A 10 year old boy is being started on growth hormone therapy for diagnosed growth hormone deficiency. The parents ask you if he will have to be on growth hormone injections for his whole life. The best response from the nurse is:

"No, the endocrinologist will stop treatment when epiphyseal plates are closed."

"No, the endocrinologist will stop treatment at the first signs of puberty."

"Yes, since your son does not make growth hormone on his own he will need to continue this medication for life."

"Yes, he will need this therapy for life, but the injections will get easier to administer as he gets older."

Answer and Explanation

The Correct Answer is A

Rationale:

A. "No, the endocrinologist will stop treatment when epiphyseal plates are closed.": Growth hormone therapy is typically discontinued once the child’s growth plates (epiphyseal plates) close, signaling the end of linear growth.

B. "No, the endocrinologist will stop treatment at the first signs of puberty.": Treatment is not usually stopped simply at the onset of puberty because growth can continue during puberty until the growth plates close. Stopping too early may prevent reaching full growth potential.

C. "Yes, since your son does not make growth hormone on his own he will need to continue this medication for life.": Life-long therapy is generally reserved for adults with growth hormone deficiency, not for children starting treatment. Pediatric therapy focuses on growth until skeletal maturity is reached.

D. "Yes, he will need this therapy for life, but the injections will get easier to administer as he gets older.": Life-long therapy is not required for children with isolated growth hormone deficiency; treatment usually ends at skeletal maturity rather than continuing indefinitely.

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Correct Answer is C

Explanation

Rationale:

B. "I understand that I will need to be careful when picking up my baby, I will need to pick her up by the head and bottom to protect her sternum.": Sternal precautions are critical to prevent strain on the healing sternum.

C. "I understand that it is important my baby continues to do tummy time once a day so her motor development does not suffer while in the hospital.": Tummy time after recent sternotomy can place pressure on the chest incision and stress the healing sternum, increasing risk of complications. It should be delayed until cleared by the surgical team.

D. "I understand that we will be in the hospital for a couple of weeks for treatment and monitoring post-op and then we will need close follow up with cardiology and the surgery team.": Post-op recovery often requires extended hospitalization and long-term follow-up to monitor cardiac function and surgical healing.

A. "Let your child know that (s)he should inform you when (s)he needs to have something done" B. "Children of this age need to learn to solve problems and assume more responsibility for themselves" C. "Just let your child know you are the parent, and that what you are doing is the right thing" D. "Continue to do what you have been doing for your child. Ten is too young for children to make any decisions for themselves”

Correct Answer is B

Explanation

Rationale:

A. "Let your child know that (s)he should inform you when (s)he needs to have something done": While communication is important, this response does not acknowledge the child’s developmental need for increasing independence, which is key at this age.

B. "Children of this age need to learn to solve problems and assume more responsibility for themselves": This response recognizes the developmental stage of a 10-year-old, who is beginning to seek autonomy and develop problem-solving skills, promoting healthy growth and self-confidence.

C. "Just let your child know you are the parent, and that what you are doing is the right thing": This authoritarian approach may undermine the child’s emerging independence and could damage the parent-child relationship.

D. "Continue to do what you have been doing for your child. Ten is too young for children to make any decisions for themselves": This dismisses the child’s developmental needs and may hinder their progress toward independence and self-management skills.

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A 10 year old boy is being started on growth hormone therapy for diagnosed growth hormone deficiency. The parents ask you if he will have to be on growth hormone injections for his whole life. The best response from the nurse is:

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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