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 child’s 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 adolescent’s 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
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 child’s 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 adolescent’s 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
