Nokea
The nurse is planning care for a child recently diagnosed with diabetes insipidus (DI). What intervention should be included?
- A. Encourage the child to wear medical identification.
- B. Discuss with the child and family ways to limit fluid intake.
- C. Teach the child and family how to do required urine testing.
- D. Reassure the child and family that this is usually not a chronic or life-threatening illness.
Correct Answer: A
Rationale: Medical identification is critical for DI, a potentially life-threatening condition requiring free access to fluids. Fluid restriction worsens dehydration, urine testing isn?t routine, and DI is chronic, requiring lifelong vasopressin.
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What clinical manifestation occurs with hypoglycemia?
- A. Lethargy
- B. Confusion
- C. Nausea and vomiting
- D. Weakness and dizziness
- E. All of the above
Correct Answer: D
Rationale: Hypoglycemia manifests as weakness, dizziness, difficulty concentrating, sweating, and pallor due to low glucose affecting the brain and body. Lethargy, confusion, and nausea are more typical of hyperglycemia, not hypoglycemia.
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.
Glucocorticoids, mineralocorticoids, and sex steroids are secreted by which gland?
- A. Thyroid gland
- B. Adrenal cortex
- C. Anterior pituitary
- D. Parathyroid glands
Correct Answer: B
Rationale: The adrenal cortex produces glucocorticoids, mineralocorticoids, and sex steroids. The thyroid produces thyroid hormone, the anterior pituitary secretes hormones like GH and ACTH, and the parathyroids produce parathyroid hormone.
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.
Homeostasis in the body is maintained by what is collectively known as the neuroendocrine system. What is the name of the nervous system that is involved?
- A. Central
- B. Skeletal
- C. Peripheral
- D. Autonomic
Correct Answer: D
Rationale: The autonomic nervous system, comprising sympathetic and parasympathetic systems, regulates involuntary functions to maintain homeostasis with the endocrine system. Central, skeletal, and peripheral nervous systems are not part of the neuroendocrine system.