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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The mother of an 11-year-old girl confides to the nurse that her child has no interest in school activities, exercise, or even family outings. The most appropriate response by the nurse would be:
- A. I would recommend that she see a counselor at school.
- B. I would not worry; she will grow out of it.
- C. Many girls this age go through a time of malaise and disinterest.
- D. If she still feels the same way when you come back for the next well-child visit, I will recommend a therapist.
Correct Answer: A
Rationale: When a child shows a lack of interest in various activities, including school, exercise, and family outings, it is essential to address the underlying reasons. Recommending that the child see a counselor at school is crucial to explore potential issues and provide appropriate support and guidance. This approach can help identify any emotional, social, or behavioral concerns the child may be experiencing and facilitate early intervention and support. Choice B is incorrect because dismissing the mother's concerns and assuming the child will grow out of it without addressing the issue is not appropriate. Choice C is incorrect because while some children may go through phases of disinterest, it is essential to investigate further rather than generalizing. Choice D is incorrect because waiting until the next visit without taking proactive steps to address the current lack of interest may delay necessary support and intervention.
How can the nurse best assess that the parents demonstrate understanding of the dressing change procedure prior to discharge for their child with burns?
- A. The parents explaining the importance of using sterile technique to the nurse.
- B. The nurse observing the parents changing the dressing using appropriate technique.
- C. The parents observing the nurse changing the dressing and confirming their understanding of the procedure.
- D. The nurse allowing the parents to explain the dressing change procedure and perform it in private to boost their confidence.
Correct Answer: B
Rationale: The most effective way for the nurse to assess the parents' understanding of the dressing change procedure is by observing them as they change the dressing using the correct technique. This direct observation ensures that the parents are able to perform the task correctly and confidently before discharge. Merely verbalizing or explaining the procedure may not accurately reflect the parents' competency in performing the actual task. Choice A involves the parents explaining to the nurse, which does not directly assess their practical skills. Choice C suggests the parents observing the nurse, which does not evaluate the parents' ability to perform the task independently. Choice D focuses on boosting the parents' confidence but does not directly assess their understanding and competency in performing the dressing change.
The nurse is planning the care of a hospitalized 4-year-old. The most appropriate technique the nurse can use to reduce the stress of hospitalization for this child is to:
- A. Encourage the child to discuss their feelings.
- B. Encourage peer visitation.
- C. Encourage the child to play with safe medical equipment.
- D. Read a story to the child.
Correct Answer: C
Rationale: Encouraging the child to play with safe medical equipment is the most appropriate technique to reduce stress for a hospitalized child. This technique helps familiarize the child with medical equipment in a non-threatening way, empowering them to feel more in control of the environment. Options A, B, and D may be helpful but do not directly address the child's exposure and interaction with the hospital environment, making them less effective in reducing stress in this context.
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.
An infant with congestive heart failure is receiving diuretic therapy. A nurse is closely monitoring the intake and output. The nurse uses which most appropriate method to assess the urine output?
- A. Weighing the diapers
- B. Inserting a Foley catheter
- C. Comparing intake with output
- D. Measuring the amount of water added to formula
Correct Answer: A
Rationale: Weighing the diapers is the most appropriate method to assess urine output in infants. Diapers will absorb and retain urine, providing a measurable indicator of urine output without invasive procedures. This method is non-invasive, simple, and convenient for monitoring urine output, especially in infants who may not be able to use other urine output measurement techniques. Inserting a Foley catheter is invasive and not indicated for routine urine output monitoring in infants. Comparing intake with output does not directly measure urine output. Measuring the amount of water added to formula does not provide an accurate assessment of urine output.