Peds chap. 31 bank Q&A

33. The nurse explains that the diagnosis of diabetes is made when the fasting blood glucose level is _______ mg/dL on two separate occasions, and the history is positive for indication of the disease

ANS: 126

34. The nurse assessing a glycosylated hemoglobin (HbA1c) test is aware that this test can evaluate average glucose levels over a period of _____ to _____ months.

ANS: 3; 4

32. The nurse reminds the parents of a diabetic with an insulin pump that the tubing of the pump should be changed aseptically every ______ hours.

ANS: 48

35. Long-acting types of insulin are seldom given to children because of the danger of ___________________ during sleep.

ANS: hypoglycemia

7. Which statement made by a 7-year-old child with type 1 diabetes mellitus indicates a need for more teaching?

a. "My pancreas is sick and needs insulin until it is well."

31. The nurse is discussing insulin shock with parents of a child recently diagnosed with diabetes mellitus. What will the nurse respond when the parents ask why children are more prone to insulin reactions? (Select all that apply.)

a. "The condition is more unstable in children." b. "Parents are often noncompliant." c. "The activities are irregular." d. "They are still growing." e. "Sleep patterns are not established." ANS: A, C, D

20. The nurse discussed treatment of hypoglycemia with an adolescent. Which statement by the adolescent leads the nurse to determine the patient understood the instructions?

a. "When my blood glucose is low or if I begin to feel hungry and weak, I will eat six LifeSavers."

24. When discussing possible causes of diabetes in children, the nurse mentions chromosomal defects. Which chromosomes are associated with diabetes? (Select all that apply.)

a. 6 b. 7 c. 12 d. 20 e. 21 ANS: A, B, C, D

26. 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 ANS: A, B, D, E

30. A child with diabetes mellitus is observed to have cold symptoms. What signs and symptoms will alert parents of the possibility of ketoacidosis? (Select all that apply.)

a. Chest congestion b. Ear pain c. Fruity breath d. Hyperactivity e. Nausea ANS: C, E

16. After a closed head injury, the unconscious 10-year-old child begins to excrete copious amounts of pale urine with an attendant drop in blood pressure (BP). Based on these symptoms, what does the nurse suspect has developed?

a. Diabetes insipidus

12. Which laboratory result indicates good metabolic control for a child with type 1 diabetes mellitus?

a. Glycosylated hemoglobin value of 8%

29. 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 ANS: A, B, C, D

10. 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

27. Which process(es) does the nurse explain the endocrine system is primarily responsible for controlling? (Select all that apply.)

a. Maturation b. Reproduction c. Stress response d. Sexual identity e. Growth ANS: A, B, C, E

25. Which food sources are high in soluble fiber? (Select all that apply.)

a. Raw fruits b. Cooked vegetables c. Beans d. Lean meat e. Bran cereal ANS: A, C, E

28. 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 ANS: A, B, E

3. On what understanding does the nurse plan the care of a child with a new diagnosis of type 1 diabetes mellitus?

a. There is an absolute deficiency of insulin.

1. A nurse is planning to teach a family about Tay-Sachs disease. What will the nurse relay about the pattern of inheritance for inborn errors of metabolism?

a. They are usually autosomal recessive.

14. What would be the most appropriate nursing response to a woman who says, "My sister had a child with Tay-Sachs disease, and I want to know if I could have a child with this condition"?

b. "A screening test can be done to determine if you are a carrier of the gene."

8. Which general dietary measure should the nurse include in a teaching plan for the child with type 1 diabetes mellitus?

b. Focus on complex carbohydrates and eat foods high in fiber.

4. 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?

b. Give the patient a snack of graham crackers and milk.

2. What occurs as a result of an inadequate secretion of insulin?

b. Increased fat breakdown leads to ketonemia.

22. What is the function of an insulin pump?

b. Provides continuous infusion of insulin

13. What condition does the nurse suspect when a child with type 1 diabetes mellitus has hyperglycemia, diaphoresis, and headaches in the morning?

b. Somogyi phenomenon

18. The parents of a child newly diagnosed with diabetes mellitus tell the nurse, "Our son's body is resistant to insulin." With what does the nurse recognize this description is consistent?

b. Type 2, non-insulin-dependent diabetes mellitus

6. Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise?

c. "Sometimes I skip my breakfast when I have a game in the morning."

11. What is an important consideration for the school-age child taking DDAVP for diabetes insipidus?

c. Arrange for the child to use the bathroom when needed.

5. Although the child with type 1 diabetes had her prescribed insulin at 7:30 AM, the child is complaining of hunger and thirst and is drowsy at 10:30 AM. What should the nurse do first?

c. Give her a cup of orange juice.

23. The nurse is preparing to administer a long-acting insulin. Which insulin is considered long acting?

c. Glargine

19. What does the nurse instruct a 12-year-old to do when teaching how to administer insulin?

c. Inject the needle at a 90-degree angle.

9. 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?

c. Ketoacidosis

15. What statement by a parent leads the nurse to determine a parent is administering levothyroxine (Synthroid) correctly?

d. "I give the medication at 8:00 AM every day."

21. Why does the nurse instruct an 11-year-old diabetic child to use the side of the finger for blood testing?

d. It has fewer nerve endings.

17. The nurse is teaching the parents of a child with diabetes insipidus about water intoxication. The nurse would tell the parents to be alert for what symptom? For

d. Lethargy