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After 6 months of treatment with diet and exercise, a 12-year-old with type 2 diabetes still has a fasting blood glucose level of 140 mg/dL. The primary care provider has decided to begin metformin (Glucophage). The adolescent asks how the medication works. The nurse should tell the client that the medicine decreases the glucose production and:
- A. Replaces natural insulin.
- B. Helps the body make more insulin.
- C. Increases insulin sensitivity.
- D. Decreases carbohydrate adsorption.
Correct Answer: C
Rationale: Metformin reduces hepatic glucose production and increases insulin sensitivity in peripheral tissues, improving glucose uptake. It does not replace insulin, stimulate insulin production, or affect carbohydrate absorption.
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The nurse identifies a nursing diagnosis of Risk for perioperative-positioning injury related to the surgical procedure for a school-age child scheduled for a tonsillectomy. Which of the following is an expected outcome for this nursing diagnosis?
- A. The child is able to tell about the surgery and recovery.
- B. The child remains on nothing-by-mouth (NPO) status for the designated preoperative period.
- C. The child and family demonstrate an understanding of the procedure.
- D. The child knows the parents will not leave.
Correct Answer: B
Rationale: The most appropriate outcome for a nursing diagnosis of Risk for perioperative-positioning injury related to the surgical procedure should be that the child remains NPO for the designated period of time before surgery, thereby minimizing the risk of aspiration during the surgery. Ability to tell about the surgery and demonstrating an understanding of the procedure are appropriate outcomes for a nursing diagnosis of Deficient knowledge. Knowing that the parents will not leave is associated with a nursing diagnosis of Anxiety or Fear related to separation from support systems or an unfamiliar environment.
Which of the following meals would be most appropriate for a 15-year-old with glomerulonephritis with severe hypertension?
- A. Egg noodles, hamburger, canned peas, milk.
- B. Baked ham, baked potato, pear, canned carrots, milk.
- C. Baked chicken, rice, beans, orange juice.
- D. Hot dog on a bun, corn chips, pickle, cookie, milk.
Correct Answer: C
Rationale: Low-sodium diet is recommended.
The mother tells the nurse she will be afraid to allow her child with hemophilia to participate in sports because of the danger of injury and bleeding. After explaining that physical fitness is important for children with hemophilia, which of the following activities should the nurse suggest as ideal?
- A. Snow skiing.
- B. Swimming.
- C. Basketball.
- D. Gymnastics.
Correct Answer: B
Rationale: Swimming is low-impact and safe, minimizing bleeding risk in hemophilia. Other sports pose higher injury risks.
The parents of a 12-year-old girl ask why their non-sexually active daughter should receive the human papillomavirus (HPV) vaccine. The nurse should tell the parents:
- A. The vaccine is most effective against cervical cancer if given before becoming sexually active.
- B. Parents are never sure when their child might become sexually active.
- C. HPV is most common in teens and women in their late twenties.
- D. If your daughter is sexually assaulted, she may be exposed to HPV.
Correct Answer: A
Rationale: The HPV vaccine is most effective when given before potential exposure to the virus.
The toddler with nephrotic syndrome exhibits generalized edema. Which of the following measures should the nurse institute for this child with a nursing diagnosis of Impaired skin integrity related to edema?
- A. Ambulate every shift while awake.
- B. Apply lotion on opposing skin surfaces.
- C. Apply powder to skinfolds.
- D. Separate opposing skin surfaces with soft cloth.
Correct Answer: D
Rationale: Prevent skin breakdown.