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Flashcards in Chapter 53 Deck (25):
1

The home health nurse is visiting a 3-month-old infant who is diagnosed with congenital hypothyroidism and is prescribed daily levothyroxine. Which should the nurse include in the infant’s continued plan of care?
1. Stopping the medication as long as the child continues to grow
2. Preventing hypothermia with appropriate clothing
3. Changing formula because it is contraindicated with prescribed medication
4. Monitoring growth and development without any other prescribed interventions

2

2

The nurse is providing information to an adolescent newly diagnosed with diabetes. Which clinical manifestations of diabetic ketoacidosis (DKA) should the nurse include in the teaching session? Select all that apply.
1. Change in mental status
2. Tachycardia
3. Fruity breath odor
4. Rapid, shallow respirations
5. Abdominal pain

1,3,5

3

A child weighing 18.2 kg with a history of diabetes insipidus (DI) has been admitted to the hospital. Which healthcare provider prescription should the nurse question?
1. Stat electrolytes
2. Urine specific gravity with each void
3. DDAVP (desmopressin) PO
4. Restrict oral fluids to 500 mL every 24 hours

4

4

A 5-year-old child with a history of hypopituitarism presents with complaints of right hip and leg pain. Which prescribed medication for the diagnosis should the nurse identify as the cause for the current symptoms?
1. Daily growth hormone
2. Insulin before meals and bedtime
3. DDAVP (desmopressin) at bedtime
4. Cortisone injections

1

5

Which clinical manifestations should the nurse anticipate when providing care to an adolescent client who presents with untreated Graves disease?
1. Hyperglycemia, ketonuria, and glucosuria
2. Weight gain, hirsutism, and muscle weakness
3. Tachycardia, fatigue, and heat intolerance
4. Dehydration, metabolic acidosis, and hypertension

3

6

A hospitalized child has been diagnosed with SIADH (syndrome of inappropriate antidiuretic hormone), a complication of his meningitis. Which laboratory data should the nurse anticipate for this child?
1. Hyponatremia
2. Hypocalcemia
3. Hyperglycemia
4. Hypernatremia

1

7

The nurse is giving discharge instructions to the parents of a child whose adrenal glands have been removed due to a tumor. Which parental statement indicates the need for further education?
1. “I will call the doctor if my child has restlessness and confusion.”
2. “If my child has any gastric irritation, I will give him antacids.”
3. “If my child has vomiting and diarrhea, I will hold his hydrocortisone.”
4. “I will give my child his hydrocortisone in the morning.”

3

8

The nurse is caring for a child just admitted with diabetic ketoacidosis (DKA). Which healthcare provider prescription should the nurse question?
1. Neurologic checks hourly
2. Insert urinary catheter and measure output hourly
3. NPH insulin IV at 0.1 unit/kg per hour
4. Stat serum electrolytes

3

9

An adolescent presents in the emergency department (ED) with confusion. The healthcare provider suspects diabetic ketoacidosis (DKA). A stat serum glucose is done, and the result is 7l5 mg/dL. Which clinical manifestations does the nurse anticipate upon assessment for this client?
1. Tachycardia, dehydration, and abdominal pain
2. Sweating, photophobia, and tremors
3. Dry mucous membranes, blurred vision, and weakness
4. Dry skin, shallow rapid breathing, and dehydration

3

10

Which teaching point should the nurse include when providing education to an adolescent client, who participates in soccer, regarding the plan of care for diabetes mellitus?
1. Decreased food intake
2. Increased doses of insulin
3. Increased food intake
4. Decreased doses of insulin

3

11

Which action related to insulin administration should the nurse include in the teaching plan for an adolescent client who has been newly diagnosed with diabetes mellitus to avoid the development of lipoatrophy?
1. Rotating injection sites
2. Checking blood sugars at mealtime and bedtime
3. Using a sliding scale for additional coverage
4. Administration of insulin via insulin pump

1

12

The nurse is teaching the caregiver of a child who is newly diagnosed with type 1 diabetes mellitus how to minimize pain with insulin injections. Which interventions should the nurse include in the teaching session? Select all that apply.
1. Do not reuse needles.
2. Remove all bubbles from the syringe before injecting.
3. Have the child flex the muscle during injection.
4. Inject insulin when it is cold.
5. Do not change the direction of the needle during insertion or withdrawal.

1,2,5

13

Which food should the nurse remove from the food tray for a toddler-age client who is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)?
1. Oatmeal
2. Yogurt
3. Biscuit
4. Watermelon

4

14

Which sequela should the nurse include in the teaching session for a parent who does not believe in medication for the treatment of the newborn’s hypothyroidism?
1. Heart disease
2. Mental retardation
3. Renal failure
4. Thyroid storm

2

15

Which changes should the school nurse implement to decrease the risk for the development of type 2 diabetes mellitus for a population who is identified as being at risk? Select all that apply.
1. Increase the amount of daily physical activity.
2. Meet with all parents and explain the risk that is associated with obesity.
3. Test each child’s urine monthly.
4. Teach the parents to avoid administering aspirin to their children.
5. Work with the cafeteria to decrease the amount of fat in the foods served.

1,2,5

16

Which assessment finding would cause the nurse to question whether a preschool-age boy, diagnosed with phenylketonuria shortly after birth, is following the prescribed dietary restrictions?
1. The child’s body has a musty odor.
2. This child is a blue-eyed blond.
3. The child appears sleepy and uninterested in the surroundings.
4. The child has a sunburn over his entire body.

1

17

The nurse is providing care to a newborn who is suspected of having Turner syndrome. Which should the nurse assess the newborn for based on the current diagnosis?
1. Club foot (talipes equinovarus)
2. Congenital heart anomalies
3. Hyperbilirubinemia due to liver abnormalities
4. Diaphragmatic hernia

2

18

Which prescription regarding an oral hydrocortisone for a toddler-age client diagnosed with congenital adrenal insufficiency should the nurse anticipate when the client is admitted to the hospital with pneumonia?
1. It will be discontinued.
2. It will be reduced.
3. It will be continued as previously prescribed.
4. It will be increased.

4

19

Which type of nutrition should the nurse include when planning care for a newborn who is diagnosed with galactosemia?
1. Goat’s milk formula
2. Breast milk
3. Cow’s milk–based formula
4. Lactose-free formula

4

20

The nurse is providing care to a newborn female who is born with ambiguous genitalia. The follow-up investigation discovers adrenogenital syndrome (also called congenital adrenal hyperplasia [CAH]). The parents question why the baby’s genitalia looks more male than female. Which response by the nurse is accurate?
1. “The disorder caused your baby to be a hermaphrodite with both male and female sex organs.”
2. “The changes in the genitalia are due to increased androgens secondary to deficient cortisol.”
3. “The excessive cortisol caused the enlargement of the female tissue, creating a male appearance.”
4. “Your baby has only one sex chromosome resulting in an XO configuration.

2

21

Which pediatric client diagnoses would cause the nurse to include information related to short stature? Select all that apply.

1. Hypothyroidism
2. Turner syndrome
3. Chronic renal failure
4. Cushing syndrome
5. Diabetes mellitus

1,2,3,4

22

Which functions of the adrenal hormone aldosterone should the nurse include in a teaching session for a pediatric client diagnosed with alterations in adrenal function? Select all that apply.

1. Stimulates bone development
2. Increases sodium ion reabsorption
3. Stimulates secondary sexual characteristics
4. Increases potassium excretion by the kidneys
5. Activates the sympathetic nervous system

2,4

23

Which functions of the adrenal androgens should the nurse include in a teaching session for a pediatric client diagnosed with alterations in adrenal function? Select all that apply.

1. Stimulates bone development
2. Increases sodium ion reabsorption
3. Stimulates secondary sexual characteristics
4. Increases potassium excretion by the kidneys
5. Activates the sympathetic nervous system

1,3

24

Which diagnostic tests should the nurse include in the plan of care for a pediatric client who is at risk for short stature? Select all that apply.

1. Thyroid function studies
2. Adrenocorticotropic hormone (ACTH) and cortisol levels
3. Complete blood count
4. Blood culture
5. Urine creatinine

1,2,3,5

25

Which assessment data for a pediatric client supports the diagnosis of familial or idiopathic central diabetes insipidus (DI)? Select all that apply.

1. Polyuria
2. Polydipsia
3. Nocturia
4. Enuresis
5. Constipation

3,4,5