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A child with a history of diabetes mellitus presents with sweating, confusion, and slurred speech. The nurse suspects the cause is:
- A. Hyperglycemia
- B. Hyperkalemia
- C. Hyponatremia
- D. Hypoglycemia
Correct Answer: D
Rationale: The correct answer is D: Hypoglycemia. In a child with a history of diabetes mellitus, sweating, confusion, and slurred speech indicate low blood sugar levels. Hypoglycemia can lead to neuroglycopenic symptoms like confusion and slurred speech. Hyperglycemia (choice A) would present with polyuria, polydipsia, and fruity breath. Hyperkalemia (choice B) can cause muscle weakness and cardiac arrhythmias. Hyponatremia (choice C) typically presents with weakness, fatigue, and confusion. In this case, the symptoms point towards hypoglycemia as the most likely cause.
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The nurse caring for an adolescent patient with a diagnosis of goiter knows that goiter is most often caused by?
- A. Kawasaki's disease
- B. Takayasu Disease
- C. Matsuzaki Disease
- D. Hashimoto Disease
Correct Answer: D
Rationale: The correct answer is D: Hashimoto Disease. Goiter is most commonly caused by Hashimoto Disease, which is an autoimmune condition where the body attacks the thyroid gland, leading to inflammation and enlargement of the gland. This results in the development of a goiter. Kawasaki's disease (A), Takayasu Disease (B), and Matsuzaki Disease (C) are not typically associated with the development of goiter. A summary of why the other choices are incorrect: A is a systemic vasculitis, B is a type of vasculitis involving the aorta and its main branches, and C is a fictional disease.
A 15-year-old with type 1 diabetes mellitus presents with a fever and 48-hour history of vomiting. As the nurse, you note the child's breath has a fruity odour, his breathing is deep and rapid, and mom states he has become less arousable. You recognize these are the signs of:
- A. Acute Hypoglycemia
- B. Diabetic Ketoacidosis
- C. Hyperglycemia
- D. Polydipsia
Correct Answer: B
Rationale: The correct answer is B: Diabetic Ketoacidosis (DKA). The fruity odor of breath, deep and rapid breathing (Kussmaul breathing), and altered mental status are classic signs of DKA. In DKA, the body produces excess ketones due to lack of insulin, leading to metabolic acidosis. Acute Hypoglycemia (A) presents with low blood sugar levels, not high as in DKA. Hyperglycemia (C) is a general term for high blood sugar without the specific ketone production seen in DKA. Polydipsia (D) refers to excessive thirst, not the symptoms described in the scenario.
Solumedrol 1.5mg/kg is ordered for a child weighing 74.8 pounds. Solumedrol is available as 125mg/2ml. How many ml must the nurse administer?
- A. 0.62ml
- B. 0.062ml
- C. 0.82ml
- D. 0.082ml
Correct Answer: C
Rationale: To calculate the dose of Solumedrol, first convert the child's weight to kg: 74.8 lbs / 2.2 = 34 kg. Then, calculate the dose: 1.5 mg/kg * 34 kg = 51 mg. Next, determine how many ml is needed: 51 mg / 125 mg/ml = 0.408 ml, which is rounded up to 0.82 ml. Choice A is incorrect because it is too low. Choice B is incorrect as it is much lower than the calculated dose. Choice D is incorrect as it is also too low.
A nurse is caring for a 2-year-old toddler. Which of the following food choices should the nurse recommend to promote independence in eating?
- A. Banana Slices
- B. Grapes
- C. Hot dog
- D. Popcorn
Correct Answer: A
Rationale: The correct answer is A: Banana Slices. Toddlers can easily pick up banana slices with their fingers, promoting independence in self-feeding. Bananas are soft and easy to chew, reducing the risk of choking compared to grapes, hot dogs, and popcorn, which are common choking hazards for young children. Grapes and hot dogs can easily get stuck in a toddler's throat due to their shape and texture. Popcorn is a choking hazard due to its hard and small size. Therefore, recommending banana slices is the safest and most developmentally appropriate choice for promoting independence in eating for a 2-year-old toddler.
Which of the following is a serious complication of acute rheumatic fever?
- A. Seizures
- B. Coronary aneurysms
- C. Pulmonary hypertension
- D. Cardiac valve damage
Correct Answer: D
Rationale: The correct answer is D: Cardiac valve damage. Acute rheumatic fever can lead to inflammation of the heart valves, causing damage and leading to conditions like mitral stenosis or regurgitation. This occurs due to an autoimmune response triggered by a previous streptococcal infection. Choice A, seizures, is not typically associated with acute rheumatic fever. Choice B, coronary aneurysms, is more commonly linked to conditions like Kawasaki disease. Choice C, pulmonary hypertension, is not a typical complication of acute rheumatic fever. Thus, the correct answer is D, as it aligns with the known pathophysiology of the disease.