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ACCNS-P : AACN Clinical Nurse Specialist - Wellness through Acute Care (Pediatric) Exam

Nursing ACCNS-P Questions & Answers

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AACN Clinical Nurse Specialist - Wellness through Acute Care (Pediatric)


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Question: 1


A 6-year-old child with type 1 diabetes mellitus is experiencing symptoms of hypoglycemia. Which intervention should the nurse prioritize?


  1. Administering a rapid-acting glucagon injection

  2. Administering oral glucose gel or tablets


    dministering an oral hypoglycemic agent


    wer: B


    anation: Hypoglycemia is characterized by low blood glucose levels a ead to neurologic symptoms if untreated. The initial treatment for glycemia in a conscious child is the administration of oral glucose gel ts. Glucagon injection is used in severe cases of hypoglycemia or whe is unconscious and unable to swallow. Rapid-acting insulin injection ypoglycemic agents are not appropriate interventions for hypoglyce


    stion: 2


    -year-old adolescent with type 1 diabetes mellitus is admitted to the gency department with symptoms of diabetic ketoacidosis (DKA). W atory finding would the nurse expect to see in this patient?

    Administering a rapid-acting insulin injection

  3. A


Ans


Expl nd

can l

hypo or

table n the

child s and

oral h mia.


Que


A 16

emer hich

labor


  1. Hyperglycemia and metabolic alkalosis

  2. Hypoglycemia and metabolic acidosis

  3. Hyperglycemia and metabolic acidosis

  4. Hypoglycemia and metabolic alkalosis


Answer: C

Explanation: Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes mellitus characterized by hyperglycemia, metabolic acidosis, and ketosis. Hyperglycemia and metabolic acidosis are hallmark findings in DKA) Hypoglycemia and metabolic alkalosis are not consistent with the pathophysiology of DKA.



-year-old adolescent presents with symptoms of growth hormone iency. Which assessment finding would be consistent with this condit


xcessive growth of facial and body hair ypertension and weight gain

apid growth and increased appetite elayed puberty and short stature


wer: D


anation: Growth hormone deficiency in adolescents can result in dela rty and short stature. Excessive growth of facial and body hair is mor monly associated with conditions such as polycystic ovary syndrome i les or androgen excess disorders in males. Rapid growth and increase tite may be seen in conditions like gigantism oracromegaly, which res excessive growth hormone production. Hypertension and weight gain ypically associated with growth hormone deficiency.

Question: 3


A 14

defic ion?


  1. E

  2. H

  3. R

  4. D


Ans


Expl yed

pube e

com n

fema d

appe ult

from are

not t


Question: 4


A 12-year-old child is admitted to the pediatric unit with suspected adrenal insufficiency. Which clinical manifestations would the nurse expect to assess in this child?

  1. Hyperglycemia and polyuria

  2. Hypertension and tachycardia

  3. Hypotension and weight loss

  4. Hypoglycemia and lethargy Answer: C

nal hormones, particularly cortisol. Clinical manifestations include tension, weight loss, fatigue, and electrolyte imbalances. Hyperglyce olyuria are more commonly associated with diabetes mellitus, while rtension and tachycardia are not typical findings in adrenal insufficien oglycemia and lethargy are more commonly seen in insulin excess or in resistance disorders, such as diabetes mellitus.


stion: 5


year-old child is diagnosed with hypothyroidism. Which clinical festation would the nurse expect to assess in this child?


eat intolerance and weight loss achycardia and hypertension xophthalmos and goiter

old intolerance and weight gain


wer: D

Explanation: Adrenal insufficiency is characterized by decreased production of adre

hypo mia

and p

hype cy.

Hyp insul


Que


A 7-

mani


  1. H

  2. T

  3. E

  4. C


Ans


Explanation: Hypothyroidism is characterized by decreased production of thyroid hormones, resulting in a decreased metabolic rate. Clinical manifestations include cold intolerance, weight gain, fatigue, constipation, and slowed growth. Heat intolerance and weight loss are more commonly seen in hyperthyroidism. Tachycardia and hypertension may be present in hyperthyroidism but are not typical findings in hypothyroidism. Exophthalmos

and goiter are associated with Graves' disease, an autoimmune disorder causing hyperthyroidism.


Question: 6



yponatremia ypokalemia ypernatremia yperkalemia


wer: A


anation: Syndrome of inappropriate antidiuretic hormone secretion DH) is characterized by excessive secretion of antidiuretic hormone H), leading to water retention and dilutional hyponatremia. Hypernatr ondition characterized by high plasma sodium levels. Hypokalemia a rkalemia refer to low and high levels of potassium, respectively, and a irectly related to SIADH.


stion: 7

A 9-year-old child is admitted to the pediatric unit with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which electrolyte imbalance would the nurse expect to assess in this child?


  1. H

  2. H

  3. H

  4. H


Ans Expl

(SIA

(AD emia

is a c nd

hype re

not d


Que


A 5-year-old child is diagnosed with hyperthyroidism. Which clinical manifestation would the nurse expect to assess in this child?


  1. Cold intolerance and weight gain

  2. Bradycardia and constipation

  3. Hypotension and depression

  4. Heat intolerance and weight loss

Answer: D


tension, and depression are not typical findings in hyperthyroidism.


stion: 8


-year-old child with newly diagnosed type 1 diabetes mellitus is at ris loping hyperglycemic hyperosmolar state (HHS). Which clinical festation would the nurse expect to assess in this child?


ussmaul respirations ruity breath odor

xtreme thirst and polyuria bdominal pain and vomiting


wer: C


anation: Hyperglycemic hyperosmolar state (HHS) is a life-threatenin plication of diabetes mellitus characterized by profound hyperglycemi dration, and hyperosmolarity without significant ketoacidosis. Clinica

Explanation: Hyperthyroidism is characterized by excessive production of thyroid hormones, resulting in an increased metabolic rate. Clinical manifestations include heat intolerance, weight loss, tachycardia, tremors, hyperactivity, and increased appetite. Cold intolerance and weight gain are more commonly seen in hypothyroidism. Bradycardia, constipation,

hypo


Que


A 10 k for

deve mani


  1. K

  2. F

  3. E

  4. A


Ans


Expl g

com a,

dehy l

manifestations include extreme thirst (polydipsia) and polyuria due to osmotic diuresis. Kussmaul respirations and fruity breath odor are more commonly seen in diabetic ketoacidosis (DKA). Abdominal pain and vomiting may be present in both DKA and HHS but are more commonly associated with DKA.


Question: 9

A neonate is diagnosed with a rare inborn error of metabolism. The nurse understands that which of the following is a key characteristic of inborn errors of metabolism?


  1. They are acquired during childhood due to environmental factors

  2. They are caused by a deficiency of specific enzymes

  3. They are typically resolved by adulthood


    wer: B


    anation: Inborn errors of metabolism are genetic disorders caused by a iency or dysfunction of specific enzymes involved in metabolic pathw are not acquired during childhood but are present from birth. Inborn

    of metabolism are chronic conditions that often require lifelong agement. The prevalence of these disorders varies, and they can affect

    and females.

    They are more common in females than in males


Ans Expl

defic ays.

They errors

man both

males


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