures like waving or nodding "yes."
END OF
PAGE
3
, KAPLAN PEDIATRICS LATEST
REVIEW
The office nurse receives a phone call from a parent of an infant client
who received the DTaP vaccine 3 days ago. The nurse is most concerned
if the parent makes which statement?
a. "There is redness at the injection site."
b. "My baby is crying continuously."
c. "My baby's temperature is 101F (38.3C)."
d. "My baby seems to be eating less." - ANSWERS-b. "My baby is
crying continuously."
High pitched, continuous crying is a serious adverse effect of the DTaP
vaccine. Other serious adverse effects include convulsions, high fever,
and loss of consciousness. Redness and swelling at the injection site is
an expected outcome. A slight temperature is a more common adverse
effect. The nurse should instruct the parent to administer acetaminophen.
Poor appetite for a few days after receiving the DTaP vaccine is a
common adverse effect.
The nurse provides care for an infant client diagnosed with a cyanotic
congenital heart defect. The nurse understands that chronic hypoxia
from this disorder can result in which finding?
END OF
PAGE
4
REVIEW
A preschool-age client is diagnosed with idiopathic hypopituitarism.
Which hormone is most commonly prescribed for a preschool client
with idiopathic hypopituitarism?
a. Estrogen
b. Parathormone
c. Growth hormone
d. Insulin - ANSWERS-c. Growth hormone
The most common hormone affected in children with hypopituitarism is
growth hormone. Growth hormone promotes growth of bone and soft
tissues, affects linear growth, and conserves carbohydrate utilization.
Estrogen accelerates growth of epithelial cells in utero, promotes protein
anabolism, promotes breast development during puberty and pregnancy,
and stimulates ripening of ova. It would not be the priority hormones
prescribed for the child with hypopituitarism. Parathormone is not
affected by hypopituitarism, but is regulated by a feedback loop due to
levels of phosphorus and calcium in the blood. Parathormone promotes
calcium reabsorption from blood, bone, and intestines. It promotes
excretion of phosphorus in the kidneys. Insulin is produced by the beta
cells of the pancreas in response to elevations of blood glucose. If blood
sugar levels are affected in hypopituitarism, they are usually decreased.
Hypoglycemia is more prevalent in hypopituitarism.
END OF
PAGE
1
,KAPLAN PEDIATRICS LATEST
REVIEW
The nurse instructs a parent about the appropriate way to instill ear drops
in the right ear of a toddler client. The nurse determines teaching is
effective if the parent makes which statement?
a. "I should pull my child's ear down and back."
b. "I will have my child stand next to me."
c. "I will place a dry cotton ball in my child's ear."
d. "My child should lie on the right side after I instill the drops." -
ANSWERS-a. "I should pull my child's ear down and back."
In children younger than 3 years of age, the nurse would straighten the
ear canal by pulling the pinna down and straight back. In children older
than 3 years of age, the nurse should pull the pinna up and back. The
child should like supine with head turned to left side for the drops to be
instilled. A dry cotton ball will cause wicking and medication will be
absorbed by the cotton. It is best to moisten the cotton ball with
medication prior to inserting. After insertion of the ear drops, the child
should lie with head turned to left side to keep the drops in the correct
position.
END OF
PAGE
2
,KAPLAN PEDIATRICS LATEST
REVIEW
An infant client is able to stand holding on to objects, plays "peek-a-
boo," and is starting to say "mama" and "dada." The nurse identifies
these behaviors are characteristic of which age?
a. 5 months
b. 6 months
c. 9 months
4. 12 months - ANSWERS-c. 9 months
At 9 months of age, the infant is able to pull self up and assumes a
seated position as well as say words such as "dada," "mama," and
"baba." At 5 months of age, the infant squeals and makes cooing sounds.
The infant is also able to reach for objects with one hand, and hold the
head steady. At 6 months of age, the infant takes pleasure in hearing
own voice and begins to imitate sounds. The infant also begins to sit
unsupported and show curiosity in surroundings. At 12 months of age,
the infant comprehends the meanings of several words, recognize
objects by name, and says 3-5 words besides "dada" and "mama." The 1-
year-old is able to respond to simple spoken requests and make simple
gestures like waving or nodding "yes."
END OF
PAGE
3
, KAPLAN PEDIATRICS LATEST
REVIEW
The office nurse receives a phone call from a parent of an infant client
who received the DTaP vaccine 3 days ago. The nurse is most concerned
if the parent makes which statement?
a. "There is redness at the injection site."
b. "My baby is crying continuously."
c. "My baby's temperature is 101F (38.3C)."
d. "My baby seems to be eating less." - ANSWERS-b. "My baby is
crying continuously."
High pitched, continuous crying is a serious adverse effect of the DTaP
vaccine. Other serious adverse effects include convulsions, high fever,
and loss of consciousness. Redness and swelling at the injection site is
an expected outcome. A slight temperature is a more common adverse
effect. The nurse should instruct the parent to administer acetaminophen.
Poor appetite for a few days after receiving the DTaP vaccine is a
common adverse effect.
The nurse provides care for an infant client diagnosed with a cyanotic
congenital heart defect. The nurse understands that chronic hypoxia
from this disorder can result in which finding?
END OF
PAGE
4
