Download PAEDIATRIC NURSING FINAL EXAM and more Exams Pediatrics in PDF only on Docsity!
PEDIATRIC NURSING FINAL EXAM LATEST UPDATE - 2025/2026-
100+ QUESTIONS AND VERIFIED ANSWERS ALL THE BEST
What is adrenarche? onset of adrenal androgen production; acne, pubic hair, adult body odor What is menarche and what is the average age of onset? onset of menstruation; around 12 years What hormones does the anterior pituitary produce? Follicle-stimulating hormone Luteinizing hormone Adrenocorticotropic hormone Thyroid stimulating hormone Prolactin Growth hormone What is considered the master gland? anterior pituitary gland What hormones are stored in the posterior pituitary gland? antidiuretic hormone (ADH) and oxytocin Decreased activity/ secretion of a certian hormone in the pituitary gland may cause: growth hormone deficiency What endocrine disorder is characterized by the child being below the 3rd percentile for height at 1 year?
growth hormone deficiency (decreased activity in pituitary gland) What might the following sx be indicative of (endocrine disorder)?
- Hypoglycemic seizures
- Hyponatremia
- Neonatal jaundice
- Micropenis, undescended testes growth hormone deficiency (along with being below the 3rd percentile in height at 1 year) T or F: Children with growth hormone deficiency appear "cherubic" with youthful facial features True Functions of the endocrine system include...
- Sexual differentiation in fetal stage
- Regulates pace of growth and development
- Maintains optimal hormone levels
- Maintains internal homeostasis
- Enables sexual reproduction Functions of the infant/ child's endocrine system include:
- Sexual __________ in fetal stage
- Regulates pace of ______ and development
- Maintains optimal __________ levels
- Maintains internal _____________
- Enables sexual reproduction differentiation; growth; hormone; homeostasis
T or F: Hispanic children are more susceptible to developing DM false: caucasians more susceptible What age range are children most likely to be dx with DM I? 7 - 8 How will you describe DM 1 to a child and her family?
- DM I is disorder of protein, carb and fat metabolism
- differentiate between the two types (insulin resistant vs insulin dependent)
- insulin production insufficiency
- autoimmune (body attacking itself); destruction of Beta cells of pancreas where insulin is produced What is DM I caused by? autoimmune destruction of insulin-producing beta cells in people who are genetically predisposed (child inherits susceptibility to the disease, not the disease itself) DM I may be caused by an autoimmune response involving... viral antibodies destroying the Beta islet cellls What causes ketones in the urine (in diabetes)? cells use fatty acids or proteins for energy when carbohydrates are not available, causing ketones (alters acid/ base balance in body)
*HgbA1C of what value confirms a DM diagnosis?
6.5% Two-hour plasma glucose ≥______ mg/dl shows DM 200 *What treatments will a child with DM I need to adhere to for the rest of their lives?
- some form of insulin (syringe, pen, pump)
- carb counting
- blood glucose monitoring 4-8 times per day
- regular exercise *What is basal-bolus therapy? basal: basal long-acting insuin administered once daily (glargine or detemir) bolus: bolus of rapid acting insulin administered with each meal based on carb count and glucose level (lispro, aspart, glulisine) What can influence the amount of insulin a child with DM I needs to receive each time? carb count, stress, infection, illness What long-term complications may a child with DM I experience? (These may occur as early as 2 years after dx)
- Diabetic retinopathy
- Renal failure
- tachycardia
- fruity breath
- altered LOC
- Hyperglycemia
- Glycosuria and ketonuria What disease/ complication involves Kussmaul respirations? DKA (DM I complication, and sometimes DM II complication) Hypotension, tachycardia, fruity breath, dehydration, altered LOC, flushed ears and cheeks, among other sx are signs of what condition/ complication? DKA (Complication of DM I and possible DM II) *What is the treatment for DKA?
- isotonic IV fluids with electrolytes (after child voids, electrolytes added- ensures kidney function)
- continuous IV infusion of short acting insulin What is most common cause of death associated with DKA? cerebral edema What is an important technique involving short acting insulin administration for DKA through an IV?
run 50-100 ml NS through new IV tubing to ensure proper dose at beginning of tx (because insulin binds to IV tubing!) T or F: insulin binds to IV tubing true T or F: An IV fluid bolus will be given for the DKA patient true (along with continuous short acting insulin) *What is the only type of insulin that can be given IV? regular T or F: Once a patient in DKA is stabilized and BS have returned to normal, administer TPN feeds and sub-Q insulin, as opposed to IV false: administer oral feeds! What are the sx of hypoglycemia (choose one from each statement)
- Lethargy or nervousness?
- Rapid os gradual onset?
- Hunger or anorexia?
- Sweating or dry skin?
- Pallor or flushed skin?
- Tremors or sleepiness?
- Seizures or shock? nervousness; rapid; hunger; sweating; pallor; tremors; seizures T or F: Hunger is a sx associated with hypoglycemia and hyperglycemia true Hypoglycemia is when blood glucose levels drop below ___ 70
Which form of DM is insulin resistant? DM II Which form of DM is insulin dependent? DM I What is acanthosis nigricans and what disease/ condition is it associated with? hyperpigmentation and thickening of skin of neck, armpit, or groin; associated with DM II T or F: 3 Ps are present in DM II and confirm the dx false: rarely present, and are not used to confirm dx (are possible though) What is the treatment for a child with DM II?
- decrease weight (diet and exercise)
- normalize blood glucose and HbA1C
- decrease weight
- Normalize the lipid profile and BP
- Metformin T or F: metformin is the only tx for DM II false: used when diet and exercise are inadequate to control the disease *What is the primary tx for DM II? diet and exercise (decreasing weight)
DM type ____ may present with severe hyperglycemia or DKA and may require insulin to get initial glycemic control. Then, transition to diet/ exercise and possibly oral anti-diabetics 2 Gynecomastia glandular breast tissue in males (more estrogen than testosterone) Amenorrhea lack of menstruation What is the treatment for amenorrhea? hormonal birth control pills (lack of menstruation) Dysmenorrhea menstrual pain/ cramping What is the difference between dysmenorrhea and amenorrhea? Dysmenorrhea: Menstrual pain or cramping Amenorrhea: lack of menstruation What is the leading cause of school absence in adolescent females? dysmenorrhea (painful menstruation/ cramping) Treat dysmenorrhea with ________ NSAIDs Gynecomastia is transient usually (disappearing in under a year) and may be due to a variety of things such as...
What is the screening process like for Phenylketonuria (PKU)? After 48 hours of age, all newborns are screened by blood test; must have had breast milk or formula for 2 days *Before screening via blood test for Phenylketonuria (PKU), what criteria must this child have met for it to be a valid test and why is the test important? 48 hours old and must have been breast fed or formula fed for 48 hours; severe complications such as severe intellectual disabilities may result if left untreated What is the treatment for Phenylketonuria (PKU)? (for newborns an older children) use special formula (Lofenalac) or breastfeed in addition to the special formula; a diet low in phenylalanine for entire life (avoid high protein foods and aspartame) A diet avoiding aspartame and low in protein (using elemental medical foods) is the treatment for a child with what disease? Phenylketonuria (PKU) What is Lofenalac (special formula) used for? Phenylketonuria (PKU) treatment (regular formulas and only breastfeeding cannot be used because too much phenylalanine) What are 6 effects of growth hormone replacement therapy and how would you explain these to a family?
- Headache
- Progression of scoliosis - curve may get worse
- Slipped capital femoral epiphysis - head of the femur is displaced from the neck of the femur
- Hyperglycemia - increase blood sugar
- Insulin resistance - when cells in your muscles, fat, and liver don't respond well to insulin
- Increased intracranial pressure - starts off as headaches - keep doctor aware of prolonged headaches Magic foundation or Human Growth Foundation are financial support organizations for what condition? growth hormone deficiency The following are signs of diabetes insipidus in an infant:
- Failure to _______
- Lethargy
- Poor _______
- Excessive _______
- Irritability
- Suck vigorously during feeding and then ______ immediately afterwards
- Rapid weight ______
- Constipation
In addition to more frequent BS checks when a diabetic patient is sick, what test should the parents perform routinely? test for ketones in the urine Type ____ diabetes can be managed without insulin most of the time. Good _____ control and regular ______ are the main areas of treatment for this type of DM 2; diet; exercise T or F: PKU may cause seizures true What should a physical inspection of the GU system include? (for males vs females) females: redness, lesions, discharge males: redness, lesions, discharge, inspect foreskin, positioning, shape, etc. What 3 things might a UTI be caused by? bacteria, fungus, virus Cystitis lower UTI (urethra and bladder) Pyelonephritis upper UTI (ureters, renal pelvis, etc.) What sex are UTIs more common in? girls (shorter urethra) What are some things that may cause UTIs?
- contamination from stool or hands
- urinary stasis
- structural abnormalities
- constipation
- chemical irritants (bubble baths)
- sex or sexual abuse Urinary stasis may cause what condition? UTIs (holding it in too long allows bacteria/ virus/ fungus to grow) How do constipation or chemical irritants lead to UTIs? Constipation: stool in bowel causes pressure on urinary system, decreases voiding completely, leads to urinary stasis Chemical irritations: peritoneal irritation, hurts to pee, holding urine, urinary stasis What diagnostic test would you use to confirm a diagnosis of a UTI? A: Urinalysis B: Urine culture and sensitivity C: CBC D: renal ultrasound B
C: no treatment B (circumcision should NOT occur, in case the foreskin is needed for the repair) What does the surgical repair of hypospadias involve? creating new urethral meatus; stent or catheter in place for urinary drainage (to maintain patency until the site is healed) Where should a catheter bag be placed? below the hips / below the bed; keep it off the floor, but not above the child's bladder What would your primary assessment area be following surgical repair of hypospadias? genitourinary What other areas will you be assessing that relate to surgical repair of hypospadias? pain, respiratory, musculoskeletal, skin assessment/ surgical site assessment, UOP, etc. The baby's urethral meatus was located on the dorsal side of his penis. This is which of the following congenital anomalies? A. Hypospadias B. Epispadias B. Epispadias T or F: urine will be blood-tinged for several days following surgical repair of Epispadias or Hypospadias true Following surgical repair of Epispadias or Hypospadias, how should you diaper the child?
double diapering technique; inside diaper collets urine draining from stent and outside diaper collects stool What is the urine appearance following surrgical repair of Epispadias or Hypospadias? blood-tinged (for several days) Opening of ureter sits too low in bladder a) Hypospadias b) Epispadias c) Congenital cordee d) Cryptorchidism e) Vesicoureteral Reflux e) Vesicoureteral Reflux Abnormal development of penis a) Hypospadias b) Epispadias c) Congenital cordee d) Cryptorchidism e) Vesicoureteral Reflux c) Congenital cordee Testes do not descent from abdomen a) Hypospadias b) Epispadias c) Congenital cordee d) Cryptorchidism
