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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?

A.

Low levels of Parathyroid hormone (PTH)

B.

Impaired production of Growth Hormone (GH)

C.

Lack of Adrenocorticotropic hormone (ACTH)

D.

Impaired production of T3 and T4

Answer and Explanation

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 B

Explanation

A. Hormone replacement is generally used to supplement deficiencies rather than inhibit excess hormone release.

B. Dopamine agonists, such as bromocriptine, are used to inhibit the release of growth hormone from the anterior pituitary, which is beneficial in treating acromegaly, a condition caused by excess growth hormone.

C. Levothyroxine is a thyroid hormone replacement and is not effective in controlling pituitary hormone release.

D. Corticosteroids do not inhibit growth hormone release and are typically used to manage inflammation rather than for pituitary hormone control.

Correct Answer is A

Explanation

A. In SIADH, excess ADH causes water retention and hyponatremia; fluid restriction helps to prevent further dilution of sodium and manage fluid balance.

B. NPO status is unnecessary unless otherwise indicated; managing fluid intake is more effective.

C. Increasing oral intake would worsen fluid overload and hyponatremia.

D. Rapid IV fluid infusion can exacerbate the client’s condition by increasing fluid volume further.

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