ATI RN
Pediatric Endocrine Exam Questions Questions
Question 1 of 5
You are going to treat a 7-year-old boy with type 1 diabetes mellitus who develops DKA due to a recent infection. Examination reveals severe dehydration and deep acidotic breathing. Lab investigations shows: blood glucose, 450 mg/dL; blood pH, 7.2; and serum bicarbonate concentration, 14 mEq/L. Which of the following should be avoided during the treatment of this girl?
Correct Answer: C
Rationale: Bicarbonate is generally avoided in DKA treatment unless pH is critically low (<6.9), as it may worsen cerebral edema or cause paradoxic acidosis. Lactated Ringer (A), glucose (B) later in treatment, insulin (D), and potassium (E) are standard components.
Question 2 of 5
A 16-year-old boy has delayed puberty and absence of secondary sexual characteristics; he has decreased sense of smell. Examination reveals shortening of the fourth finger. MRI of the brain shows absence of the olfactory bulbs and sulci; abdominal ultrasonography shows absence of the right kidney. Of the following, the MOST likely diagnosis is
Correct Answer: B
Rationale: Kallmann syndrome features hypogonadotropic hypogonadism, anosmia (absent olfactory bulbs), and may include renal agenesis or brachydactyly, matching this case. Other syndromes (A, C, D, E) lack this specific combination.
Question 3 of 5
You are examining a 10-month-old male infant during a routine visit; you find that he has wide wrists. He is still breast fed. X-ray of the wrist joint shows signs of rickets. Of the following, the BEST reflection of vitamin D deficiency is
Correct Answer: D
Rationale: Serum 25-hydroxyvitamin D is the best indicator of vitamin D status, reflecting stores and deficiency in rickets. Calcium (A), phosphate (B), PTH (C), and 1,25-hydroxyvitamin D (D) are affected but less direct measures.
Question 4 of 5
A 7-year-old boy is going to undergo orthopedic surgery for right total hip replacement; he has been diagnosed with Addison disease 2 years ago and he is on replacement therapy by hydrocortisone since that time. Of the following, the MOST important step in the management of this boy is
Correct Answer: D
Rationale: In Addison disease, surgery is a stress requiring increased hydrocortisone (stress dosing) to prevent adrenal crisis, making it the most important step. Monitoring (A), fludrocortisone (B), and fluids (E) are supportive, and surgery (C) proceeds after stabilization.
Question 5 of 5
Autosomal recessive PKD is characterized by which of the following?
Correct Answer: C
Rationale: Autosomal recessive PKD is characterized by marked bilateral renal enlargement, interstitial fibrosis, and early kidney failure, often with hepatic fibrosis leading to portal hypertension.