NURS 6551 FINAL EXAM 2 PEDIATRICS
GROWTH DEVELOPMENT AND HEALTH
PROMOTION 2026
◉ Test results reveal elevated growth hormone levels in an
adolescent male. Based on this finding, the nurse suspects that the
child may have: Answer: pituitary adenoma.
Rationale:
Hypersecretion of growth hormone after s\epiphyseal plate closure
places the individual at risk to develop acromegaly. Typically, this
condition is due to the presence of a pituitary adenoma. Gigantism
occurs when there is excessive growth hormone secretion prior to
epiphyseal plate closure. Diabetes insipidus occurs due to a decrease
in anti-diuretic hormone and diabetes mellitus occurs in response to
alterations in pancreatic function.
◉ In the diagnostic work up of a child for central precocious
puberty, one of the etiologies associated with this disease is:
Answer: neoplasm.
Rationale:
Neoplasms can be a cause for central precocious puberty. Albright
syndrome and primary hypothyroidism can be a cause for
,peripheral precocious puberty. Preterm menarche can be a cause for
idiopathic precocious puberty.
◉ What is the most common cause of secondary
hyperparathyroidism? Answer: Chronic renal disease
Rationale:
Chronic renal disease is the most common cause of secondary
hyperparathyroidism. The parathyroid gland plays an integral role in
the maintenance of calcium in the body, as do the kidneys. Diabetes
mellitus does not contribute to secondary hypoparathyroidism.
Congenital heart disease and/or growth hormone deficiency does
not contribute to secondary hypoparathyroidism.
◉ Which statement best describes Cushing syndrome? Answer: It is
caused by excessive production of cortisol.
Rationale:
Cushing syndrome is a description of the clinical manifestations
caused by too much circulating cortisol. Exophthalmia and
pigmentary changes are manifestations of hyperthyroidism, not
Cushing syndrome. The treatment for Cushing syndrome involves
the reduction of circulating cortisol. If the cause is a pituitary tumor,
surgery is indicated. Hypertension and hypokalemia—not
hypotension, hyperkalemia, or polyuria—are expected findings with
Cushing syndrome.
,◉ The newborn diagnosed with phenylketonuria (PKU) will require
long-term follow-up to assess for the development of: Answer:
cognitive impairment.
Rationale:
PKU, an inborn error of metabolism, may lead to cognitive
impairment if early intervention is not performed. Obesity, diabetes
insipidus and respiratory distress are not associated with PKU.
◉ A breastfed newborn has just been diagnosed with galactosemia.
The therapeutic management for this newborn is to: Answer: stop
breastfeeding.
Rationale:
All milk- and lactose-containing formulas, including breast milk,
must be stopped during infancy. Soy protein is the formula of choice
for newborns and infants with galactosemia. Breast milk should not
be used in newborns and infants with galactosemia. The formula
used for a newborn and infant with galactosemia cannot contain
lactose. Breast milk should not be used in newborns and infants
with galactosemia.
◉ A school-age child recently diagnosed with type 1 diabetes
mellitus asks the nurse if playing soccer, playing baseball, and
, swimming are still possible. The nurse's response should be based
on knowledge that: Answer: exercise is not restricted unless
indicated by other health conditions.
Rationale:
Exercise is encouraged for children with type 1 diabetes because it
lowers blood glucose levels. Insulin and meal requirements require
careful monitoring to ensure the child has sufficient energy for
exercise. Exercise is highly encouraged. The decrease in blood
glucose can be accommodated by having snacks available. Sports are
encouraged, with insulin and food adjusted for the exercise. The
child needs to be cautioned to monitor responses to the exercise.
The level of activity does not depend on the type of insulin used.
Long-acting and short-acting insulin may both be used to provide
coverage for the training and sporting events.
◉ The nurse is caring for a child hospitalized with acute
adrenocortical insufficiency. The acute phase seems to be over when
ascending flaccid paralysis occurs. What is the most appropriate
nursing action? Answer: Reassure the family that this condition is
temporary.
Rationale:
During the recovery phase, paralysis may develop. It is a temporary,
quickly reversible clinical manifestation. Flaccid paralysis is
problematic if not reversible. Flaccidity can indicate impending
death in a child with neurologic deficits but is not associated with
GROWTH DEVELOPMENT AND HEALTH
PROMOTION 2026
◉ Test results reveal elevated growth hormone levels in an
adolescent male. Based on this finding, the nurse suspects that the
child may have: Answer: pituitary adenoma.
Rationale:
Hypersecretion of growth hormone after s\epiphyseal plate closure
places the individual at risk to develop acromegaly. Typically, this
condition is due to the presence of a pituitary adenoma. Gigantism
occurs when there is excessive growth hormone secretion prior to
epiphyseal plate closure. Diabetes insipidus occurs due to a decrease
in anti-diuretic hormone and diabetes mellitus occurs in response to
alterations in pancreatic function.
◉ In the diagnostic work up of a child for central precocious
puberty, one of the etiologies associated with this disease is:
Answer: neoplasm.
Rationale:
Neoplasms can be a cause for central precocious puberty. Albright
syndrome and primary hypothyroidism can be a cause for
,peripheral precocious puberty. Preterm menarche can be a cause for
idiopathic precocious puberty.
◉ What is the most common cause of secondary
hyperparathyroidism? Answer: Chronic renal disease
Rationale:
Chronic renal disease is the most common cause of secondary
hyperparathyroidism. The parathyroid gland plays an integral role in
the maintenance of calcium in the body, as do the kidneys. Diabetes
mellitus does not contribute to secondary hypoparathyroidism.
Congenital heart disease and/or growth hormone deficiency does
not contribute to secondary hypoparathyroidism.
◉ Which statement best describes Cushing syndrome? Answer: It is
caused by excessive production of cortisol.
Rationale:
Cushing syndrome is a description of the clinical manifestations
caused by too much circulating cortisol. Exophthalmia and
pigmentary changes are manifestations of hyperthyroidism, not
Cushing syndrome. The treatment for Cushing syndrome involves
the reduction of circulating cortisol. If the cause is a pituitary tumor,
surgery is indicated. Hypertension and hypokalemia—not
hypotension, hyperkalemia, or polyuria—are expected findings with
Cushing syndrome.
,◉ The newborn diagnosed with phenylketonuria (PKU) will require
long-term follow-up to assess for the development of: Answer:
cognitive impairment.
Rationale:
PKU, an inborn error of metabolism, may lead to cognitive
impairment if early intervention is not performed. Obesity, diabetes
insipidus and respiratory distress are not associated with PKU.
◉ A breastfed newborn has just been diagnosed with galactosemia.
The therapeutic management for this newborn is to: Answer: stop
breastfeeding.
Rationale:
All milk- and lactose-containing formulas, including breast milk,
must be stopped during infancy. Soy protein is the formula of choice
for newborns and infants with galactosemia. Breast milk should not
be used in newborns and infants with galactosemia. The formula
used for a newborn and infant with galactosemia cannot contain
lactose. Breast milk should not be used in newborns and infants
with galactosemia.
◉ A school-age child recently diagnosed with type 1 diabetes
mellitus asks the nurse if playing soccer, playing baseball, and
, swimming are still possible. The nurse's response should be based
on knowledge that: Answer: exercise is not restricted unless
indicated by other health conditions.
Rationale:
Exercise is encouraged for children with type 1 diabetes because it
lowers blood glucose levels. Insulin and meal requirements require
careful monitoring to ensure the child has sufficient energy for
exercise. Exercise is highly encouraged. The decrease in blood
glucose can be accommodated by having snacks available. Sports are
encouraged, with insulin and food adjusted for the exercise. The
child needs to be cautioned to monitor responses to the exercise.
The level of activity does not depend on the type of insulin used.
Long-acting and short-acting insulin may both be used to provide
coverage for the training and sporting events.
◉ The nurse is caring for a child hospitalized with acute
adrenocortical insufficiency. The acute phase seems to be over when
ascending flaccid paralysis occurs. What is the most appropriate
nursing action? Answer: Reassure the family that this condition is
temporary.
Rationale:
During the recovery phase, paralysis may develop. It is a temporary,
quickly reversible clinical manifestation. Flaccid paralysis is
problematic if not reversible. Flaccidity can indicate impending
death in a child with neurologic deficits but is not associated with
