NURS 380 ACTUAL EXAM QUESTIONS
ANND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY
GRADED A+
Type 2 DM in pediatric patients - Answer--type 2 DM can be caused by a slowed
response of the pancreas
-metformin is commonly used to manage type 2 DM
diabetes insipidus: central and nephrogenic - Answer--due to pituitary dysfunction/ADH
-posterior pituitary targets the renal tubules and collecting tubules to make them
permeable to water, thus increasing reabsorption and decreasing excretion of urine.
-vasopressin is the treatment of choice
-polyuria, polydipsia, extreme dehydration, dilute urine, craving water, fever, confusion
DKA in pediatric patients - Answer--fat is broken down for energy and leaves behind
ketones
-glucose greater than 330
-pH-acidodic 7.3 or less
-look at bicarb, anion gap (are electrolytes out of balance and is blood too acidic or
basic)
-IV, cardiac monitor, lab work, VBG, fluid, insulin drip
-review renal function before adding potassium replacements
-when glucose decreases to 250 add insulin
-IV fluids first
-monitor for hypokalemia, usually elevated before cellular shift
-insulin drip 0.1/u/kg/hr
-education is very important
*need kidney function before potassium replacement*
growth hormone deficiency - Answer--naturally released from pituitary gland
-decreased somatic growth (delayed growth of less than 2 inches per year)
-have a declination of growth measurement on the growth chart over time and a high
weight-to-height ration with increased abdominal fat.
-hypopituitarianism
-risk factors:
*tumors
*trauma
*structural defects
*hereditary disorders
*deficiency of TSH or ACTH or GH deficiencies can be idiopathic
, child with growth hormone deficiency may have - Answer--delayed dental eruption
-decreased muscle mass
-cherubic0like appearance or appearing to be younger than actual age
-delayed puberty during adolescent period and a high-pitched voice
diagnostic testing for growth hormone deficiency - Answer--growth is less than the 3rd
percentile
-biological parental heights are calculated to determine the mid-parental height of the
parents or average
-bone x-ray of the left hand and wrist used to determine the actual age of the bones in
comparison with the child's actual age
*bone age greater than 2 standard deviations (SD) below normal merits further
evaluation
-MRI of the head focusing on the pituitary gland
-blood test for cortisol levels, blood cell count and electrolytes
-ACTH and cortisol levels to detect the presence of other hormone deficiencies
-urine creatinine, pH, specific gravity, BUN and electrolytes to detect possibility of short
stature being caused by chronic renal failure.
nursing interventions for growth hormone deficiency - Answer--careful measurement
and documentation of growth on the child's age and sex appropriate growth chart
-GH replacement therapy is a medical regimen administered in the home setting.
Follow-up with the endocrinologist every 3-4 months is crucial for assessing response to
therapy
physical assessment growth hormone deficiency - Answer--short stature
-underdeveloped jaw
-delayed sexual maturation
-growth velocity less than one standard deviation for age and two standard deviations
for height (plotted on height and weight charts)
-radiographs of hands and wrists
-skull films for structural abnormalities
-need to go to endocronologist for hormones so they can grow
Growth Hormone Excess/hyperpituitarism - Answer--uncontrolled growth >95th
percentile
-percocius puberty (due to tumor may need surgery)
-overgrowth of bones: acromegaly seen on XRAY
-enlargement of hands, feet, coarse facial hair, enlarged features
-muscle weakness, joint pain
-accurate assessment of growth
-connect to endocrinologist
percocious puberty - Answer-Early Puberty
• For Girls age 8 (normal- age 10)
ANND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY
GRADED A+
Type 2 DM in pediatric patients - Answer--type 2 DM can be caused by a slowed
response of the pancreas
-metformin is commonly used to manage type 2 DM
diabetes insipidus: central and nephrogenic - Answer--due to pituitary dysfunction/ADH
-posterior pituitary targets the renal tubules and collecting tubules to make them
permeable to water, thus increasing reabsorption and decreasing excretion of urine.
-vasopressin is the treatment of choice
-polyuria, polydipsia, extreme dehydration, dilute urine, craving water, fever, confusion
DKA in pediatric patients - Answer--fat is broken down for energy and leaves behind
ketones
-glucose greater than 330
-pH-acidodic 7.3 or less
-look at bicarb, anion gap (are electrolytes out of balance and is blood too acidic or
basic)
-IV, cardiac monitor, lab work, VBG, fluid, insulin drip
-review renal function before adding potassium replacements
-when glucose decreases to 250 add insulin
-IV fluids first
-monitor for hypokalemia, usually elevated before cellular shift
-insulin drip 0.1/u/kg/hr
-education is very important
*need kidney function before potassium replacement*
growth hormone deficiency - Answer--naturally released from pituitary gland
-decreased somatic growth (delayed growth of less than 2 inches per year)
-have a declination of growth measurement on the growth chart over time and a high
weight-to-height ration with increased abdominal fat.
-hypopituitarianism
-risk factors:
*tumors
*trauma
*structural defects
*hereditary disorders
*deficiency of TSH or ACTH or GH deficiencies can be idiopathic
, child with growth hormone deficiency may have - Answer--delayed dental eruption
-decreased muscle mass
-cherubic0like appearance or appearing to be younger than actual age
-delayed puberty during adolescent period and a high-pitched voice
diagnostic testing for growth hormone deficiency - Answer--growth is less than the 3rd
percentile
-biological parental heights are calculated to determine the mid-parental height of the
parents or average
-bone x-ray of the left hand and wrist used to determine the actual age of the bones in
comparison with the child's actual age
*bone age greater than 2 standard deviations (SD) below normal merits further
evaluation
-MRI of the head focusing on the pituitary gland
-blood test for cortisol levels, blood cell count and electrolytes
-ACTH and cortisol levels to detect the presence of other hormone deficiencies
-urine creatinine, pH, specific gravity, BUN and electrolytes to detect possibility of short
stature being caused by chronic renal failure.
nursing interventions for growth hormone deficiency - Answer--careful measurement
and documentation of growth on the child's age and sex appropriate growth chart
-GH replacement therapy is a medical regimen administered in the home setting.
Follow-up with the endocrinologist every 3-4 months is crucial for assessing response to
therapy
physical assessment growth hormone deficiency - Answer--short stature
-underdeveloped jaw
-delayed sexual maturation
-growth velocity less than one standard deviation for age and two standard deviations
for height (plotted on height and weight charts)
-radiographs of hands and wrists
-skull films for structural abnormalities
-need to go to endocronologist for hormones so they can grow
Growth Hormone Excess/hyperpituitarism - Answer--uncontrolled growth >95th
percentile
-percocius puberty (due to tumor may need surgery)
-overgrowth of bones: acromegaly seen on XRAY
-enlargement of hands, feet, coarse facial hair, enlarged features
-muscle weakness, joint pain
-accurate assessment of growth
-connect to endocrinologist
percocious puberty - Answer-Early Puberty
• For Girls age 8 (normal- age 10)
