Nokea
An adolescent with insulin-dependent diabetes is being taught the importance of rotating the sites of insulin injections. The nurse should judge that the teaching was successful when the adolescent identifies which of the following as a result of using the same site?
- A. Unstruction of the fat tissue and poor absorption.
- B. Destruction of nerves and painful neuritis.
- C. Destruction of the tissue and too-rapid insulin uptake.
- D. Development of resistance to insulin and need for increased amounts.
Correct Answer: A
Rationale: Repeated injections at the same site cause lipodystrophy, leading to poor insulin absorption. Nerve damage, rapid uptake, or insulin resistance are not primary consequences.
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The nurse is assessing a neonate with suspected tracheoesophageal fistula. Which of the following findings would be most concerning?
- A. Excessive drooling.
- B. Mild cyanosis during feeding.
- C. Heart rate of 140 bpm.
- D. Temperature of 37°C.
Correct Answer: B
Rationale: Mild cyanosis during feeding indicates potential airway compromise, a critical concern in TEF.
A 16-month-old child diagnosed with Kawasaki disease (KD) is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. The nurse should do which of the following first?
- A. Apply lotion to the hands and feet.
- B. Offer foods the toddler likes.
- C. Place the toddler in a quiet environment.
- D. Encourage the parents to get some rest.
Correct Answer: C
Rationale: Irritability in Kawasaki disease is often due to discomfort and inflammation. A quiet environment reduces stimulation and promotes comfort, addressing the primary issue first.
A child with a nut allergy is admitted with a severe reaction for the third time in three months. The parent says, 'I am having trouble with the food labels.' The nurse should first:
- A. Assess the parent's ability to read.
- B. Refer the client to the dietician.
- C. Notify the primary care provider.
- D. Obtain a social service consult.
Correct Answer: B
Rationale: A dietician can provide expert guidance on reading labels to avoid allergens. Reading assessment, provider notification, or social services may follow but are not the priority.
An adolescent is to receive radioactive iodine for Graves' diseases. Which statement by the client reflects the need for more teaching?
- A. I plan to talk on Facebook since I have to keep several feet from my friends for 3 days.
- B. Taking radioactive iodine will not affect my ability to have children in the future.
- C. The advantage of radioactive iodine is that I will not need future medication for my disease.
- D. I should try to use a separate bathroom from the rest of my family for several days.
Correct Answer: C
Rationale: Radioactive iodine often leads to hypothyroidism, requiring lifelong thyroid hormone replacement. Options A, B, and D reflect correct understanding of radiation precautions and fertility.
Which of the following, if described by the parents of a child with cystic fibrosis (CF), indicates that the parents understand the underlying problem of the disease?
- A. An abnormality in the body's mucus-secreting glands.
- B. Formation of fibrous cysts in various body organs.
- C. Failure of the pancreatic ducts to develop properly.
- D. Addition to the formation of antibodies against streptococcus.
Correct Answer: A
Rationale: Cystic fibrosis is caused by an abnormality in mucus-secreting glands, leading to thick mucus that affects multiple organs, particularly the lungs and pancreas.