Nokea
Tara 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 would be option C, "Your body does not make insulin, so the insulin injections help to replace it." This response directly addresses Tara's question about why she needs insulin injections instead of pills. In type 1 diabetes mellitus, the body's immune system mistakenly attacks the beta cells in the pancreas that produce insulin. As a result, individuals with type 1 DM do not produce insulin, so they require insulin injections to replace the missing hormone. Unlike type 2 diabetes where oral medications can be used to manage the condition, individuals with type 1 diabetes rely on insulin injections to regulate their blood glucose levels.
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What is the purpose of pursed lip breathing?
- A. Helps exhale less volume of air during expiration
- B. Increases expiration
- C. Promotes effective use of the diaphragm
- D. Relieves compensatory burden on upper thorax
Correct Answer: A
Rationale: Pursed lip breathing is a breathing technique commonly used to help improve breathing efficiency in individuals with respiratory conditions such as chronic obstructive pulmonary disease (COPD). By pursing the lips during exhalation, it creates back pressure that helps to keep the airways open longer. This results in slower and more controlled expiration, allowing the individual to exhale a smaller volume of air while maintaining adequate oxygen exchange. This can reduce the feeling of dyspnea (difficulty breathing) and help improve oxygen saturation levels in the blood.
An 11-month-old girl infant is found to have low weight and height consistent with FTT. She was exclusively breast feeding till the age of 4 month, and then artificial milk-formula was added. She has had a normal growth pattern till the age of 6 month when the mother introduced juices and cereals. Examination is unremarkable apart from significant decline of normal growth pattern. Of the following, the MOST likely cause is
- A. failed breast feeding
- B. improper formula preparation
- C. congenital syndromes
- D. congenital infections
Correct Answer: B
Rationale: Improper formula preparation can lead to inadequate nutrition, causing FTT. This scenario suggests a dietary issue rather than congenital or infectious causes.
Which of the ff nursing interventions may reduce hemostasis and decrease the potential for thrombophlebitis for a client with a neurologic disorder?
- A. Remove and reapply elastic stockings
- B. Keep extremities at neutral position
- C. Change the clients position
- D. Use a flotation mattress NEUROMUSCULAR DISORDERS
Correct Answer: B
Rationale: Keeping the extremities at a neutral position for a client with a neurologic disorder can help reduce hemostasis and decrease the potential for thrombophlebitis. This positioning helps maintain proper blood flow and prevents excessive pressure on the veins, which can lead to blood clots. Removing and reapplying elastic stockings, changing the client's position, and using a flotation mattress may have their own benefits, but in this case, keeping the extremities at a neutral position is the most direct and effective intervention to address the issue of hemostasis and thrombophlebitis for a client with a neurologic disorder.
Three days after admission Ms. CC continued to have frequent stools. Her oral intake of both fluids and solids are poor. Her physician ordered parenteral hyperalimentation. Hyperalimentation solutions are:
- A. Hypotonic solutions used primarily to increase osmotic pressure of blood plasma
- B. Hypertonic solutions used primarily for hydration when hemoconcentration is present
- C. Alkalizing solutions used to treat metabolic acidosis thus reducing cellular sweating
- D. Hyperosmolar solutions used primarily to reverse negative nitrogen balance
Correct Answer: D
Rationale: Hyperalimentation solutions are hypertonic or hyperosmolar solutions used to provide complete nutrition intravenously when a patient is unable to receive adequate nutrition orally. These solutions contain a high concentration of glucose, amino acids, electrolytes, and essential vitamins and minerals. They are used to reverse negative nitrogen balance, provide adequate caloric intake, and promote healing and recovery in patients who are unable to eat or absorb nutrients properly. Hyperalimentation solutions are not used to increase the osmotic pressure of blood plasma (Choice A), for hydration when hemoconcentration is present (Choice B), or to treat metabolic acidosis (Choice C).
After receiving an immunization for pediatric diphtheria, tetanus, and acellular pertussis (DTaP), a patient develops swelling and tenderness at the injection site, a low-grade fever, and malaise. The pediatric nurse informs the patient's parents that:
- A. they should delay future immunizations until the patient sees an allergist.
- B. this is a mild reaction, and teaches them how to manage it.
- C. this is an appropriate reaction, and instructs them to do nothing.
- D. none of the above.
Correct Answer: B
Rationale: Mild reactions like swelling, tenderness, low-grade fever, and malaise are common after DTaP vaccination and can be managed with supportive care.