Nokea
A child with hypopituitarism is being started on growth hormone (GH) therapy. Nursing considerations should be based on which knowledge?
- A. Therapy is most successful if it is started during adolescence.
- B. Replacement therapy requires daily subcutaneous injections.
- C. Hormonal supplementation will be required throughout childs lifetime.
- D. Treatment is considered successful if children attain full stature by adolescence.
Correct Answer: B
Rationale: GH therapy involves daily subcutaneous injections, with education for self-management in school-age children. It?s most effective in younger or severely deficient children, not adolescents, and isn?t needed lifelong after final height. Success involves near-final height, not necessarily by adolescence.
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A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid-releasing sugar should be followed by which dietary intervention?
- A. Sports drink and fruit
- B. Glucose tabs and protein
- C. Glass of water and crackers
- D. Milk and peanut butter on bread
Correct Answer: D
Rationale: After rapid-releasing sugar for hypoglycemia, milk (with lactose and protein) and peanut butter on bread (complex carbohydrate and protein) provide sustained glucose stabilization. Sports drinks and fruit lack protein, glucose tabs are rapid-acting, and crackers with water lack sufficient protein.
What nursing care should be included for a child diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)?
- A. Maintain the child NPO (nothing by mouth).
- B. Turn the child frequently.
- C. Restrict fluids.
- D. Encourage fluids.
Correct Answer: C
Rationale: SIADH causes excessive water retention, so fluid restriction is key to prevent hyponatremia and fluid overload. NPO status isn?t needed, frequent turning is unnecessary unless unresponsive, and encouraging fluids worsens the condition.
Congenital adrenal hyperplasia (CAH) is suspected in a newborn because of ambiguous genitalia. The parents are appropriately upset and concerned about their childs gender. In teaching the parents about CAH, what should the nurse explain?
- A. Reconstructive surgery as a female is preferred.
- B. Sexual assignment should wait until genetic sex is determined.
- C. Prenatal masculinization will strongly influence the childs development.
- D. The child should be raised as a boy because of the presence of a penis and scrotum.
Correct Answer: B
Rationale: Sexual assignment in CAH should align with genetic sex, determined before deciding on surgery or rearing. Female genetic sex with hormone therapy can reverse virilization, while male genetic sex may require supplementation. Prenatal masculinization doesn?t dictate development, and genital appearance alone doesn?t determine gender.
What is a condition that can result if hypersecretion of growth hormone (GH) occurs after epiphyseal closure?
- A. Cretinism
- B. Dwarfism
- C. Gigantism
- D. Acromegaly
Correct Answer: D
Rationale: Acromegaly results from excess GH after epiphyseal closure, causing bone and tissue overgrowth. Cretinism is linked to hypothyroidism, dwarfism to GH deficiency, and gigantism to GH excess before closure.
What form of diabetes is characterized by destruction of pancreatic beta cells, resulting in insulin deficiency?
- A. Type 1 diabetes
- B. Type 2 diabetes
- C. Gestational diabetes
- D. Maturity-onset diabetes of the young (MODY)
Correct Answer: A
Rationale: Type 1 diabetes results from autoimmune destruction of pancreatic beta cells, causing absolute insulin deficiency. Type 2 involves insulin resistance, gestational diabetes is temporary, and MODY is a genetic defect in beta cell function without destruction.