Nokea
A 9-year-old child is newly diagnosed with type 1 diabetes mellitus. The nurse is planning for home care with the child and the family and determines that which is an age-appropriate activity for health maintenance?
- A. Administering insulin drawn up by an adult
- B. Self-administering insulin with adult supervision
- C. Making independent decisions with regard to sliding-scale coverage of insulin
- D. Having an adult assist in the self-administration of insulin and glucose monitoring
Correct Answer: B
Rationale: School-age children have the cognitive and motor skills to draw up and administer insulin with adult supervision. Developmentally, they do not yet have the maturity to make independent decisions such as about sliding-scale coverage without adult validation. Options requiring adult to manage insulin administration and glucose monitoring suppress the maximum level of independence appropriate to the level of this child.
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The nurse is teaching a client with a new diagnosis of type 2 diabetes about foot care. Which of the following instructions should be included? Select all that apply.
- A. Inspect feet daily for cuts or sores.
- B. Wear well-fitting shoes.
- C. Soak feet in hot water daily.
- D. Apply lotion between the toes.
- E. Trim toenails straight across.
Correct Answer: A, B, E
Rationale: Daily inspection, well-fitting shoes, and straight toenail trimming prevent complications. Hot water and lotion between toes increase infection risk.
The nurse is caring for a client with a history of chronic bronchitis who is prescribed theophylline (Theo-Dur). Which of the following symptoms indicates theophylline toxicity?
- A. Bradycardia.
- B. Tachycardia.
- C. Hypotension.
- D. Weight loss.
Correct Answer: B
Rationale: Tachycardia is a sign of theophylline toxicity, indicating the need for immediate medical evaluation.
The nurse is caring for a client with a ventricular shunt for hydrocephalus. Which finding requires immediate reporting?
- A. Clear drainage from the incision
- B. Mild headache
- C. Temperature of 98.6°F (37°C)
- D. Pupils equal and reactive
Correct Answer: A
Rationale: Clear drainage from a shunt incision may indicate cerebrospinal fluid leakage, a serious complication requiring immediate reporting.
A 24-year-old nulligravid client with a history of irregular menstrual cycles visits the clinic because she suspects that she is 'about 6 weeks pregnant.' An ultrasound is scheduled in 2 weeks. The nurse should instruct the client that this test will be done to:
- A. Assess gestational age.
- B. Determine a multifetal pregnancy.
- C. Identify the gender of the fetus.
- D. Assess of maternal pelvic adequacy.
Correct Answer: A
Rationale: An early ultrasound at around 8 weeks is primarily used to confirm gestational age and viability.
The nurse reviews the serum laboratory results for a client prescribed hydrochlorothiazide. Which most frequent side effect of this medication should the nurse specifically monitor for?
- A. Hypokalemia
- B. Hypocalcemia
- C. Hypernatremia
- D. Hyperphosphatemia
Correct Answer: A
Rationale: The client taking a potassium-losing diuretic must be monitored for decreased potassium levels. Other fluid and electrolyte imbalances that occur with the use of this medication include hyponatremia, hypercalcemia, hypomagnesemia, and hypophosphatemia.