Nokea
The home health nurse is monitoring an 8-month-old child with hypothyroidism taking levothyroxine (Synthroid). Which symptoms does the nurse recognize as signs of overdose? (Select all that apply.)
- A. Tachycardia
- B. Irritability
- C. Vomiting
- D. Weight gain
- E. Diaphoresis
Correct Answer: A,B,E
Rationale: Tachycardia, irritability, and diaphoresis are signs of levothyroxine overdose, while weight gain and vomiting are not.
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What condition does the nurse suspect when a child with type 1 diabetes mellitus has hyperglycemia, diaphoresis, and headaches in the morning?
- A. Dawn phenomenon
- B. Somogyi phenomenon
- C. Honeymoon effect
- D. Ketoacidosis
Correct Answer: B
Rationale: The Somogyi phenomenon involves rebound hyperglycemia due to low blood glucose triggering counter-regulatory hormones.
Which general dietary measure should the nurse include in a teaching plan for the child with type 1 diabetes mellitus?
- A. Control intake of carbohydrates and consume fewer calories.
- B. Focus on complex carbohydrates and eat foods high in fiber.
- C. Obtain most calories from proteins and fats.
- D. Eat a diet low in fat and low in complex carbohydrates.
Correct Answer: B
Rationale: The nutritional needs of a child with diabetes mellitus focus on complex carbohydrates and high-fiber foods to help manage blood glucose levels.
What makes keeping diabetes in control in an adolescent difficult? (Select all that apply.)
- A. Hormonal changes
- B. Developmental conflicts
- C. Preference for fast food
- D. Growth spurts
- E. Knowledge of disease
Correct Answer: A,B,C,D
Rationale: Hormonal changes, developmental conflicts, fast food preferences, and growth spurts complicate diabetes management in adolescents.
What is an important consideration for the school-age child taking DDAVP for diabetes insipidus?
- A. Observe for signs of water deprivation.
- B. Restrict his physical education program.
- C. Arrange for the child to use the bathroom when needed.
- D. Limit fluid intake other than during the lunch period.
Correct Answer: C
Rationale: The child with diabetes insipidus needs liberal access to bathrooms due to frequent urination.
What occurs as a result of an inadequate secretion of insulin?
- A. Protein synthesis is increased.
- B. Increased fat breakdown leads to ketonemia.
- C. Serum glucose levels are markedly decreased.
- D. More rapid conversion and storage of carbohydrates to glucose occurs.
Correct Answer: B
Rationale: When insulin is deficient, the body cannot metabolize carbohydrates for energy, leading to increased fat breakdown and ketonemia.