Nokea
Nana Esi is an 11-year-old girl diagnosed with type 1 diabetes mellitus (DM). She asks her attending nurse why she can't take a pill rather than shots like her grandmother does. Which of the following would be the nurse's best reply?
- A. If your blood glucose levels are controlled, you can switch to using pills.
- B. The pills correct fat and protein metabolism, not carbohydrate metabolism.
- C. Your body does not make insulin, so the insulin injections help to replace it.
- D. The pills work on the adult pancreas; you can switch when you are 18.
Correct Answer: C
Rationale: The nurse's best reply to Nana Esi is option C: 'Your body does not make insulin, so the insulin injections help to replace it.' In type 1 diabetes, the body's immune system destroys the insulin-producing beta cells in the pancreas. As a result, individuals with type 1 diabetes do not produce insulin, necessitating insulin injections for survival. Option A is incorrect as type 1 diabetes always requires insulin therapy. Option B is inaccurate as pills do not replace the function of insulin. Option D is also incorrect as there is no age restriction on using insulin therapy for type 1 diabetes.
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What comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect?
- A. He is always hungry.
- B. He tires out during feedings.
- C. He is fussy for several hours every day.
- D. He sleeps all the time.
Correct Answer: B
Rationale: Observing a 1-month-old tiring out during feedings should alert the nurse to the possibility of a congenital heart defect. This symptom may indicate that the infant is expending excess energy to compensate for a heart issue, leading to fatigue during feeding. Choices A, C, and D do not directly relate to a congenital heart defect. Being always hungry, fussy, or sleeping a lot are not specific signs of a congenital heart defect in a 1-month-old.
When working with a new adolescent patient, which greeting by the nurse indicates awareness of the needs of the adolescent client?
- A. I will talk with your parents first, and then you can tell me why you are here.
- B. Please let me know what your concerns are, and if you have any questions.
- C. Before we begin, I will need to know if you are sexually active.
- D. I will do the physical exam first, and then we will talk about your history.
Correct Answer: B
Rationale: The greeting 'Please let me know what your concerns are, and if you have any questions.' indicates awareness of the needs of the adolescent client. It encourages open communication, allows the adolescent to voice their concerns, and shows that their questions are welcomed and valued, fostering a trusting nurse-patient relationship. Choices A, C, and D do not prioritize the adolescent's perspective or promote open communication. Asking to talk to the parents first (Choice A) may hinder the adolescent's autonomy and trust. Inquiring about sexual activity (Choice C) may be necessary but should be approached with sensitivity and privacy. Doing the physical exam first (Choice D) before discussing the patient's history may not align with the adolescent's need for communication and understanding.
Based on the complaints provided by Madam KK, is the child exhibiting danger signs?
- A. Yes
- B. No
- C. I don't know
- D. Yes
Correct Answer: A
Rationale: Yes, the child is displaying danger signs with symptoms such as fever and rapid breathing, indicating a potential serious health issue that requires immediate attention. The correct answer is 'Yes' because the symptoms described in Madam KK's complaints align with danger signs that suggest a severe health problem. Choices B and C are incorrect because the symptoms mentioned clearly indicate the presence of danger signs. Choice D is a duplicate of choice A and does not provide a valid alternative.
In the Integrated Management of Neonatal and Childhood Illnesses, one of the things to look for is danger signs. Which of the following will you consider a danger sign in a child?
- A. The child vomits everything
- B. A child with diarrhea
- C. A child with headache
- D. All of the above
Correct Answer: A
Rationale: The correct answer is A: 'The child vomits everything.' Vomiting everything is considered a danger sign in a child as it can lead to dehydration and other serious complications. Recognizing this sign early can help in timely intervention and management of the child's condition. Choices B and C are incorrect as diarrhea and headache, while concerning, are not specific danger signs highlighted in the Integrated Management of Neonatal and Childhood Illnesses.
A child is being admitted to the hospital for probable pneumonia. The nurse asks what the parents have done at home for this illness. The parent comments that they have given the child a tea made up of herbs that a neighbor recommended. The parents ask if that is a safe thing to do. The most appropriate response for the nurse is:
- A. Sure, if it doesn't make the child worse, it could help.
- B. Of course, teas are rarely harmful.
- C. It might be safe for adults, but research might not have been conducted on the effects on children.
- D. Absolutely not, herbal teas are not appropriate for children.
Correct Answer: C
Rationale: The most appropriate response is C: 'It might be safe for adults, but research might not have been conducted on the effects on children.' This response acknowledges the potential differences in the effects of herbal teas on adults versus children and highlights the importance of considering the lack of specific research on this topic when it comes to pediatric care. Choice A is incorrect because assuming something is safe without evidence can be risky in a pediatric setting. Choice B is also incorrect as it oversimplifies the safety of herbal teas. Choice D is too definitive and does not consider the possibility that herbal teas might have different effects on children than on adults.