Nokea
A nurse is teaching an 8-year-old with diabetes and her parents about managing diabetes during illness. The nurse determines the parents understand the instruction when they indicate that, when the child is ill, they will provide:
- A. More calories.
- B. More insulin.
- C. Less insulin.
- D. Less protein and fat.
Correct Answer: B
Rationale: Illness increases insulin resistance, often requiring more insulin to manage elevated blood glucose. Calorie, protein, or fat adjustments are secondary to insulin needs.
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The nurse is evaluating a child’s skills in self-administering insulin (see fi gure). The nurse should:
- A. Have the child use both hands on the syringe.
- B. Ask the child to place the needle at a 45 degreeangle
- C. Tell the child to use a site lower on her thigh.
- D. Remind the child to rotate sites.
Correct Answer: D
Rationale: The child is using correct injection technique, and the nurse can remind the child to rotate sites. The nurse should also reinforce that the child has used correct technique and praise the child for doing so. If the child can manipulate the plunger of the syringe with one hand, this is appropriate. Insulin is administered at a 90 degree angle as shown. The child should identify appropriate sites on the thighs as one handbreadth below the hip and above the knee; the child is using appropriate sites.
The parent of an 18-year-old with chronic renal disease states, "My son has so many problems. I'm really worried that he will not get the right care if he gets sick at college." The nurse should tell the parent:
- A. I can have his records sent to the school's health center.
- B. Make sure your son always carries his nephrologist's phone number.
- C. Your son can make an e-health history to facilitate his care if he gets sick away from home.
- D. Your son is going to need to learn to manage his own disease.
Correct Answer: D
Rationale: Promoting self-management is key.
A mother brings her 18-month-old to the clinic because the child 'eats ashes, crayons, and paper.' Which of the following information about the toddler should the nurse assess first?
- A. Evidence of eruption of large teeth.
- B. Amount of attention from the mother.
- C. Any changes in the home environment.
- D. Intake of a soft, low-roughage diet.
Correct Answer: C
Rationale: Changes in the home environment may contribute to pica, which requires immediate assessment.
After reading the vaccine information sheets, the parent of a 2-month-old infant is hesitant to consent to the recommended vaccinations. The nurse should first ask the parent:
- A. Did you know that vaccinations are required by law for school entry?
- B. What personal beliefs or safety concerns do you have about vaccinations?
- C. Would you prefer that fewer vaccines are given at a time?
- D. Can you please sign this vaccine waiver form?
Correct Answer: B
Rationale: Addressing the parent's specific concerns fosters trust and encourages informed decision-making.
A 12-year-old with cystic fibrosis is being treated in the hospital for pneumonia. The physician is calling in a telephone order for ampicillin. The nurse should do which of the following? Select all that apply.
- A. Ask the unit clerk to listen on the speaker phone with the nurse and write down the order.
- B. Ask the physician to come to the hospital and write the order.
- C. Repeat the order to the physician.
- D. Ask the physician to confirm that the order is correct as understood by the nurse.
- E. Ask the nursing supervisor to cosign the telephone order as transcribed by the nurse.
Correct Answer: C,D
Rationale: Repeating the order to the physician and asking for confirmation ensures accuracy and safety in transcribing the telephone order for ampicillin.