Nokea
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.
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What does the nurse remind the adolescent with diabetes that soluble fiber in the diet can reduce? (Select all that apply.)
- A. Blood glucose
- B. Serum cholesterol
- C. Incidence of infections
- D. Absorption of sugar
- E. Insulin requirements
Correct Answer: A,B,D,E
Rationale: Soluble fiber can reduce blood glucose, serum cholesterol, sugar absorption, and insulin requirements.
A child with diabetes is brought to the emergency department. He is flushed and drowsy, and his skin is dry. His father states that the child has been feeling progressively worse since the morning. What is this child most likely experiencing?
- A. Somogyi phenomenon
- B. Dawn syndrome
- C. Ketoacidosis
- D. Water intoxication
Correct Answer: C
Rationale: In ketoacidosis, the child's skin is dry, the face is flushed, and the breath has a fruity odor, indicating a serious complication of diabetes.
A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The nurse recognizes these signs are characteristic of what?
- A. Hypothyroidism
- B. Hyperthyroidism
- C. Type 1 diabetes mellitus
- D. Tay-Sachs disease
Correct Answer: A
Rationale: The infant with hypothyroidism appears sluggish with an enlarged tongue, causing noisy respiration.
A child receives a combination of regular and NPH insulin at 8:00 AM. At 8:45 AM the breakfast trays have not yet arrived from the kitchen. What is the best action by the nurse?
- A. Notify the charge nurse.
- B. Give the patient a snack of graham crackers and milk.
- C. Ambulate the patient in the hall for a short time.
- D. Give the patient more insulin according to the sliding scale.
Correct Answer: B
Rationale: A child who receives regular insulin before meals may have an insulin reaction if food is not eaten within 20 minutes. A snack of graham crackers and milk will prevent an episode of hypoglycemia.
Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise?
- A. I carry a piece of hard candy with me in case I start to feel shaky.'
- B. I make sure I have emergency money when I have soccer practice or a game.'
- C. Sometimes I skip my breakfast when I have a game in the morning.'
- D. I play in soccer games that are scheduled after dinner.'
Correct Answer: C
Rationale: Skipping a meal before exercise increases the risk of hypoglycemia in a child with type 1 diabetes mellitus.