Module 6 (Ch. 26) Flashcards
The primary care pediatric nurse practitioner is performing a well child examination on a 5yearold girl. The parents ask if the child s adult height can be predicted. The nurse practitioner learns that the mother is 5’8” tall and the father is 5’11” tall. The nurse practitioner will estimate which expected adult height for this child?
5’7” tall
The primary care pediatric nurse practitioner is performing a well child examination on a 2yearold child with a history of intrauterine growth retardation (IUGR) whose height remains less than the 3rd percentile on a WHO growth chart. What will the nurse practitioner do?
Refer the child to a pediatric endocrinologist
The primary care pediatric nurse practitioner is evaluating a child who has short stature. Although bone age studies reveal a delay in bone age, the child’s growth is consistent with bone age. Which diagnosis is most likely?
Constitutional growth delay
The mother of a female infant is concerned that her daughter is developing breasts. The primary care pediatric nurse practitioner notes mild breast development but no pubic or axillary hair. What is the likely diagnosis?
Premature thelarche which will resolve over time
A 7yearold female has recently developed pubic and axillary hair without breast development. Her bone age is consistent with her chronological age, and a pediatric endocrinologist has diagnosed idiopathic premature adrenarche. The primary care pediatric nurse practitioner will monitor this child for which condition?
Polycystic ovary syndrome
A 6yearold female has had a recent growth spurt and an exam reveals breast and pubic hair development. Her bone age is determined to be 8 years. What will the primary care pediatric nurse practitioner do next?
Refer the child to a pediatric endocrinologist for management.
An infant has congenital adrenal hyperplasia. At a routine well baby checkup, the primary care pediatric nurse practitioner notes vomiting, poor feeding, lethargy, and dehydration. Which action is correct?
Refer the infant to the emergency department for fluids, dextrose, and steroids.
The primary care pediatric nurse practitioner performs a physical examination on a 9monthold infant with congenital hypothyroidism who takes daily levothyroxine sodium and notes a recent slowing of the infant’s growth rate. What will the nurse practitioner order?
Free serum T4 and TSH levels
A 12yearold child has a recent history of increased thirst and frequent urination. The child’s weight has been in the 95th percentile for several years. A dipstick UA is positive for glucose, and random plasma glucose is 350 mg/dL. Which test will the primary care pediatric nurse practitioner order to determine the type of diabetes in this child?
Pancreatic antibodies
The primary care pediatric nurse practitioner diagnoses an 8yearold child with type 1 diabetes after a routine urine screen is positive for glucose and negative for ketones and plasma glucose is 350 mg/dL. The child’s weight is normal and the parents report a mild increase in thirst and urine output in the past few days. Which course of action is correct?
Begin insulin and refer the child to a children’s diabetes center
The primary care pediatric nurse practitioner is reviewing lab work and diabetes management with a schoolage child whose HbA1C is 7.6% who reports usual blood sugars before meals as being 80 to 90 mg/dL. The nurse practitioner will consult with the child’s endocrinologist to consider which therapy?
Continuous glucose monitoring
The primary care pediatric nurse practitioner is performing a well child examination on a 12yearold child who was diagnosed with type 1 diabetes at age 9. The child had a lipid screen at age 10 with an LDL cholesterol <100 mg/dL. What will the nurse practitioner recommend as part of ongoing management for this child?
Comprehensive ophthalmologic exam
A 13yearold Native American female has a BMI at the 90th percentile for age. The primary care pediatric nurse practitioner notes the presence of a hyperpigmented velvetlike rash in skin folds. The child denies polydipsia, polyphagia, and polyuria. The nurse practitioner will
order a fasting blood sample for a metabolic screen for type 2 diabetes
The primary care pediatric nurse practitioner prescribes metformin for a 15year old adolescent newly diagnosed with type 2 diabetes. What will the nurse practitioner include when teaching the adolescent about this drug?
The importance of checking blood glucose 3 or 4 times daily
A 16yearold adolescent female whose BMI is at the 90th percentile reports irregular periods. The primary care pediatric nurse practitioner notes widespread acne on her face and back and an abnormal distribution of facial hair. The nurse practitioner will evaluate her further based on a suspicion of which diagnosis?
Polycystic ovary syndrome
