Nokea
A 12-year-old girl has been diagnosed with insulin-dependent diabetes mellitus. Which of these principles would best guide her nutritional management?
- A. Concentrated sweets are taken during increased activity.
- B. Food restriction is imposed to reduce weight.
- C. Caloric distribution should be calculated to fit activity patterns.
- D. Fat requirements are increased owing to the possibility of ketoacidosis.
Correct Answer: C
Rationale: Concentrated sweets are eliminated from diet planning. Complex carbohydrates may be taken at the time of increased activity. Food restriction is not used for diabetic control of growing children. Caloric restriction may be imposed for weight control if necessary. Total caloric intake and proportions of basic nutrients should be consistent from day to day. Distribution of these calories should fit the activity pattern. Extra food is needed for increased activity. A balance of food, exercise, and insulin should be maintained. Because of the increased risk of atherosclerosis, the fat percentage of the total caloric intake is reduced.
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The nurse is assessing the client’s bowel sounds. Which finding indicates normal bowel sounds?
- A. Stronger than normal
- B. Hypoactive
- C. Normal
- D. Hyperactive
Correct Answer: C
Rationale: Normal bowel sounds are described as 'normal,' occurring every 5–20 seconds with a gurgling quality. Stronger than normal or hyperactive sounds suggest increased motility (e.g., diarrhea), while hypoactive sounds indicate reduced motility (e.g., ileus).
The doctor has ordered Ampicillin 100 mg every six hours IV push for an infant weighing 7 kg. The suggested dose for infants is 25-50 mg/kg/day in equally divided doses. The nurse should:
- A. Give the medication as ordered.
- B. Give half the amount ordered.
- C. Give the ordered amount q 12 hrs.
- D. Check the order with the doctor.
Correct Answer: D
Rationale: The ordered dose (100 mg q6h = 400 mg/day) for a 7 kg infant is 57.14 mg/kg/day, exceeding the recommended 25-50 mg/kg/day. The nurse should verify the order to prevent overdose.
Which of the following findings would necessitate discontinuing an IV potassium infusion in an adult with ketoacidosis?
- A. Urine output 22 mL/hr for 2 hours
- B. Serum potassium level of 3.7
- C. Small T wave of ECG
- D. Serum glucose level of 180
Correct Answer: A
Rationale: Adequate renal flow of 30 mL/hr is a necessity with potassium infusions because potassium is excreted renally. Because potassium level will decrease during correction of diabetic ketoacidosis, potassium will be infused even if plasma levels of potassium are normal. A small T wave is normal and desired on the electrocardiogram. A tall, peaked T-wave could indicate overinfusion of potassium and hyperkalemia. Glucose levels of <200 are desirable.
Which of the following is an expected finding in the assessment of a client with bulimia nervosa?
- A. Extreme weight loss
- B. Presence of lanugo over body
- C. Erosion of tooth enamel
- D. Muscle wasting
Correct Answer: C
Rationale: Bulimia nervosa involves recurrent binge eating followed by purging, often through vomiting, which exposes teeth to stomach acid, leading to enamel erosion. Extreme weight loss and lanugo are more characteristic of anorexia nervosa, and muscle wasting is not a primary feature of bulimia.
The nurse is teaching circumcision care to the mother of a newborn. Which statement indicates that the mother needs further teaching?
- A. I will apply a petroleum gauze to the area with each diaper change.
- B. I will clean the area carefully with each diaper change.
- C. I can place a heat lamp to the area to speed up the healing process.
- D. I should carefully observe the area for signs of infection.
Correct Answer: C
Rationale: Using a heat lamp is incorrect and could cause burns or delay healing. Petroleum gauze, cleaning, and monitoring for infection are appropriate circumcision care practices.