A nurse is caring for a client who had a brain tumor and chemotherapy as an infant. The assessment reveals short stature and delayed onset of menarche. The nurse recognizes the assessed problems are most likely caused by which of the following?
Low levels of Parathyroid hormone (PTH)
Impaired production of Growth Hormone (GH)
Lack of Adrenocorticotropic hormone (ACTH)
Impaired production of T3 and T4
The Correct Answer is B
A. Low levels of PTH would primarily affect calcium metabolism and would not directly explain short stature or delayed menarche.
B. Impaired production of GH is most likely the cause of short stature, as growth hormone plays a critical role in growth and development during childhood.
C. Lack of ACTH affects adrenal hormone production but does not directly lead to short stature or delayed menarche.
D. Impaired production of T3 and T4 would affect metabolism and growth but is less likely to be the primary cause of the symptoms presented compared to growth hormone deficiencies.
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Correct Answer is A
Explanation
A. Elevated PTH levels lead to increased calcium reabsorption from bones and enhanced calcium absorption in the kidneys, which can result in hypercalcemia and increase the risk of renal calculi (kidney stones).
B. Irritability and anxiety are not directly associated with high PTH levels. They are more often linked to thyroid hormone imbalances.
C. Frequent diarrhea is not a common symptom of elevated PTH levels; instead, hypercalcemia can lead to constipation.
D. Tetany and muscle pain are more commonly associated with low calcium levels, such as in hypoparathyroidism, not elevated PTH.
Correct Answer is B
Explanation
A. Quadriplegia, or tetraplegia, is typically associated with injuries at or above the C4 level, not T2-T3.
B. A T2-T3 spinal cord injury can lead to loss of sensation and motor function below the level of injury, affecting the thoracic region and lower body.
C. Hemiplegia, which refers to paralysis on one side of the body, is typically due to brain injuries or strokes, not spinal cord injuries.
D. While bladder control may be affected, the most direct impact of T2-T3 injury is the loss of sensation and motor function below that level.