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A child with nephrotic syndrome is admitted for worsening edema. Which of the following labs would support the diagnosis? (Select all that apply)
A. Urine dipstick: +3 protein
B. Serum albumin: 2.0 g/dL
C. Total cholesterol: 275 mg/dL
D. Hemoglobin A1C: 6.8%
E. Creatinine: Normal
Answers: A, B, C
Which signs suggest diabetic ketoacidosis (DKA) in a newly diagnosed Type 1 diabetic child? (Select all that apply)
A. Fruity breath odor
B. Rapid, deep breathing
C. Severe hypertension
D. Nausea and vomiting
E. Blood glucose >250 mg/dL
Answers: A, B, D, E
Which insulin is most appropriate to manage overnight blood glucose in a pediatric patient?
A. Lispro
B. Regular
C. Glargine
D. Aspart
Answer: C. Glargine
A 5-year-old girl with early breast development and pubic hair is diagnosed with central precocious puberty. What is the first-line treatment?
A. Estrogen blockers
B. Surgical removal of ovaries
C. Gonadotropin-releasing hormone (GnRH) agonist
D. Thyroid hormone replacement
Answer: C. GnRH agonist
A 10-year-old with ESRD is undergoing evaluation for kidney transplant. The parents ask why their child needs dialysis first. Which is the best response?
A. "Dialysis cures the kidney disease while waiting."
B. "Dialysis is used temporarily until transplant is scheduled."
C. "It helps manage liver failure from kidney disease."
D. "Dialysis is always safer and preferred over transplant."
Answer: B. "Dialysis is used temporarily until transplant is scheduled."
Which of the following clinical findings is most characteristic of diabetes insipidus in children?
A. Weight gain and edema
B. Polyuria and polydipsia
C. Low urine output and concentrated urine
D. Hypoglycemia and ketonuria
Answer: B. Polyuria and polydipsia
Which of the following are expected findings in a child with hypothyroidism? (Select all that apply)
A. Bradycardia
B. Constipation
C. Delayed growth
D. Insomnia
E. Cold intolerance
Answers: A, B, C, E
Which nursing response is appropriate when parents express concern about the emotional impact of precocious puberty on their child?
A. “Children usually aren’t affected emotionally by early puberty.”
B. “Your child might feel different from peers; we can help provide support and counseling resources.”
C. “Ignore the emotional issues; focus on medical treatment.”
D. “Avoid discussing puberty to prevent anxiety.”
Answer: B. “Your child might feel different from peers; we can help provide support and counseling resources.”
Which of the following are priority assessments in the child after kidney transplantation? (Select all that apply)
A. Signs of rejection (fever, decreased urine output)
B. Blood glucose monitoring
C. Blood pressure
D. Medication adherence
E. Checking for proteinuria
Answers: A, C, D, E
A 6-year-old with suspected DI has a serum sodium of 152 mEq/L and urine specific gravity of 1.002. What is the priority treatment?
A. Increase sodium intake
B. Administer desmopressin
C. Begin IV insulin
D. Restrict oral fluids
Answer: B. Administer desmopressin
A 13-year-old girl presents with weight loss despite increased appetite, heat intolerance, and anxiety. Her T3 and T4 levels are elevated. What diagnosis does the nurse expect?
A. Type 1 diabetes
B. Graves’ disease
C. Hashimoto’s thyroiditis
D. Cushing syndrome
Answer: B. Graves’ disease
Which adventitious lung sound is described as a high-pitched, musical sound most often heard during expiration in children with asthma?
A. Crackles
B. Wheezes
C. Rhonchi
D. Stridor
Answer: B. Wheezes
What is a common trigger of acute glomerulonephritis in children?
A. Recent viral gastroenteritis
B. Untreated streptococcal throat infection
C. Chronic dehydration
D. High-protein diet
Answer: B. Untreated streptococcal throat infection
A school-age child with Type 1 diabetes is prescribed Lispro insulin (Humalog) before meals. When should the nurse administer this insulin?
A. 1 hour before meals
B. With the last bite of food
C. 15 minutes before meals
D. 30–60 minutes after meals
Answer: C. 15 minutes before meals
Which of the following is a priority nursing intervention for a child with hyperthyroidism?
A. Encourage high-protein snacks
B. Monitor for signs of thyroid storm
C. Restrict fluids to prevent overload
D. Allow vigorous physical activity
Answer: B. Monitor for signs of thyroid storm
A newborn is diagnosed with transposition of the great vessels. The nurse notes cyanosis despite oxygen therapy. What is the pathophysiological cause of this symptom?
A. Mixing of oxygenated and deoxygenated blood due to septal defect
B. The aorta arises from the right ventricle and the pulmonary artery from the left ventricle
C. Left ventricular hypertrophy causes poor cardiac output
D. The pulmonary valve is stenotic
Answer: B. The aorta arises from the right ventricle and the pulmonary artery from the left ventricle
Which of the following is true about Type 1 vs. Type 2 diabetes in pediatric patients?
A. Type 1 is associated with obesity and insulin resistance.
B. Type 2 typically presents with diabetic ketoacidosis.
C. Type 1 requires insulin for life.
D. Type 2 results from autoimmune beta-cell destruction.
Answer: C. Type 1 requires insulin for life.
Match each insulin type with its peak effect:
Lispro (Humalog)
Regular insulin
NPH
Glargine (Lantus)
A. 4–12 hours
B. 2–4 hours
C. No peak
D. 30–90 minutes
Answers:
1 → D
2 → B
3 → A
4 → C
Which child meets the definition of precocious puberty?
A. A 7-year-old girl with breast development
B. A 12-year-old girl with menarche
C. A 10-year-old boy with increased height
D. A 6-year-old girl with acne
Answer: A. A 7-year-old girl with breast development