Nokea
What clinical manifestation is considered a cardinal sign of diabetes mellitus?
- A. Nausea
- B. Seizures
- C. Impaired vision
- D. Frequent urination
Correct Answer: D
Rationale: Frequent urination (polyuria), along with glycosuria and polydipsia, is a hallmark of diabetes mellitus due to glucose-driven osmotic diuresis. Nausea and seizures are not typical, and impaired vision is a long-term complication, not a cardinal sign.
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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.
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 hyperthyroidism (Graves disease) is receiving propylthiouracil. The parents and child should be taught to recognize and report which sign or symptom immediately?
- A. Fatigue
- B. Weight loss
- C. Fever, sore throat
- D. Upper respiratory tract infection
Correct Answer: C
Rationale: Fever and sore throat may indicate leukopenia, a serious side effect of propylthiouracil, requiring immediate reporting. Fatigue and weight loss are symptoms of hyperthyroidism, not drug complications, and upper respiratory infections are typically viral, not urgent.
Peripheral precocious puberty (PPP) differs from central precocious puberty (CPP) in which manner?
- A. PPP results from a central nervous system (CNS) insult.
- B. PPP occurs more frequently in girls.
- C. PPP may be viewed as a variation in sexual development.
- D. PPP results from hormonal stimulation of the hypothalamic gonadotropin-releasing hormone (Gn-RH).
Correct Answer: C
Rationale: PPP, caused by non-hypothalamic hormone sources, may be considered a variation in sexual development. CPP stems from CNS-driven Gn-RH stimulation, is more common in girls, and isn?t a variation but a pathological early puberty.
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.