Inquire through: | Professional | Confidential Support
Chapter 28: The Child with Endocrine
Dysfunction Hockenberry: Wong's Essentials
of Pediatric Nursing, 10th Edition Verified
and Updated Questions and Answers (100%
Correct Answers)
1. Parents of a toddler with hypopituitarism ask the nurse, "What can we expect with
this condition?" The nurse should respond with which statement?
a. Growth is normal during the first 3 years of life.
b. Weight is usually more retarded than height.
c. Skeletal proportions are normal for age.
d. Most of these children have subnormal intelligence.
Answer: c. Skeletal proportions are normal for age
In children with hypopituitarism, the skeletal proportions are normal. Growth is
within normal limits for the first year of life. Height is usually more delayed than
weight. Intelligence is not affected by
hypopituitarism.
2. A child with hypopituitarism is being started on growth hormone (GH) therapy.
Nursing considerations should be based on which knowledge?
a. Treatment is most successful if it is started during adolescence.
b. Treatment is considered successful if children attain full stature by adulthood.
c. Replacement therapy requires daily subcutaneous injections.
d. Replacement therapy will be required throughout the child's lifetime.
Answer: c. Replacement therapy requires daily subcutaneous injections.
Additional support is required for children who require hormone replacement
therapy, such as preparation for daily subcutaneous injections and education for
,Inquire through: | Professional | Confidential Support
self-management during the school-age years. Young children, obese children, and
those who are severely GH deficient have the best response to therapy. When therapy
is successful, children can attain their actual or near-final adult height at a slower
rate than their peers. Replacement therapy is not needed after attaining final height.
They are no longer GH deficient.
3. A child with growth hormone (GH) deficiency is receiving GH therapy. When is the
best time for the GH to be administered?
a. At bedtime
b. After meals
c. Before meals
d. On arising in the morning
Answer: a. At bedtime
Injections are best given at bedtime to more closely approximate the physiologic
release of GH. After or before meals and on arising in the morning do not mimic the
physiologic release of the hormone.
4. An adolescent is being seen in the clinic for evaluation of acromegaly. The nurse
understands that which occurs with acromegaly?
a. There is a lack of growth hormone (GH) being produced.
b. There is excess growth hormone (GH) after closure of the epiphyseal plates.
c. There is an excess of growth hormone (GH) before the closure of the epiphyseal
plates.
d. There is a lack of thyroid hormone being produced.
Answer: b. There is excess growth hormone (GH) after closure of the epiphyseal
plates.
Excess GH after closure of the epiphyseal plates results in acromegaly. A lack of
growth hormone results in delayed growth or even dwarfism. Gigantism occurs when
there is hypersecretion of GH before the closure of the epiphyseal plates. Cretinism
is associated with hypothyroidism.
, Inquire through: | Professional | Confidential Support
5. A child will start treatment for precocious puberty. The nurse recognizes that this
will involve the injection of which synthetic medication?
a. Thyrotropin
b. Gonadotropins
c. Somatotropic hormone
d. Luteinizing hormone-releasing hormone
Answer: d. Luteinizing hormone-releasing hormone
Precocious puberty of central origin is treated with monthly subcutaneous injections
of luteinizing hormone-releasing hormone. Thyrotropin, gonadotropins, and
somatotropic hormone are not the
appropriate therapies for precocious puberty.
6. The nurse is conducting a staff in-service on childhood endocrine disorders.
Diabetes insipidus is a disorder of:
a. anterior pituitary.
b. posterior pituitary.
c. adrenal cortex.
d. adrenal medulla.
Answer: b. posterior pituitary.
The principal disorder of posterior pituitary hypofunction is diabetes insipidus. The
anterior pituitary produces hormones such as GH, thyroid-stimulating hormone,
adrenocorticotropic hormone,
gonadotropin, prolactin, and melanocyte-stimulating hormone. The adrenal cortex
produces aldosterone, sex hormones, and glucocorticoids. The adrenal medulla
produces catecholamines.
7. The nurse is caring for a preschool child with suspected diabetes insipidus. Which
clinical manifestation should the nurse expect to observe?
Chapter 28: The Child with Endocrine
Dysfunction Hockenberry: Wong's Essentials
of Pediatric Nursing, 10th Edition Verified
and Updated Questions and Answers (100%
Correct Answers)
1. Parents of a toddler with hypopituitarism ask the nurse, "What can we expect with
this condition?" The nurse should respond with which statement?
a. Growth is normal during the first 3 years of life.
b. Weight is usually more retarded than height.
c. Skeletal proportions are normal for age.
d. Most of these children have subnormal intelligence.
Answer: c. Skeletal proportions are normal for age
In children with hypopituitarism, the skeletal proportions are normal. Growth is
within normal limits for the first year of life. Height is usually more delayed than
weight. Intelligence is not affected by
hypopituitarism.
2. A child with hypopituitarism is being started on growth hormone (GH) therapy.
Nursing considerations should be based on which knowledge?
a. Treatment is most successful if it is started during adolescence.
b. Treatment is considered successful if children attain full stature by adulthood.
c. Replacement therapy requires daily subcutaneous injections.
d. Replacement therapy will be required throughout the child's lifetime.
Answer: c. Replacement therapy requires daily subcutaneous injections.
Additional support is required for children who require hormone replacement
therapy, such as preparation for daily subcutaneous injections and education for
,Inquire through: | Professional | Confidential Support
self-management during the school-age years. Young children, obese children, and
those who are severely GH deficient have the best response to therapy. When therapy
is successful, children can attain their actual or near-final adult height at a slower
rate than their peers. Replacement therapy is not needed after attaining final height.
They are no longer GH deficient.
3. A child with growth hormone (GH) deficiency is receiving GH therapy. When is the
best time for the GH to be administered?
a. At bedtime
b. After meals
c. Before meals
d. On arising in the morning
Answer: a. At bedtime
Injections are best given at bedtime to more closely approximate the physiologic
release of GH. After or before meals and on arising in the morning do not mimic the
physiologic release of the hormone.
4. An adolescent is being seen in the clinic for evaluation of acromegaly. The nurse
understands that which occurs with acromegaly?
a. There is a lack of growth hormone (GH) being produced.
b. There is excess growth hormone (GH) after closure of the epiphyseal plates.
c. There is an excess of growth hormone (GH) before the closure of the epiphyseal
plates.
d. There is a lack of thyroid hormone being produced.
Answer: b. There is excess growth hormone (GH) after closure of the epiphyseal
plates.
Excess GH after closure of the epiphyseal plates results in acromegaly. A lack of
growth hormone results in delayed growth or even dwarfism. Gigantism occurs when
there is hypersecretion of GH before the closure of the epiphyseal plates. Cretinism
is associated with hypothyroidism.
, Inquire through: | Professional | Confidential Support
5. A child will start treatment for precocious puberty. The nurse recognizes that this
will involve the injection of which synthetic medication?
a. Thyrotropin
b. Gonadotropins
c. Somatotropic hormone
d. Luteinizing hormone-releasing hormone
Answer: d. Luteinizing hormone-releasing hormone
Precocious puberty of central origin is treated with monthly subcutaneous injections
of luteinizing hormone-releasing hormone. Thyrotropin, gonadotropins, and
somatotropic hormone are not the
appropriate therapies for precocious puberty.
6. The nurse is conducting a staff in-service on childhood endocrine disorders.
Diabetes insipidus is a disorder of:
a. anterior pituitary.
b. posterior pituitary.
c. adrenal cortex.
d. adrenal medulla.
Answer: b. posterior pituitary.
The principal disorder of posterior pituitary hypofunction is diabetes insipidus. The
anterior pituitary produces hormones such as GH, thyroid-stimulating hormone,
adrenocorticotropic hormone,
gonadotropin, prolactin, and melanocyte-stimulating hormone. The adrenal cortex
produces aldosterone, sex hormones, and glucocorticoids. The adrenal medulla
produces catecholamines.
7. The nurse is caring for a preschool child with suspected diabetes insipidus. Which
clinical manifestation should the nurse expect to observe?
