ATI RN
Pediatric Endocrine Nursing Questions Questions
Question 1 of 5
A 14-year-old presents with poor growth and delayed puberty. She denies headaches or poor school performance. She is physically sluggish and has a small goiter, and her serum cholesterol is 500 mg/dL. The most likely diagnosis is
Correct Answer: A
Rationale: Hashimoto’s thyroiditis causes hypothyroidism with goiter, delayed puberty, and elevated cholesterol.
Question 2 of 5
The hypothalamus secretes releasing or inhibiting factors to control the anterior pituitary gland. Of the following, the pituitary hormone that is elevated in a hypothalamic disease is
Correct Answer: D
Rationale: Hypothalamic disease often disrupts inhibitory control, such as dopamine’s inhibition of prolactin. Thus, prolactin levels rise due to lack of suppression, unlike other hormones (A, B, C, E) which are stimulated by hypothalamic releasing factors and may decrease in hypothalamic dysfunction.
Question 3 of 5
A 9-year-old girl develops polyuria, vomiting, abdominal pain, and deep acidotic breathing during an intercurrent illness. She has been diagnosed with type 1 diabetes mellitus 5 years ago. Lab investigations reveal: blood glucose, 600 mg/dL; blood pH, 7.28; serum bicarbonate concentration, 14 mEq/L; and ketones in urine are positive. Of the following, the MOST serious complication that may occur in this girl is
Correct Answer: B
Rationale: Cerebral edema is the most serious complication of DKA in children, potentially fatal due to brain swelling from rapid fluid shifts during treatment. Arrhythmias (A), renal injury (C), pulmonary edema (D), and bowel ischemia (E) are less common or less immediately life-threatening.
Question 4 of 5
Hypoglycemia may result from absence or deficiency of the counter-regulatory hormones (growth hormone and cortisol). It is sometimes difficult to differentiate it from hyperinsulinism. Which of the following suggests hypoglycemia due to absence of counter-regulatory hormones rather than hyperinsulinism?
Correct Answer: A
Rationale: Absence of counter-regulatory hormones (GH, cortisol) leads to hypoglycemia with ketosis due to unopposed fat breakdown, unlike hyperinsulinism where ketones are absent (C) due to insulin’s suppression of ketogenesis. Options B, D, and E do not distinguish effectively.
Question 5 of 5
A 16-year-old boy has delayed puberty; he doesn’t develop secondary sexual characteristics; he has a normal stature according to his chronological age. Examination reveals an upper-to-lower segment ratio of 0.8 (normal ratio is more than 0.9). Of the following, the MOST important test to confirm diagnosis is
Correct Answer: A
Rationale: Delayed puberty with eunuchoid proportions (low upper-to-lower ratio) suggests hypogonadism; gonadotropin levels distinguish primary (high) from secondary (low) causes, guiding further evaluation. Other tests (B, C, D, E) are less immediately diagnostic.