Nokea
A 14-year-old is using glargine (Lantus) and lispro (Humolog) to manage type I diabetes. The order for sliding scale lispro reads: Lispro subcutaneous give units according to sliding scale: Blood glucose: 70-150 mg/dL = 0 units, 151-200 mg/dL = 1 unit, 201-250 mg/dL = 2 units, 251-300 mg/dL = 3 units, 301-350 mg/dL = 4 units, Call for Blood glucose >350. In addition give 1 unit for every 15 grams of carbohydrate. The morning blood glucose is $202 \mathrm{mg} / \mathrm{dL}$ and the client is going to eat 2 carbohydrate exchanges. The nurse has the client administer how many units of lispro?
Correct Answer: 4
Rationale: Blood glucose of 202 mg/dL requires 2 units (sliding scale). Two carbohydrate exchanges (30 g) require 2 units (1 unit/15 g). Total: 2 + 2 = 4 units of lispro.
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The parents of a child tell the nurse that they feel guilty because their child almost drowned. Which of the following remarks by the nurse would be most appropriate?
- A. I can understand why you feel guilty, but these things happen.'
- B. Tell me a little bit more about your feelings of guilt.'
- C. You should not have taken your eyes off of your child.'
- D. You really shouldn't feel guilty; you're lucky because your child will be all right.'
Correct Answer: B
Rationale: Encouraging parents to express their feelings facilitates therapeutic communication and supports emotional processing.
The parents of a child with a tracheoesophageal fistula express feelings of guilt about their baby's anomaly. Which of the following approaches by the nurse would best support the parents?
- A. Helping the parents accept their feelings as a normal reaction.
- B. Explaining that the parents did nothing to cause the newborn's defect.
- C. Encouraging the parents to concentrate on planning their baby's care.
- D. Urging the parents to visit their newborn as often as possible.
Correct Answer: A
Rationale: Acknowledging and normalizing the parents' guilt helps them process emotions and supports coping.
The nurse is caring for a 2-year-old with iron deficiency anemia. Which laboratory finding would the nurse expect to see?
- A. Elevated hemoglobin levels.
- B. Decreased mean corpuscular volume (MCV).
- C. Increased serum ferritin levels.
- D. Elevated white blood cell count.
Correct Answer: B
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When preparing to deliver back slaps to an infant who is choking on a foreign body, in which of the following positions should the nurse position the infant?
- A. Head down and lower than the trunk.
- B. Head up and raised above the trunk.
- C. Head to one side and even with the trunk.
- D. Head parallel to the nurse and supported at the buttocks.
Correct Answer: A
Rationale: Positioning the infant head down and lower than the trunk facilitates dislodgement of the foreign body by gravity during back slaps.
A 6-month-old child is discharged with a urinary stent after a procedure to repair a hypospadias. The nurse should tell the parents to:
- A. Avoid tub baths until the stent is removed.
- B. Measure output in the urinary bag.
- C. Avoid drinking fruit juice.
- D. Clean the tip of the penis 3 times a day with soap and water.
Correct Answer: A
Rationale: Avoiding tub baths prevents infection.