Nokea
A child with diabetes mellitus is observed to have cold symptoms. What signs and symptoms will alert parents of the possibility of ketoacidosis? (Select all that apply.)
- A. Chest congestion
- B. Ear pain
- C. Fruity breath
- D. Hyperactivity
- E. Nausea
Correct Answer: C,E
Rationale: Fruity breath and nausea are key indicators of ketoacidosis in a diabetic child.
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What would be the most appropriate nursing response to a woman who says, 'My sister had a child with Tay-Sachs disease, and I want to know if I could have a child with this condition'?
- A. The disease is rare. It is unlikely that you would have a child with Tay-Sachs disease.'
- B. A screening test can be done to determine if you are a carrier of the gene.'
- C. The gene for Tay-Sachs disease is transmitted by the father.'
- D. The cause of Tay-Sachs disease is thought to be an autoimmune response to a virus.'
Correct Answer: B
Rationale: Carriers of Tay-Sachs disease can be identified by screening tests, given its autosomal recessive inheritance.
A child with diabetes is brought to the emergency department. He is flushed and drowsy, and his skin is dry. His father states that the child has been feeling progressively worse since the morning. What is this child most likely experiencing?
- A. Somogyi phenomenon
- B. Dawn syndrome
- C. Ketoacidosis
- D. Water intoxication
Correct Answer: C
Rationale: In ketoacidosis, the child's skin is dry, the face is flushed, and the breath has a fruity odor, indicating a serious complication of diabetes.
What does the nurse instruct a 12-year-old to do when teaching how to administer insulin?
- A. Make sure injection sites are 6 inches apart.
- B. Select an injection site that was recently exercised.
- C. Inject the needle at a 90-degree angle.
- D. Give the injection deep into the muscle.
Correct Answer: C
Rationale: Children often find it easier to inject insulin at a 90-degree angle for proper administration.
The nurse explains that the diagnosis of diabetes is made when the fasting blood glucose level is mg/dL on two separate occasions, and the history is positive for indication of the disease.
Correct Answer: 126
Rationale: A fasting blood glucose level of 126 mg/dL on two separate occasions, with a positive history, confirms diabetes.
What statement by a parent leads the nurse to determine a parent is administering levothyroxine (Synthroid) correctly?
- A. I stopped giving the medication because my daughter was losing her hair.'
- B. I am using a different brand now because it costs less money.'
- C. I don't give the medication on the weekends.'
- D. I give the medication at 8:00 AM every day.'
Correct Answer: D
Rationale: Synthroid should be given at the same time each day, preferably in the morning, for consistent therapeutic effect.