Gastrointestinal Disorders
A child describes abdominal discomfort around the belly button that later becomes sharper and more localized. Which condition should the nurse investigate?
Appendicitis
A child has been drinking unusually large amounts of water, urinating frequently, and losing weight despite eating well. Which endocrine disorder should the nurse suspect first?
Type 1 diabetes mellitus. Check blood glucose promptly.
A 7-year-old develops breast tissue and begins growing taller more rapidly than expected for age. What condition should prompt further evaluation?
Precocious puberty.
A teenager experiences fatigue, joint pain, and a butterfly-shaped facial rash. Which autoimmune disorder is a likely explanation?
Systemic lupus erythematosus (SLE).
During a health education session, a teenager asks which behaviors can transmit HIV. Name two examples of exposures that can transmit the virus.
Sharing contaminated injection equipment or having sexual exposure without appropriate protection. HIV can also be transmitted through infected blood exposure and from parent to child in certain circumstances.
An infant has sudden episodes of intense crying, draws the knees toward the abdomen, and appears comfortable between episodes. What intestinal problem should the nurse suspect?
Intussusception, in which one portion of the intestine telescopes into another.
A child produces large amounts of very dilute urine and becomes intensely thirsty. The problem is traced to inadequate release of a hormone from the posterior pituitary. Name the hormone and the condition.
Antidiuretic hormone (ADH); diabetes insipidus.
An adolescent boy has not begun expected pubertal changes. Which physical finding is particularly important when evaluating possible delayed puberty?
Lack of testicular enlargement.
A child with juvenile idiopathic arthritis is discouraged because joint symptoms interfere with sports and time with friends. What is an appropriate nursing approach?
Help the child identify adapted activities that support participation and social connection while respecting pain, joint protection, and the individualized care plan.
A school-age child with HIV wants to join an organized sports team. What should the nurse emphasize about participation?
HIV alone does not automatically exclude the child from sports. Support participation with appropriate standard precautions for blood exposure and individualized clinical guidance.
A child with worsening abdominal pain develops guarding, abdominal rigidity, and fever. What potentially life-threatening complication should the nurse report promptly?
Peritonitis, which can occur following intestinal or appendiceal perforation.
A child taking desmopressin develops nausea, worsening headache, and unusual lethargy. Which laboratory value should the nurse be concerned about, and why?
Serum sodium. Desmopressin can cause water retention and hyponatremia.
A child takes levothyroxine every morning. Which laboratory test is routinely used to help assess thyroid replacement, depending on the child's clinical circumstances?
Thyroid-stimulating hormone (TSH).
A school is preparing for a student who has a history of a severe reaction to a food allergen. Name two safety measures the family and school should coordinate.
Create an individualized allergy and emergency action plan, and ensure staff know how to avoid exposure and access/administer prescribed epinephrine promptly.
A teenager with a chronic inflammatory illness has stopped seeing friends, reports feeling hopeless, and no longer enjoys favorite activities. What should the nurse do?
Assess for depression and safety concerns, provide supportive communication, and coordinate appropriate mental health support.
A school-age child has persistent diarrhea, abdominal bloating, and poor weight gain. The provider suspects an immune-mediated response to gluten. Which antibody test is commonly used in the initial evaluation?
Tissue transglutaminase IgA (tTG-IgA), typically interpreted alongside total IgA.
A newborn's results suggest insufficient thyroid hormone production. Why is prompt treatment important even if the newborn appears healthy?
Untreated congenital hypothyroidism can impair brain development and growth. Prompt levothyroxine treatment helps prevent complications.
A child taking levothyroxine develops a racing heartbeat, tremors, and unexpected weight loss. What should the nurse suspect?
Possible excessive thyroid hormone replacement; notify the prescribing provider for assessment and laboratory evaluation.
Minutes after allergen exposure, a child develops itchy raised welts surrounded by redness. Which immune mechanism commonly causes this response?
IgE-mediated type I hypersensitivity, involving mast-cell mediator release.
A child is prescribed 24 mg of a medication by injection. The vial contains 40 mg/mL. How many milliliters should the nurse administer? Round to the nearest tenth.
Answer: 0.6 mL.
Calculation: 24 mg ÷ 40 mg/mL = 0.6 mL.
A young infant with a structural opening in the roof of the mouth has difficulty feeding and is approaching the age when speech develops. What developmental area needs particular attention?
Speech and language development. The team should also monitor feeding, nutrition, and hearing as appropriate.
During recess, a child with diabetes becomes shaky, sweaty, and confused. The child is awake but having difficulty following directions. What should the school nurse do?
Stop activity, assess the child's condition, and check blood glucose promptly. If hypoglycemia is confirmed or strongly suspected and the child can swallow safely, give fast-acting carbohydrate according to the care plan. If swallowing is unsafe, do not give anything orally; follow the emergency protocol.
Following surgery to remove a pituitary tumor, a child develops marked thirst and produces large amounts of dilute urine. Which complication should the nurse consider, and what must be monitored?
Possible diabetes insipidus due to impaired ADH release. Monitor fluid intake and output, hydration, serum sodium, and urine concentration.
A child with SLE has joint inflammation and systemic symptoms. Name two medications from the course material that may be used in managing SLE.
Any two of the following: hydroxychloroquine, prednisone, ibuprofen, or belimumab. Selection depends on manifestations and the prescribed treatment plan.
An infant weighs 18 lb and is prescribed an oral medication at 12 mg/kg per dose. The solution contains 100 mg per 5 mL. How many milliliters should the nurse administer per dose? Round to the nearest tenth.
Answer: 4.9 mL per dose.
Calculation: 18 lb ÷ 2.2 = 8.18 kg; 8.18 kg × 12 mg/kg = 98.2 mg; 98.2 mg × 5 mL ÷ 100 mg = 4.91 mL, rounded to 4.9 mL.