Nokea
A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?
- A. Always keep insulin vials refrigerated
- B. Increase the amount of insulin before exercise
- C. Ketones in the urine signify a need for less insulin
- D. Systematically rotate injection sites
Correct Answer: D
Rationale: The correct concept that should be reinforced in the teaching plan is to systematically rotate injection sites. Rotating injection sites helps prevent lipodystrophy - changes in fat tissue due to repeated injections in the same spot. This can ensure that the insulin is properly absorbed and prevent complications. It is important for the child and their family to understand the importance of rotating injection sites to maintain good insulin absorption and reduce the risk of complications.
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An infant with bladder exstrophy has had a continent urinary reservoir placed. Which discharge instruction should be included?
- A. Allow your child to sleep on the abdomen for comfort.
- B. Avoid contact with latex-containing surfaces (e.g., playgrounds with rubber) to prevent allergic reactions.
- C. Encourage a varied diet to prevent allergies.
- D. Provide brightly colored objects to stimulate development.
Correct Answer: B
Rationale: Children with urologic malformations are prone to latex allergies; parents should be advised to avoid latex exposure.
Although melanoma is relatively rare in children, some risk factors may increase its incidence. All the following are risk factors for development of melanoma EXCEPT
- A. positive family history of melanoma
- B. dark-skinned child
- C. hairy nevus
- D. dysplastic nevus
Correct Answer: B
Rationale: Dark-skinned individuals have a lower risk of melanoma.
Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
- A. Social isolation
- B. Level of stress
- C. Degree of depression
- D. Desire to punish others
Correct Answer: D
Rationale: The most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats is the desire to punish others. Individuals who commit suicide often exhibit behaviors or thought patterns indicating a desire to cause harm or guilt to others. This desire to punish others may drive them to take their own lives as a way to make others feel responsible or suffer the consequences of their actions. On the other hand, individuals who make suicidal attempts or threats may not have the same level of intent to harm others through their actions, and their motivations may stem from different underlying issues such as social isolation, stress, or depression. Therefore, the desire to punish others is a crucial factor that sets those who commit suicide apart from those who make attempts or threats.
A child with a poor nutritional status and weight loss is at risk for a negative nitrogen balance. To help diagnose this problem, the nurse in charge anticipates that the doctor will order which laboratory test?
- A. Total iron-binding capacity
- B. Hemoglobin
- C. Total protein
- D. Serum transferrin
Correct Answer: C
Rationale: Total protein is a laboratory test that is commonly ordered to assess the nutritional status of an individual. In the case of a child with poor nutritional status and weight loss, assessing the total protein levels can help in diagnosing a negative nitrogen balance. Total protein levels may decrease in individuals with inadequate protein intake, malnutrition, or negative nitrogen balance. Monitoring total protein levels can provide valuable information about the child's nutritional status and help guide further interventions to improve their overall health and well-being.
A mother is upset because her newborn has erythema toxicum neonatorum. What information should the nurse base the response to the mother?
- A. Easily treated
- B. Benign and transient
- C. Usually not contagious
- D. Usually not disfiguring
Correct Answer: B
Rationale: Erythema toxicum neonatorum is a common benign and transient rash that affects newborns. It typically appears in the first days of life and presents as red or pink blotches with small white or yellow papules in the center. The rash is not harmful, usually resolves on its own within a few days, and does not require treatment. Educating the mother that erythema toxicum neonatorum is a benign and transient condition can help alleviate her concerns and reassure her that it is a normal occurrence in newborns.