Nokea
Exophthalmos (protruding eyeballs) may occur in children with which condition?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Hypoparathyroidism
- D. Hyperparathyroidism
Correct Answer: B
Rationale: Exophthalmos is a classic sign of hyperthyroidism, often due to Graves? disease, from tissue swelling behind the eyes. It is not associated with hypothyroidism, hypoparathyroidism, or hyperparathyroidism.
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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.
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.
A 20-kg (44-lb) child in ketoacidosis is admitted to the pediatric intensive care unit. What order should the nurse not implement until clarified with the physician?
- A. Weigh on admission and daily.
- B. Replace fluid volume deficit over 48 hours.
- C. Begin intravenous line with D5 0.45% normal saline with 20 mEq of potassium chloride.
- D. Give intravenous regular insulin 2 units/kg/hr after initial rehydration bolus.
Correct Answer: C
Rationale: D5 0.45% normal saline with potassium should be clarified, as initial rehydration in DKA uses 0.9% saline, and potassium is delayed until renal function is confirmed (urine output ?25 ml/hr). Daily weights, 48-hour fluid replacement, and insulin dosing are appropriate.
A child with hypoparathyroidism is receiving vitamin D therapy. The parents should be advised to watch for which signs or symptoms of vitamin D toxicity?
- A. Headache and seizures
- B. Weakness and lassitude
- C. Anorexia and insomnia
- D. Physical restlessness, voracious appetite without weight gain
Correct Answer: B
Rationale: Vitamin D toxicity can cause weakness, lassitude, nausea, vomiting, and renal issues like polyuria. Headaches occur but seizures do not, anorexia and insomnia are not typical, and restlessness with appetite changes suggests hyperthyroidism, not toxicity.
What blood glucose measurement is most likely associated with diabetic ketoacidosis?
- A. 185 mg/dl
- B. 220 mg/dl
- C. 280 mg/dl
- D. 330 mg/dl
Correct Answer: D
Rationale: Diabetic ketoacidosis (DKA) typically involves blood glucose levels ?330 mg/dl, reflecting severe insulin deficiency. Levels of 185, 220, and 280 mg/dl are hyperglycemic but below the threshold commonly associated with DKA.