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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.
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A child will start treatment for central precocious puberty. What synthetic hormone will be injected?
- A. Thyrotropin
- B. Gonadotropins
- C. Somatotropic hormone
- D. Luteinizing hormone-releasing hormone
Correct Answer: D
Rationale: Monthly luteinizing hormone-releasing hormone injections regulate pituitary secretions in central precocious puberty. Thyrotropin, gonadotropins, and somatotropic hormone are not used for this condition.
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.
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.
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.