Test Bank for Introduction to
Maternity and Pediatric
Nursing 9th Edition by Gloria
Leifer
Chapter 31-34
Chapter 31: The Child with a Metabolic
Condition
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The
nurse recognizes these signs are characteristic of what?
a. Hypothyroidism
b. Hyperthyroidism
c. Type 1 diabetes mellitus
d. Tay-Sachs disease
ANS: A
, The infant with hypothyroidism will appear sluggish, and the tongue will be enlarged,
causing noisy respiration.
DIF: Cognitive Level: Analysis REF: p. 726 OBJ: 3
TOP: Hypothyroidism KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
2. What is an important consideration for the school-age child taking DDAVP for diabetes
insipidus?
a. Observe for signs of water deprivation.
b. Restrict his physical education program.
c. Arrange for the child to use the bathroom when needed.
d. Limit fluid intake other than during the lunch period.
ANS: C
The child with diabetes insipidus needs liberal access to bathrooms and water fountains.
Arrangements may have to be made with the school to allow access.
DIF: Cognitive Level: Application REF: pp. 726-727 OBJ: 4
TOP: Diabetes Insipidus KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
3. What condition does the nurse suspect when a child with type 1 diabetes mellitus has
hyperglycemia, diaphoresis, and headaches in the morning?
a. Dawn phenomenon
b. Somogyi phenomenon
c. Honeymoon effect
d. Ketoacidosis
ANS: B
The Somogyi phenomenon (rebound hyperglycemia) occurs when the blood glucose level is
lowered to the point at which the body‘s counter-regulatory hormones are released, producing
the symptoms described.
DIF: Cognitive Level: Analysis REF: p. 736 OBJ: 11
TOP: Somogyi Phenomenon KEY: Nursing Process Step: Data Collection
, MSC: NCLEX: Physiological Integrity
4. What would be the most appropriate nursing response to a woman who says, “My sister had a
child with Tay-Sachs disease, and I want to know if I could have a child with this condition”?
a. “The disease is rare. It is unlikely that you would have a child with Tay-Sachs disease.”
b. “A screening test can be done to determine if you are a carrier of the gene.”
c. “The gene for Tay-Sachs disease is transmitted by the father.”
d. “The cause of Tay-Sachs disease is thought to be an autoimmune response to a virus.”
ANS: B
Carriers can be identified by screening tests. Tay-Sachs disease has an autosomal recessive
pattern of transmission.
DIF: Cognitive Level: Comprehension REF: p. 725 OBJ: 2
TOP: Tay-Sachs Disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
5. What statement by a parent leads the nurse to determine a parent is administering levothyroxine
(Synthroid) correctly?
a. “I stopped giving the medication because my daughter was losing her hair.”
b. “I am using a different brand now because it costs less money.”
c. “I don‘t give the medication on the weekends.”
d. “I give the medication at 8:00 AM every day.”
ANS: D
Synthroid should be given at the same time each day, preferably in the morning.
DIF: Cognitive Level: Comprehension REF: p. 726 OBJ: 3
TOP: Levothyroxine (Synthroid) KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
6. After a closed head injury, the unconscious 10-year-old child begins to excrete copious amounts
of pale urine with an attendant drop in blood pressure (BP). Based on these symptoms, what does
the nurse suspect has developed?
a. Diabetes insipidus
, b. Diabetes mellitus
c. Hypothyroidism
d. Hyperthyroidism
ANS: A
Diabetes insipidus can be acquired as the result of a head injury or tumor, and suppression of
the posterior pituitary causes copious urine output with an attendant drop in BP. The child
can become dehydrated very quickly if some remedy is not applied.
DIF: Cognitive Level: Analysis REF: p. 726 OBJ: 4
TOP: Diabetes Insipidus KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
7. The nurse is teaching the parents of a child with diabetes insipidus about water intoxication. The
nurse would tell the parents to be alert for what symptom?
a. Polyuria
b. Cough
c. Weight loss
d. Lethargy
ANS: D
Signs of water intoxication include edema, lethargy, nausea, and central nervous system
signs.
DIF: Cognitive Level: Comprehension REF: p. 726 OBJ: 4
TOP: Diabetes Insipidus KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
8. A nurse is planning to teach a family about Tay-Sachs disease. What will the nurse relay about
the pattern of inheritance for inborn errors of metabolism?
a. They are usually autosomal recessive.
b. They are usually autosomal dominant.
c. They are usually X-linked recessive.
d. They are usually multifactorial.
Maternity and Pediatric
Nursing 9th Edition by Gloria
Leifer
Chapter 31-34
Chapter 31: The Child with a Metabolic
Condition
Leifer: Introduction to Maternity and Pediatric Nursing, 9th Edition
MULTIPLE CHOICE
1. A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The
nurse recognizes these signs are characteristic of what?
a. Hypothyroidism
b. Hyperthyroidism
c. Type 1 diabetes mellitus
d. Tay-Sachs disease
ANS: A
, The infant with hypothyroidism will appear sluggish, and the tongue will be enlarged,
causing noisy respiration.
DIF: Cognitive Level: Analysis REF: p. 726 OBJ: 3
TOP: Hypothyroidism KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
2. What is an important consideration for the school-age child taking DDAVP for diabetes
insipidus?
a. Observe for signs of water deprivation.
b. Restrict his physical education program.
c. Arrange for the child to use the bathroom when needed.
d. Limit fluid intake other than during the lunch period.
ANS: C
The child with diabetes insipidus needs liberal access to bathrooms and water fountains.
Arrangements may have to be made with the school to allow access.
DIF: Cognitive Level: Application REF: pp. 726-727 OBJ: 4
TOP: Diabetes Insipidus KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
3. What condition does the nurse suspect when a child with type 1 diabetes mellitus has
hyperglycemia, diaphoresis, and headaches in the morning?
a. Dawn phenomenon
b. Somogyi phenomenon
c. Honeymoon effect
d. Ketoacidosis
ANS: B
The Somogyi phenomenon (rebound hyperglycemia) occurs when the blood glucose level is
lowered to the point at which the body‘s counter-regulatory hormones are released, producing
the symptoms described.
DIF: Cognitive Level: Analysis REF: p. 736 OBJ: 11
TOP: Somogyi Phenomenon KEY: Nursing Process Step: Data Collection
, MSC: NCLEX: Physiological Integrity
4. What would be the most appropriate nursing response to a woman who says, “My sister had a
child with Tay-Sachs disease, and I want to know if I could have a child with this condition”?
a. “The disease is rare. It is unlikely that you would have a child with Tay-Sachs disease.”
b. “A screening test can be done to determine if you are a carrier of the gene.”
c. “The gene for Tay-Sachs disease is transmitted by the father.”
d. “The cause of Tay-Sachs disease is thought to be an autoimmune response to a virus.”
ANS: B
Carriers can be identified by screening tests. Tay-Sachs disease has an autosomal recessive
pattern of transmission.
DIF: Cognitive Level: Comprehension REF: p. 725 OBJ: 2
TOP: Tay-Sachs Disease KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
5. What statement by a parent leads the nurse to determine a parent is administering levothyroxine
(Synthroid) correctly?
a. “I stopped giving the medication because my daughter was losing her hair.”
b. “I am using a different brand now because it costs less money.”
c. “I don‘t give the medication on the weekends.”
d. “I give the medication at 8:00 AM every day.”
ANS: D
Synthroid should be given at the same time each day, preferably in the morning.
DIF: Cognitive Level: Comprehension REF: p. 726 OBJ: 3
TOP: Levothyroxine (Synthroid) KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
6. After a closed head injury, the unconscious 10-year-old child begins to excrete copious amounts
of pale urine with an attendant drop in blood pressure (BP). Based on these symptoms, what does
the nurse suspect has developed?
a. Diabetes insipidus
, b. Diabetes mellitus
c. Hypothyroidism
d. Hyperthyroidism
ANS: A
Diabetes insipidus can be acquired as the result of a head injury or tumor, and suppression of
the posterior pituitary causes copious urine output with an attendant drop in BP. The child
can become dehydrated very quickly if some remedy is not applied.
DIF: Cognitive Level: Analysis REF: p. 726 OBJ: 4
TOP: Diabetes Insipidus KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
7. The nurse is teaching the parents of a child with diabetes insipidus about water intoxication. The
nurse would tell the parents to be alert for what symptom?
a. Polyuria
b. Cough
c. Weight loss
d. Lethargy
ANS: D
Signs of water intoxication include edema, lethargy, nausea, and central nervous system
signs.
DIF: Cognitive Level: Comprehension REF: p. 726 OBJ: 4
TOP: Diabetes Insipidus KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection
of Disease
8. A nurse is planning to teach a family about Tay-Sachs disease. What will the nurse relay about
the pattern of inheritance for inborn errors of metabolism?
a. They are usually autosomal recessive.
b. They are usually autosomal dominant.
c. They are usually X-linked recessive.
d. They are usually multifactorial.
