Essentials of Pediatric Nursing - Chapter 26 Exam Questions and Correct Answers (Graded A+)
An 8-year-old girl presents to the clinic for moodiness and irritability. The child has begun to develop
breasts and pubic hair and the parents are concerned that the child is at too early an age for this to
begin. The nurse knows that these symptoms may be indicative of what disorder? - Answers precocious
puberty
Explanation:
Precocious puberty occurs when the child's sexual characterisitics begin to develop before the normal
age of puberty. Appropriate treatment can halt, and sometimes even reverse, sexual development and
can stop the rapid growth that results in severe short adult stature caused by premature closure of the
epiphysis. Treatment for precocious puberty allows the child to achieve the maximum growth potential
possible. Mental development in children with precocious puberty is normal, and developmental
milestones are not affected. The behavior may change to that of a typical adolescent. Girls may have
episodes of moodiness and irritability, whereas boys may become more aggressive. Psuedopuberty
occurs when there is only partial development after testosterone is secreted. It occurs in males. Adrenal
hyperplasia is an inherited disorder and it affects the production of androgen. Neurofibromatosis is a
genetic disorder of the nervous system where tumors grow on the nerves.
A 12-year-old is being seen in the office and has hyperthyroidism; the nurse knows that the most
common cause of hyperthyroidism is: - Answers Graves disease
Explanation:
Hyperthyroidism occurs less often in children than hypothyroidism. Graves' disease, the most common
cause of hyperthyroidism in children, occurs in 1 in 5,000 children between 11 and 15 years of age.
Hyperthyroidism occurs more often in females, and the peak incidence occurs during adolescence.
Kate and her parents are being seen in the office after discharge from the hospital with a new diagnosis
of type 2 diabetes. Which statement by the nurse is true? - Answers "Kids can usually be managed with
an oral agent, meal planning, and exercise."
Explanation:
Treating type 2 diabetes in children may require insulin at the outset if the child is acidotic and acutely
ill. More commonly, the child can be managed initially with oral agents, meal planning, and increasing
activity. Telling the child that she is lucky she did not have to learn how to give a shot might scare her so
,it will inhibit her from seeking future health care. The condition will not rectify itself if all orders are
followed. A weight-loss program might need to be implemented but that is not always the case.
The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus.
The caregiver states, "She is hungry all the time and eats everything, but she is losing weight." The
caregiver's statement indicates the child most likely has: - Answers Polyphagia
Explanation:
Symptoms of type 1 diabetes mellitus include polyphagia (increased hunger and food consumption),
polyuria (dramatic increase in urinary output, probably with enuresis) and polydipsia (increased thirst).
Pica is eating nonfood substances.
The nurse is caring for a 10-year-old child with growth hormone (GH) deficiency. Which therapy would
you anticipate will be prescribed for the child? - Answers Injections of GH
Explanation:
Growth hormone (GH) deficiency occurs when the anterior pituitary is unable to produce enough
hormone for usual growth. Somatotrophin is the name of the growth hormone administered.
Administering subcutaneous GH to the child helps correct this deficiency. The GH dosage is 0.2 to
0.3mg/kg given daily. It is not administered orally. Aldosterone causes sodium to be retained and a
provocation would be the administration of diuretics to reduce the sodium. Beta cells are found in the
heart muscles, smooth muscles, airways, and arteries. They are also found in the pancreas to secrete
insulin. None of these cell actions are related to the anterior pituary.
A newborn was diagnosed as having hypothyroidism at birth. The parent asks the nurse how the disease
could be discovered this early. Which is the nurse's best answer? - Answers A simple blood test to
diagnose hypothyroidism is required in most states.
Explanation:
With hypothyroidism there is an insufficent production of the thyroid hormones required to meet the
body's metabolic as well as growth and developmental needs. Without these hormones cognitive
impairment occurs. Hypothyroidism is diagnosed by a newborn screening procedure. This screening
procedure is required by most states. With early diagnosis the condition can be treated by replacing the
missing hormones. The later the diagnosis is made, the more irreversable cognitive impairment
becomes. At birth a newborn with hypothyroidism will be a poor feeder. Other symptoms, such as
lethargy and hypotonicity, become evident after the first month of life. There are not other outward
manifestations, such as rashes or appearances, that can be seen. These are not part of the condition.
, A 7-year-old child is diagnosed as having type 1 diabetes. What is one of the first symptoms usually
noticed by parents when this illness develops? - Answers loss of weight
Explanation:
The classic signs of type 1 diabetes are polydipsia, polyuria, and polyphagia. With polyphagia, the child
has an increased appetite and an increased hunger, and the child eats all the time but is losing weight.
This occurs because the lack of energy sugar supplies cause the muscle tissues and the fat stores to
shrink. The lack of insulin also reduces the ability of the body's cells to use glucose. This leads to
starvation of the cells. Loss of weight is an early symptom parents see first. They tend to equate the
increased appetite as normal with growing, but become concerned when the child starts losing weight
even though the child is eating. Itching and swelling are not signs of diabetes. A craving for sweets is
normal for a child, especially one who is growing rapidly.
The nurse is teaching a child with type 1 diabetes mellitus to administer insulin. The child is receiving a
combination of short-acting and long-acting insulin. The nurse knows that the child has appropriately
learned the technique when the child: - Answers draws up the short-acting insulin into the syringe first.
Explanation:
Drawing up the short-acting insulin first prevents mixing a long-acting form into the vial of short-acting
insulin. This maintains the short-acting insulin for an emergency. Insulin is given subcutaneously not
intramuscularly. A SQ injection is administered at a 90-degree angle if the person can grasp 2 in (5 cm) of
skin. If only 1 in (2.5 cm) of skin can be grasped, then the injection should be given at a 45 degree angle.
The needle is sterile. It should not be wiped with an alcohol swab. Only the top of the insulin vial should
be wiped with an alcohol swab.
A child with a primary growth hormone deficiency is to receive biosynthetic growth hormone. The nurse
would explain to the child and parents that this hormone would be given at which frequency? - Answers
Daily
Explanation:
Biosynthetic growth hormone, derived from recombinant DNA, is given by subcutaneous injection. The
weekly dosage is 0.2 to 0.3 mg/kg, divided into equal doses given daily for best growth.
A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess? - Answers
Heat intolerance
An 8-year-old girl presents to the clinic for moodiness and irritability. The child has begun to develop
breasts and pubic hair and the parents are concerned that the child is at too early an age for this to
begin. The nurse knows that these symptoms may be indicative of what disorder? - Answers precocious
puberty
Explanation:
Precocious puberty occurs when the child's sexual characterisitics begin to develop before the normal
age of puberty. Appropriate treatment can halt, and sometimes even reverse, sexual development and
can stop the rapid growth that results in severe short adult stature caused by premature closure of the
epiphysis. Treatment for precocious puberty allows the child to achieve the maximum growth potential
possible. Mental development in children with precocious puberty is normal, and developmental
milestones are not affected. The behavior may change to that of a typical adolescent. Girls may have
episodes of moodiness and irritability, whereas boys may become more aggressive. Psuedopuberty
occurs when there is only partial development after testosterone is secreted. It occurs in males. Adrenal
hyperplasia is an inherited disorder and it affects the production of androgen. Neurofibromatosis is a
genetic disorder of the nervous system where tumors grow on the nerves.
A 12-year-old is being seen in the office and has hyperthyroidism; the nurse knows that the most
common cause of hyperthyroidism is: - Answers Graves disease
Explanation:
Hyperthyroidism occurs less often in children than hypothyroidism. Graves' disease, the most common
cause of hyperthyroidism in children, occurs in 1 in 5,000 children between 11 and 15 years of age.
Hyperthyroidism occurs more often in females, and the peak incidence occurs during adolescence.
Kate and her parents are being seen in the office after discharge from the hospital with a new diagnosis
of type 2 diabetes. Which statement by the nurse is true? - Answers "Kids can usually be managed with
an oral agent, meal planning, and exercise."
Explanation:
Treating type 2 diabetes in children may require insulin at the outset if the child is acidotic and acutely
ill. More commonly, the child can be managed initially with oral agents, meal planning, and increasing
activity. Telling the child that she is lucky she did not have to learn how to give a shot might scare her so
,it will inhibit her from seeking future health care. The condition will not rectify itself if all orders are
followed. A weight-loss program might need to be implemented but that is not always the case.
The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus.
The caregiver states, "She is hungry all the time and eats everything, but she is losing weight." The
caregiver's statement indicates the child most likely has: - Answers Polyphagia
Explanation:
Symptoms of type 1 diabetes mellitus include polyphagia (increased hunger and food consumption),
polyuria (dramatic increase in urinary output, probably with enuresis) and polydipsia (increased thirst).
Pica is eating nonfood substances.
The nurse is caring for a 10-year-old child with growth hormone (GH) deficiency. Which therapy would
you anticipate will be prescribed for the child? - Answers Injections of GH
Explanation:
Growth hormone (GH) deficiency occurs when the anterior pituitary is unable to produce enough
hormone for usual growth. Somatotrophin is the name of the growth hormone administered.
Administering subcutaneous GH to the child helps correct this deficiency. The GH dosage is 0.2 to
0.3mg/kg given daily. It is not administered orally. Aldosterone causes sodium to be retained and a
provocation would be the administration of diuretics to reduce the sodium. Beta cells are found in the
heart muscles, smooth muscles, airways, and arteries. They are also found in the pancreas to secrete
insulin. None of these cell actions are related to the anterior pituary.
A newborn was diagnosed as having hypothyroidism at birth. The parent asks the nurse how the disease
could be discovered this early. Which is the nurse's best answer? - Answers A simple blood test to
diagnose hypothyroidism is required in most states.
Explanation:
With hypothyroidism there is an insufficent production of the thyroid hormones required to meet the
body's metabolic as well as growth and developmental needs. Without these hormones cognitive
impairment occurs. Hypothyroidism is diagnosed by a newborn screening procedure. This screening
procedure is required by most states. With early diagnosis the condition can be treated by replacing the
missing hormones. The later the diagnosis is made, the more irreversable cognitive impairment
becomes. At birth a newborn with hypothyroidism will be a poor feeder. Other symptoms, such as
lethargy and hypotonicity, become evident after the first month of life. There are not other outward
manifestations, such as rashes or appearances, that can be seen. These are not part of the condition.
, A 7-year-old child is diagnosed as having type 1 diabetes. What is one of the first symptoms usually
noticed by parents when this illness develops? - Answers loss of weight
Explanation:
The classic signs of type 1 diabetes are polydipsia, polyuria, and polyphagia. With polyphagia, the child
has an increased appetite and an increased hunger, and the child eats all the time but is losing weight.
This occurs because the lack of energy sugar supplies cause the muscle tissues and the fat stores to
shrink. The lack of insulin also reduces the ability of the body's cells to use glucose. This leads to
starvation of the cells. Loss of weight is an early symptom parents see first. They tend to equate the
increased appetite as normal with growing, but become concerned when the child starts losing weight
even though the child is eating. Itching and swelling are not signs of diabetes. A craving for sweets is
normal for a child, especially one who is growing rapidly.
The nurse is teaching a child with type 1 diabetes mellitus to administer insulin. The child is receiving a
combination of short-acting and long-acting insulin. The nurse knows that the child has appropriately
learned the technique when the child: - Answers draws up the short-acting insulin into the syringe first.
Explanation:
Drawing up the short-acting insulin first prevents mixing a long-acting form into the vial of short-acting
insulin. This maintains the short-acting insulin for an emergency. Insulin is given subcutaneously not
intramuscularly. A SQ injection is administered at a 90-degree angle if the person can grasp 2 in (5 cm) of
skin. If only 1 in (2.5 cm) of skin can be grasped, then the injection should be given at a 45 degree angle.
The needle is sterile. It should not be wiped with an alcohol swab. Only the top of the insulin vial should
be wiped with an alcohol swab.
A child with a primary growth hormone deficiency is to receive biosynthetic growth hormone. The nurse
would explain to the child and parents that this hormone would be given at which frequency? - Answers
Daily
Explanation:
Biosynthetic growth hormone, derived from recombinant DNA, is given by subcutaneous injection. The
weekly dosage is 0.2 to 0.3 mg/kg, divided into equal doses given daily for best growth.
A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess? - Answers
Heat intolerance
