All of the following are true of Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus

Question 1All of the following are true of Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) EXCEPT:

 

T1DM is characterized by insulin deficiency while T2DM is characterized by insulin resistance with relative insulin deficiency.

 

Patients with T1DM are not commonly overweight while patients with T2DM commonly have a BMI > 95th percentile.

 

T1DM commonly presents after onset of puberty while T2DM commonly presents at a younger age, often before age 10.

 

Aconthosis nigricans is more commonly seen in pateints with T2DM.

 

Question 2Sleep problems common in preschool years are all of the following EXCEPT:

 

Nightmares

 

Night terrors

 

Insomnia

 

Bedtime fears

 

Question 3All of the following are ways that a child is screened for type 1 diabetes during routine care EXCEPT:

 

Urinalysis

 

Growth chart evaluation

 

Finger stick blood glucose testing

 

Assessment of eating, drinking, and urinating pattern

 

Question 4The diagnostic criteria for autistic disorders include which of the following:

 

Speech delay, ataxia, mental retardation

 

Impairments in social interactions, interpersonal communication and staring spells

 

Mental retardation, impairment of social interactions and stereotypical restricted pattern of interests and activities

 

Impairment of social interactions, impairment of interpersonal communication and stereotypical restricted pattern of interests and activities

 

Question 5Which of the following is not a common sign or symptom of hypothyroidism in children?

 

Delayed growth

 

Frequent stools

 

Constipation

 

Lethargy

 

Question 6The primary care pediatric nurse practitioner performs a physical examination on a 9-month-old 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

 

Serum levothyroxine level

 

Total T4 and free T4 levels

 

TSH and total T4 levels

 

Question 7A 6-year-old 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?

 

Order LH and FSH levels and a long-acting GnRH agonist.

 

Order thyroid function tests to exclude primary hypothyroidism.

 

Reassure the parent that this is most likely idiopathic.

 

Refer the child to a pediatric endocrinologist for management.

 

Question 8A 13-year-old Native American female has a body mass index (BMI) at the 90th percentile for age. The primary care pediatric nurse practitioner notes the presence of a hyperpigmented velvet-like rash in skin folds. The child denies polydipsia, polyphagia, and polyuria. The nurse practitioner will take what action?

 

Counsel the child to lose weight to prevent type 2 diabetes.

 

Diagnose type 2 diabetes if the child has a random glucose of 180 mg/dL.

 

Order a fasting blood sample for a metabolic screen for type 2 diabetes.

 

Refer the child to a pediatric endocrinologist.

 

Question 9A 16-year-old adolescent female whose body mass index (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?

 

Dyslipidemia

 

Hypothyroidism

 

Nonalcoholic steatohepatitis

 

Polycystic ovary syndrome

 

Question 10A 14-year-old female comes to the clinic with amenorrhea for 3 months. A pregnancy test is negative. The adolescent’s body weight is at 82% of expected for height and age. The mother reports that her daughter often throws up and refuses to eat most foods. Which condition does the primary care pediatric nurse practitioner suspect?

 

Anorexia nervosa

 

Bulimia nervosa

 

Depression

 

Substance abuse

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