N406 Exam 3 Endocrine

A nurse is reviewing common endocrine diagnostic evaluations for pediatric clients. Which diagnostic procedure should the nurse anticipate preparing a child for if the provider needs to confirm a diagnosis of Diabetes Insipidus?

Water deprivation test

The nurse is assessing a 6-year-old girl who presents with a rapid growth rate, advanced bone maturation, and the premature appearance of secondary sexual characteristics. The nurse knows that this condition is classified as precocious puberty if manifestations appear before which age parameters?

Before age 7 in girls and before age 9 in boys.

The parents of a 6-year-old child diagnosed with central precocious puberty ask the nurse about the long-term physical consequences of the condition if left untreated. Which major consequence should the nurse discuss?

Rapid bone growth which causes early growth plate fusion, leading to a shorter adult stature.

A nurse is reviewing the diagnostic workup for a child with suspected precocious puberty. Which radiograph should the nurse expect the provider to order to evaluate skeletal maturation and predict adult height?

Radiographs of the wrists.

A child is undergoing diagnostic testing for precocious puberty. The provider orders a Gonadotropin-Releasing Hormone (GnRH) stimulation test. The nurse knows that the primary purpose of this specific test is to achieve which clinical objective?

To differentiate between central and peripheral causes of early puberty.

A 7-year-old boy is diagnosed with central precocious puberty, and an abdominal ultrasound rules out adrenal or ovarian/testicular tumors. Which pharmacological management should the nurse anticipate administering?

Administration of a GnRH agonist or blocker.

The nurse is providing educational and emotional support to the family of an 8-year-old child with precocious puberty. Which psychosocial issue is a management priority for the nurse to monitor and address?

Self-esteem issues and body image concerns.

A nurse is caring for a child who is admitted with an inability to concentrate urine, uncontrolled diuresis, excessive thirst, and dehydration. The nurse notes a deficiency of vasopressin (antidiuretic hormone). Which condition is consistent with this presentation?

Diabetes Insipidus

A child with suspected Diabetes Insipidus is undergoing a water deprivation test. Which combination of findings confirms a positive diagnosis during this study?

The patient continues to excrete large amounts of dilute urine, a low urine specific gravity, and an increased serum sodium level.

The nurse is establishing a plan of care for a child newly diagnosed with Diabetes Insipidus. Which nursing intervention is a priority to include in the management plan?

Maintain fluid balance by allowing free access to water and toilet facilities, and monitor urine specific gravity.

A child with Diabetes Insipidus is prescribed desmopressin acetate (DDAVP). The nurse knows that this medication serves as a synthetic replacement for which deficient hormone?

Vasopressin (antidiuretic hormone)

A nurse is assessing a school-aged child who presents with polyuria, polydipsia, polyphagia, fatigue, blurred vision, and recent unexplained weight loss despite an increased food intake. Which condition should the nurse suspect?

Hyperglycemia / Diabetes Mellitus

The nurse is caring for a 10-year-old child who was recently diagnosed with Type 1 Diabetes Mellitus. The nurse knows that Type 1 Diabetes is best characterized by which pathophysiological mechanism?

An autoimmune disease where the pancreas is unable to produce and secrete an adequate amount of insulin.

A nurse is reviewing the medical history of a child with Type 2 Diabetes Mellitus. The nurse knows that children with diabetes are prone to developing other co-existing autoimmune conditions, including which disorders?

Graves disease, Hashimoto thyroiditis, and Celiac disease.

The nurse is evaluating the laboratory diagnostic results of a child with suspected diabetes mellitus. Which laboratory values meets the formal diagnostic threshold for diabetes?

Random serum glucose > 200 mg/dL or a Fasting blood glucose (FBS) >126 mg/dL and Oral glucose tolerance test >200

A nurse is teaching the parents of a child newly diagnosed with Type 1 Diabetes about establishing a nutrition plan. Which educational principle should guide the nurse’s dietary instructions?

Build a diet plan with consistent intake that is easy to understand, tailored to food preferences, and changes as needed to meet dietary needs.

The nurse is providing exercise guidelines to an adolescent client with Type 1 Diabetes Mellitus. Which instruction should the nurse include to safely manage physical activity?

Instruct the client to maintain proper hydration, teach how to prevent hypoglycemia, and add carbohydrates as appropriate for exercise.

A nurse is preparing an educational session on developmental issues in pediatric diabetes care. When assigning tasks to a school-aged child with diabetes, which principle should the nurse implement?

Know developmental characteristics of each age group, allow the child to manage tasks as appropriate for age, and let the child help with their diet.

An adolescent client with Type 1 Diabetes is brought to the emergency department presenting with nausea, vomiting, abdominal pain, a fruity breath odor, dehydration, and deep, rapid, sighing respirations. What life-threatening complication should the nurse suspect?

Diabetic Ketoacidosis (DKA)

A nurse is teaching a student nurse about the common precipitating factors for Diabetic Ketoacidosis (DKA) in pediatric versus adolescent populations. Which statement by the student is correct?

The most common causes in children are insulin resistance, stress, and infections; in adolescents, it is missed insulin injections.

A child presenting with severe Diabetic Ketoacidosis (DKA) is admitted to the Pediatric Intensive Care Unit (PICU). Which combination of nursing interventions represents a management priority for this client?

Monitor glucose, administer IV insulin to rehydrate, and monitor I&Os, vital signs, neurologic checks, IV fluid replacements, and electrolyte status.

The nurse is assessing a child with DKA and notes deep, rapid, labored respirations. How should the nurse document this specific respiratory pattern?

Kussmaul respirations

A nurse is reviewing laboratory evaluations for a child who has presented with polyuria and polydipsia. To definitively rule out diabetes mellitus and evaluate for diabetes insipidus, which finding is most significant?

An absence of hyperglycemia paired with a low urine specific gravity.

The nurse is caring for a toddler with Type 1 Diabetes Mellitus. When teaching the child's parents about the pathophysiological consequences of a severe insulin deficit, the nurse explains that it leads to hyperglycemia, metabolic acidosis, and the accumulation of what substances in the blood?

Ketone bodies.

A nurse is caring for an adolescent client with Type 2 Diabetes Mellitus. The nurse knows that Type 2 Diabetes is best characterized by which physiological state?

The pancreas produces insulin, but the body is resistant to the insulin.

The nurse is evaluating a child's response to therapies for Diabetes Insipidus. Which diagnostic test result indicates that desmopressin (DDAVP) therapy is effective?

Urine specific gravity increases toward normal parameters and uncontrolled diuresis decreases.

A nurse is performing a shift assessment on an adolescent client in the PICU who is being treated for DKA. The nurse notes the client has become increasingly disoriented, indifferent, and drowsy compared to the previous hour. Which complication should the nurse suspect?

Decreased level of consciousness / Cerebral edema.

The nurse is reviewing common endocrine screenings. Which screening is mandated at birth for all infants to detect congenital metabolic and endocrine disorders?

Newborn Metabolic Screening

A child is admitted with a history of polyuria and an elevated random serum glucose of 245 mg/dL. Which lab test should the nurse expect the provider to evaluate to track the child's long-term glucose control over the past 3 months?

Hemoglobin A1c

The nurse is updating the care plan for an 8-year-old child with Type 1 Diabetes Mellitus. To minimize the risk of exercise-induced hypoglycemia, what adjustment should the nurse teach the child and parents?

Avoid exercising when insulin is peaking, and add carbohydrates as appropriate for exercise.

A nurse is preparing an adolescent client with Type 1 Diabetes for discharge. Which factor should the nurse emphasize as the most common cause of DKA in this specific adolescent age group?

Missed insulin injections.

A nurse is caring for an infant in the intensive care unit. The clinical record notes the client has uncompensated diabetes insipidus. Which clinical manifestation should the nurse anticipate noting during the shift assessment?

Increased urination, excessive thirst, nocturia, and dehydration.

The nurse is reviewing the clinical indications for a client admitted with Diabetic Ketoacidosis. The nurse knows that the presence of an acetone, fruity odor to the breath is a direct clinical manifestation of what metabolic state?

Severe insulin deficit leading to hyperglycemia and ketone bodies in the blood.