1
Endocrine Disorders NCLEX-RN Review | Saunders 9th Ed
Chapter 47 | Diabetes, SIADH, DKA | 2025–2026 NGN A+
Verified Practice Questions with Rationales
1. A nurse is caring for a child newly diagnosed with type 1 diabetes mellitus.
Which actions should be included in the initial care plan?
Select all that apply.
A. Administer basal-bolus insulin as prescribed
B. Monitor blood glucose before meals and at bedtime
C. Limit fluid intake to prevent polyuria
D. Educate the family on recognizing hypoglycemia
E. Instruct the child to avoid all carbohydrate foods
Correct Answers: A, B, D
Rationale: Initial care of a child with type 1 diabetes includes administering
insulin according to a basal-bolus schedule to mimic normal pancreatic function.
Blood glucose should be checked regularly to assess trends and prevent extremes.
Families must learn how to identify and respond to signs of hypoglycemia. Fluids
, 2
should not be restricted as adequate hydration is essential. Carbohydrates are
necessary for energy and should be managed through consistent carbohydrate
counting, not avoided entirely.
2. A nurse is assessing a child with suspected diabetic ketoacidosis (DKA).
Which clinical findings support this diagnosis?
Select all that apply.
A. Kussmaul respirations
B. Fruity-smelling breath
C. Bradycardia
D. Abdominal pain
E. Hyperglycemia
Correct Answers: A, B, D, E
Rationale: DKA is characterized by Kussmaul respirations (deep and labored),
fruity breath due to acetone, abdominal pain, and significantly elevated blood
glucose levels. Bradycardia is not typical; tachycardia is more common due to
dehydration and metabolic stress.
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3. A child with type 1 diabetes is participating in sports. What guidance should
the nurse provide to the parents?
Select all that apply.
A. Provide a carbohydrate snack before activity
B. Delay insulin dose before sports
C. Monitor blood glucose before and after exercise
D. Encourage hydration
E. Avoid exercise altogether
Correct Answers: A, C, D
Rationale: Children with diabetes should have a snack before sports to prevent
hypoglycemia, especially if exercise is prolonged. Blood glucose should be
monitored before and after physical activity. Staying hydrated is important due to
increased fluid loss. Insulin timing may need adjustment, but complete avoidance
of insulin or exercise is not appropriate.
4. A nurse is caring for a child diagnosed with SIADH. Which interventions
are appropriate?
Select all that apply.
A. Restrict fluid intake
, 4
B. Administer prescribed diuretics
C. Monitor serum sodium levels
D. Encourage salt-rich foods
E. Provide free water with meals
Correct Answers: A, B, C, D
Rationale: SIADH causes water retention and hyponatremia. Fluid restriction is
essential to reduce water overload. Diuretics may be used to promote fluid
excretion. Sodium levels should be closely monitored. Salt-rich foods may help
correct sodium deficits. Free water should be limited, not encouraged, as it dilutes
serum sodium further.
5. A nurse is evaluating a child with diabetes for signs of hypoglycemia. Which
symptoms would the child most likely exhibit?
Select all that apply.
A. Tremors
B. Confusion
C. Sweating
D. Tachycardia
E. Flushed skin
Endocrine Disorders NCLEX-RN Review | Saunders 9th Ed
Chapter 47 | Diabetes, SIADH, DKA | 2025–2026 NGN A+
Verified Practice Questions with Rationales
1. A nurse is caring for a child newly diagnosed with type 1 diabetes mellitus.
Which actions should be included in the initial care plan?
Select all that apply.
A. Administer basal-bolus insulin as prescribed
B. Monitor blood glucose before meals and at bedtime
C. Limit fluid intake to prevent polyuria
D. Educate the family on recognizing hypoglycemia
E. Instruct the child to avoid all carbohydrate foods
Correct Answers: A, B, D
Rationale: Initial care of a child with type 1 diabetes includes administering
insulin according to a basal-bolus schedule to mimic normal pancreatic function.
Blood glucose should be checked regularly to assess trends and prevent extremes.
Families must learn how to identify and respond to signs of hypoglycemia. Fluids
, 2
should not be restricted as adequate hydration is essential. Carbohydrates are
necessary for energy and should be managed through consistent carbohydrate
counting, not avoided entirely.
2. A nurse is assessing a child with suspected diabetic ketoacidosis (DKA).
Which clinical findings support this diagnosis?
Select all that apply.
A. Kussmaul respirations
B. Fruity-smelling breath
C. Bradycardia
D. Abdominal pain
E. Hyperglycemia
Correct Answers: A, B, D, E
Rationale: DKA is characterized by Kussmaul respirations (deep and labored),
fruity breath due to acetone, abdominal pain, and significantly elevated blood
glucose levels. Bradycardia is not typical; tachycardia is more common due to
dehydration and metabolic stress.
, 3
3. A child with type 1 diabetes is participating in sports. What guidance should
the nurse provide to the parents?
Select all that apply.
A. Provide a carbohydrate snack before activity
B. Delay insulin dose before sports
C. Monitor blood glucose before and after exercise
D. Encourage hydration
E. Avoid exercise altogether
Correct Answers: A, C, D
Rationale: Children with diabetes should have a snack before sports to prevent
hypoglycemia, especially if exercise is prolonged. Blood glucose should be
monitored before and after physical activity. Staying hydrated is important due to
increased fluid loss. Insulin timing may need adjustment, but complete avoidance
of insulin or exercise is not appropriate.
4. A nurse is caring for a child diagnosed with SIADH. Which interventions
are appropriate?
Select all that apply.
A. Restrict fluid intake
, 4
B. Administer prescribed diuretics
C. Monitor serum sodium levels
D. Encourage salt-rich foods
E. Provide free water with meals
Correct Answers: A, B, C, D
Rationale: SIADH causes water retention and hyponatremia. Fluid restriction is
essential to reduce water overload. Diuretics may be used to promote fluid
excretion. Sodium levels should be closely monitored. Salt-rich foods may help
correct sodium deficits. Free water should be limited, not encouraged, as it dilutes
serum sodium further.
5. A nurse is evaluating a child with diabetes for signs of hypoglycemia. Which
symptoms would the child most likely exhibit?
Select all that apply.
A. Tremors
B. Confusion
C. Sweating
D. Tachycardia
E. Flushed skin
