©THESTAR 2025 ALL RIGHTS RESERVED
NUR2010 TRANSITIONS: ALL COMP
EXAMS 357 QUESTIONS AND ANSWERS
100% PASS
Patho of HYPOpituitarism - ANS - growth hormone deficiency due to LOW amounts of
growth hormones (patients will be small & frail)
- can be caused by congenital defect, trauma that damages pituitary gland, pituitary tumor, or
issue with hypothalamus
Signs & Symptoms of Hypopituitarism - ANS dwarfism, developmental delay, various visual
and neurological symptoms, seizure disorder, congenital malformations, delayed sexual
maturation (amenorrhea, micropenis, undescended testicles), hypoglycemia, diabetes
Diagnostics for hypopituitarism - ANS Not something that is automatically screened for, but
will be obvious when height & weight is plotted & there is no progression
- hormone stimulation test: administer insulin, argining, glucagon and check the release of
growth hormones
- Bone density tests
- Xrays/CT scans
Treatment of hypopituitarism - ANS Biosynthetic growth hormone injection Somatropin
(Humatrope) - VERY EXPENSIVE and child will only take until they reach optimal height (what
height this is will depend on parents/pediatrician discussion)
, ©THESTAR 2025 ALL RIGHTS RESERVED
Other hormone replacements (levothyroxine, estrogen, testosterone, progesterone, synthroid,
cortisone)
Nursing teaching for hypothyroidism - ANS - Patient not growing taller, but growing wider -
body image issues
- Teaching about growth hormone injections - 2cm from umbilicus or thighs, rotate sites, teach
infection control, teach child how to clean and eventually adminster these injections on their
own (so they can be involved in their own healthcare)
patho of precocious puberty - ANS Disorder of gonads, adrenal glands, or hypothalamic-
pituitary-gonadal axis - cause is usually unknown
2 types - central (most common, kids can reproduce & have somatic growth) & peripheral
(overproduction of gonads, increased sex organ sensitivity)
S&S of precocious puberty - ANS Sexual development before 9 in boys (typically 11-14) or
before 8 in girls (usually 10-12)
Treatment/management of precocious puberty - ANS Can treat the cause if the cause is
known
- Surgery, chemo, radiation to remove any tumors
- GnRH analog for central precocious puberty
- Girls: luteinizing hormone releasing hormone (Lupron): HOT FLASHES is a normal side effect
- Depoprovera shot or Cycrin tables to reduce secretion of gonadrotrophins & stop
menstruation
- Stop medications when child reaches normal pubertal age
, ©THESTAR 2025 ALL RIGHTS RESERVED
- Parents will need to have "birds and bees" conversation early with these children - teach them
about body image, periods, etc.
Patho of hypothyroidism - ANS Juvenile hypothyroid can be congenital (genetic mutation,
most common preventable cause of intellectual disability, covered in newborn screening test)
or acquired (such as from a thyroidectomy or radiation for Hodgkins)
S&S of hypothyroidism in Peds - ANS Thyroid enlargement the compromises newborn
airway, decelerated growth, periorbital edema, delayed mental responsivenessm constipation
All other symptoms like adults - low and slow body
Babies hard to wake up, round belly from decreased peristalsis, sparse hair and dry skin
Treatment of hypothyroidism - ANS Levothyroxine (Synthroid)
- measure & record growth at regular intervals
- Obtain thyroid tests more frequently until adolescence (every 3-4 mths, then every 6-12 as
adolescents)
- Provide additional rest periods and extra measures for thermoregulation
patho of congenital adrenal hyperplasia - ANS Prolonged oversecretion of adrenocorticopic
hormone causes enlargement or hyperplasia of adrenal glands & EXCESS ANDROGEN
PRODUCTION - makes male characteristics appear too early or inappropriately
S&S of congenital adrenal hyperplasia - ANS - Males will usually have no genital
abnormalities
- females will have ambiguous genitalia - enlarged clitoris that appears to look like a small
phallus, fused labia that can produce a sac-like structure, internal anatomy will be normal for
females
, ©THESTAR 2025 ALL RIGHTS RESERVED
- Can also cause hypogycemia & adult testicular tumors
- ACUTE adrenal hyperplasia crisis - like an Addisonian crisis - patient will have severe
dehydration and salt loss, require IV steroids
Diagnostics for congenital adrenal hyperplasia - ANS - Metabolic screening that reveals 21-
OH enzyme deficiency
- Random hormone level test
- Radiographs/xrays to look for advanced bone age, premature closure of epiphyseal plates or
long bones, chromosomal typing
Treatment/management of congenital adrenal hyperplasia - ANS Confirm diagnosis and
assign a sex to the baby according to their genotype (use an ultrasound to visualize a uterus for
confirmation)
Cortisone (dexamethasone, hydrocortisone) to suppress high secretion of ACTH
Reconstructive surgery
Monitor for acute adrenal crisis
Nursing considerations for congenital adrenal hyperplasia - ANS - Teach parents the signs of
acute adrenal crisis: signs of dehydration like sunken fontanels, dry membranes)
- Help family understand disease
- Teach hormone supplementation
- Genetic counseling b/c increased chances of having another child born this way
- LEGALLY, parents can decide to choose one gender or another, decision may be difficult
depending on their preference & ethical considerations
NUR2010 TRANSITIONS: ALL COMP
EXAMS 357 QUESTIONS AND ANSWERS
100% PASS
Patho of HYPOpituitarism - ANS - growth hormone deficiency due to LOW amounts of
growth hormones (patients will be small & frail)
- can be caused by congenital defect, trauma that damages pituitary gland, pituitary tumor, or
issue with hypothalamus
Signs & Symptoms of Hypopituitarism - ANS dwarfism, developmental delay, various visual
and neurological symptoms, seizure disorder, congenital malformations, delayed sexual
maturation (amenorrhea, micropenis, undescended testicles), hypoglycemia, diabetes
Diagnostics for hypopituitarism - ANS Not something that is automatically screened for, but
will be obvious when height & weight is plotted & there is no progression
- hormone stimulation test: administer insulin, argining, glucagon and check the release of
growth hormones
- Bone density tests
- Xrays/CT scans
Treatment of hypopituitarism - ANS Biosynthetic growth hormone injection Somatropin
(Humatrope) - VERY EXPENSIVE and child will only take until they reach optimal height (what
height this is will depend on parents/pediatrician discussion)
, ©THESTAR 2025 ALL RIGHTS RESERVED
Other hormone replacements (levothyroxine, estrogen, testosterone, progesterone, synthroid,
cortisone)
Nursing teaching for hypothyroidism - ANS - Patient not growing taller, but growing wider -
body image issues
- Teaching about growth hormone injections - 2cm from umbilicus or thighs, rotate sites, teach
infection control, teach child how to clean and eventually adminster these injections on their
own (so they can be involved in their own healthcare)
patho of precocious puberty - ANS Disorder of gonads, adrenal glands, or hypothalamic-
pituitary-gonadal axis - cause is usually unknown
2 types - central (most common, kids can reproduce & have somatic growth) & peripheral
(overproduction of gonads, increased sex organ sensitivity)
S&S of precocious puberty - ANS Sexual development before 9 in boys (typically 11-14) or
before 8 in girls (usually 10-12)
Treatment/management of precocious puberty - ANS Can treat the cause if the cause is
known
- Surgery, chemo, radiation to remove any tumors
- GnRH analog for central precocious puberty
- Girls: luteinizing hormone releasing hormone (Lupron): HOT FLASHES is a normal side effect
- Depoprovera shot or Cycrin tables to reduce secretion of gonadrotrophins & stop
menstruation
- Stop medications when child reaches normal pubertal age
, ©THESTAR 2025 ALL RIGHTS RESERVED
- Parents will need to have "birds and bees" conversation early with these children - teach them
about body image, periods, etc.
Patho of hypothyroidism - ANS Juvenile hypothyroid can be congenital (genetic mutation,
most common preventable cause of intellectual disability, covered in newborn screening test)
or acquired (such as from a thyroidectomy or radiation for Hodgkins)
S&S of hypothyroidism in Peds - ANS Thyroid enlargement the compromises newborn
airway, decelerated growth, periorbital edema, delayed mental responsivenessm constipation
All other symptoms like adults - low and slow body
Babies hard to wake up, round belly from decreased peristalsis, sparse hair and dry skin
Treatment of hypothyroidism - ANS Levothyroxine (Synthroid)
- measure & record growth at regular intervals
- Obtain thyroid tests more frequently until adolescence (every 3-4 mths, then every 6-12 as
adolescents)
- Provide additional rest periods and extra measures for thermoregulation
patho of congenital adrenal hyperplasia - ANS Prolonged oversecretion of adrenocorticopic
hormone causes enlargement or hyperplasia of adrenal glands & EXCESS ANDROGEN
PRODUCTION - makes male characteristics appear too early or inappropriately
S&S of congenital adrenal hyperplasia - ANS - Males will usually have no genital
abnormalities
- females will have ambiguous genitalia - enlarged clitoris that appears to look like a small
phallus, fused labia that can produce a sac-like structure, internal anatomy will be normal for
females
, ©THESTAR 2025 ALL RIGHTS RESERVED
- Can also cause hypogycemia & adult testicular tumors
- ACUTE adrenal hyperplasia crisis - like an Addisonian crisis - patient will have severe
dehydration and salt loss, require IV steroids
Diagnostics for congenital adrenal hyperplasia - ANS - Metabolic screening that reveals 21-
OH enzyme deficiency
- Random hormone level test
- Radiographs/xrays to look for advanced bone age, premature closure of epiphyseal plates or
long bones, chromosomal typing
Treatment/management of congenital adrenal hyperplasia - ANS Confirm diagnosis and
assign a sex to the baby according to their genotype (use an ultrasound to visualize a uterus for
confirmation)
Cortisone (dexamethasone, hydrocortisone) to suppress high secretion of ACTH
Reconstructive surgery
Monitor for acute adrenal crisis
Nursing considerations for congenital adrenal hyperplasia - ANS - Teach parents the signs of
acute adrenal crisis: signs of dehydration like sunken fontanels, dry membranes)
- Help family understand disease
- Teach hormone supplementation
- Genetic counseling b/c increased chances of having another child born this way
- LEGALLY, parents can decide to choose one gender or another, decision may be difficult
depending on their preference & ethical considerations
