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Justine is admitted to the pediatric unit due to the occurrence of diabetic ketoacidosis signaling a new diagnosis of diabetes. The diabetes team explores the cause of the episode and takes steps to prevent a recurrence. Diabetic ketoacidosis (DKA) results from an excessive accumulation of which of the following?
- A. Sodium bicarbonate from renal compensation
- B. Potassium from cell death
- C. Glucose from carbohydrate metabolism
- D. Ketone bodies from fat metabolism
Correct Answer: D
Rationale: Diabetic ketoacidosis (DKA) results from the excessive accumulation of ketone bodies from fat metabolism. During DKA, there is a lack of insulin leading to the breakdown of fat stores into fatty acids and their subsequent conversion into ketone bodies. These ketone bodies accumulate in the blood, leading to metabolic acidosis and the characteristic symptoms of DKA.
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Which of the following are not infectious causes of diarrhea?
- A. Allergy
- B. Bacteria
- C. Parasite
- D. Virus
Correct Answer: A
Rationale: Diarrhea can be caused by various infectious agents such as bacteria, parasites, and viruses. Allergy, on the other hand, is a non-infectious cause of diarrhea. When an individual with a food allergy consumes the specific food they are allergic to, it can trigger diarrhea as a part of the allergic reaction.
Madam Esinam, a 45-year-old trader at the Kotokuraba community market, has brought her 8-year-old daughter Bubunyo to the clinic where you are working. According to her, Bubunyo eats very well but looks like her 5-year-old brother in terms of stature. What investigation would you request to give a definitive diagnosis of Bubunyo's condition?
- A. Renal and Liver function test
- B. Pancreatic function test
- C. Sedimentation rate (ESR)
- D. Growth hormone assessment
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares a discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?
- A. Always store insulin vials in the refrigerator
- B. Adjust insulin dosage before exercise
- C. Presence of ketones in urine indicates a need for less insulin
- D. Systematically rotate injection sites
Correct Answer: D
Rationale: Systematically rotating injection sites is crucial to prevent tissue damage and ensure optimal insulin absorption. This practice helps in preventing lipohypertrophy, a condition characterized by fat accumulation at injection sites, which can affect insulin absorption and lead to inconsistent blood glucose control. By rotating injection sites, the risk of skin and tissue damage is minimized, and insulin's effectiveness is maintained over time.
In the pediatric ward at Nyamebekyere teaching hospital, when should oxygen be applied to children?
- A. Central cyanosis
- B. Respiratory rate >70 breaths per minute
- C. Grunting noted on assessment
- D. All of the above
Correct Answer: D
Rationale: All the listed conditions, central cyanosis, respiratory rate >70 breaths per minute, and grunting on assessment, are indicative of the need for oxygen therapy. Central cyanosis suggests severe hypoxemia, a respiratory rate >70 breaths per minute can indicate respiratory distress, and grunting is a sign of increased work of breathing. Administering oxygen in these situations can help improve oxygenation and support the child's respiratory function, making option D the correct choice.
The parents of a child hospitalized with asthma who is recovering and is being prepared for discharge are receiving home care instructions from the nurse. Which statement by a parent indicates a need for further instruction?
- A. Coughing spells may be triggered by dust or smoke
- B. Vomiting may occur when our child has coughing episodes
- C. We need to encourage our child to drink fluids
- D. We need to maintain droplet precautions and a quiet environment for at least 2 weeks
Correct Answer: D
Rationale: The statement 'We need to maintain droplet precautions and a quiet environment for at least 2 weeks' indicates a need for further instruction. Asthma management does not typically require maintaining droplet precautions. The focus should be on environmental control, medication adherence, and monitoring symptoms rather than droplet precautions, which are more relevant for contagious respiratory infections.