Nokea
A child receives a combination of regular and NPH insulin at 8:00 AM. At 8:45 AM the breakfast trays have not yet arrived from the kitchen. What is the best action by the nurse?
- A. Notify the charge nurse.
- B. Give the patient a snack of graham crackers and milk.
- C. Ambulate the patient in the hall for a short time.
- D. Give the patient more insulin according to the sliding scale.
Correct Answer: B
Rationale: A child who receives regular insulin before meals may have an insulin reaction if food is not eaten within 20 minutes. A snack of graham crackers and milk will prevent an episode of hypoglycemia.
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After a closed head injury, the unconscious 10-year-old child begins to excrete copious amounts of pale urine with an attendant drop in blood pressure (BP). Based on these symptoms, what does the nurse suspect has developed?
- A. Diabetes insipidus
- B. Diabetes mellitus
- C. Hypothyroidism
- D. Hyperthyroidism
Correct Answer: A
Rationale: Diabetes insipidus, often triggered by head injury, causes copious urine output and can lead to dehydration and low BP.
What condition does the nurse suspect when a child with type 1 diabetes mellitus has hyperglycemia, diaphoresis, and headaches in the morning?
- A. Dawn phenomenon
- B. Somogyi phenomenon
- C. Honeymoon effect
- D. Ketoacidosis
Correct Answer: B
Rationale: The Somogyi phenomenon involves rebound hyperglycemia due to low blood glucose triggering counter-regulatory hormones.
Which process(es) does the nurse explain the endocrine system is primarily responsible for controlling? (Select all that apply.)
- A. Maturation
- B. Reproduction
- C. Stress response
- D. Sexual identity
- E. Growth
Correct Answer: A,B,C,E
Rationale: The endocrine system governs maturation, reproduction, stress response, and growth, but not sexual identity.
What does the nurse remind the adolescent with diabetes that soluble fiber in the diet can reduce? (Select all that apply.)
- A. Blood glucose
- B. Serum cholesterol
- C. Incidence of infections
- D. Absorption of sugar
- E. Insulin requirements
Correct Answer: A,B,D,E
Rationale: Soluble fiber can reduce blood glucose, serum cholesterol, sugar absorption, and insulin requirements.
The nurse is preparing to administer a long-acting insulin. Which insulin is considered long acting?
- A. Lispro
- B. Aspart
- C. Glargine
- D. Regular
Correct Answer: C
Rationale: Insulin glargine is a long-acting insulin, unlike Lispro, Aspart, and Regular which are rapid or short-acting.