C HAPTER 31: T HE C HILD WITH A M ETABOLIC
C ONDITION
Introduction to Maternity and Pediatric Nursing , 8th Edition ; Leifer
MULTIPLE CHOICE
1. Which laboratory result indicates good metabolic control for a child with
type 1 diabetes mellitus?
a. Gl ycosylated hemoglobin value of 8%
b. Fasting blood glucose level less than 140 mg/dL
c. Glucose tolerance test result of 190 mg/dL
d. No glucose or ketones present in the urine
ANS: A
Gl ycosylated hemoglobin reflects gl ycemic levels over a period of
months. Levels of 6% to 9% represent good metabolic control.
DIF: Cognitive Level: Comprehension REF: Page 725
TOP: Hemoglobin A1c KEY: Nursing Process Step:
Data Collection MSC: NC LEX: Physiological Integrit y:
Physiological Adaptation
2. What condition does the nurse suspect when a child with t ype 1 diabetes
mellitus has hyperglycemia, diaphoresis, and headaches in the morning?
a. Dawn phenomenon
b. Somogyi phenomenon
, c. Honeymoon effect
d. Ketoacidosis
ANS: B
The Somogyi phenomenon (rebound hypergl ycemia) occurs when the
blood glucose level is lowered to the point at which the bodys counter -
regulatory hormones are released, p roducing the symptoms described.
DIF: Cognitive Level: Anal ysis REF: Page 732 TOP:
Somogyi Phenomenon KEY: Nursing Process Step: Data
Collection MSC: NC LEX: Physiological Integrit y
3. 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?
a. The disease is rare. It is unlikel y that you would have a child with
Tay-Sachs disease.
b. A screening test can be done to determine if you are a carrier of the
gene.
c. The gene for Tay-Sachs disease is transmitted by the father.
d. The cause of Tay-Sachs disease is thought to be an autoimmune
response to a virus.
ANS: B
Carriers can be identified by screening tests. Tay -Sachs disease has an
autosomal recessive pattern of transmission.
, DIF: Cognitive Level: Comprehension REF: Page 720
OBJ: 2 TOP: Tay-Sachs Disease KEY: Nursing
Process Step: Implementation MSC: NC LEX: Health
Promotion and Maintenance: Prevention and Earl y Detection of
Disease
4. What statement by a parent leads the nurse to determine a parent is
administering levothyroxine (S ynthroid) correctl y?
a. I stopped giving the medication because my daughter was losing her
hair.
b. I am using a different brand now because it costs less money.
c. I dont give the medication on the weekends.
d. I give the medication at 8:00 AM every day.
ANS: D
Synthroid should be given at the same time each day, preferabl y in the
morning.
DIF: Cognitive Level: Comprehension REF: Page 721
TOP: Levothyroxine (S ynthroid ) KEY: Nursing
Process Step: Evaluation MSC: NC LEX: Physiological
Integrit y: Pharmacological Therapies
5. 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
b. Diabetes mellitus
C ONDITION
Introduction to Maternity and Pediatric Nursing , 8th Edition ; Leifer
MULTIPLE CHOICE
1. Which laboratory result indicates good metabolic control for a child with
type 1 diabetes mellitus?
a. Gl ycosylated hemoglobin value of 8%
b. Fasting blood glucose level less than 140 mg/dL
c. Glucose tolerance test result of 190 mg/dL
d. No glucose or ketones present in the urine
ANS: A
Gl ycosylated hemoglobin reflects gl ycemic levels over a period of
months. Levels of 6% to 9% represent good metabolic control.
DIF: Cognitive Level: Comprehension REF: Page 725
TOP: Hemoglobin A1c KEY: Nursing Process Step:
Data Collection MSC: NC LEX: Physiological Integrit y:
Physiological Adaptation
2. What condition does the nurse suspect when a child with t ype 1 diabetes
mellitus has hyperglycemia, diaphoresis, and headaches in the morning?
a. Dawn phenomenon
b. Somogyi phenomenon
, c. Honeymoon effect
d. Ketoacidosis
ANS: B
The Somogyi phenomenon (rebound hypergl ycemia) occurs when the
blood glucose level is lowered to the point at which the bodys counter -
regulatory hormones are released, p roducing the symptoms described.
DIF: Cognitive Level: Anal ysis REF: Page 732 TOP:
Somogyi Phenomenon KEY: Nursing Process Step: Data
Collection MSC: NC LEX: Physiological Integrit y
3. 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?
a. The disease is rare. It is unlikel y that you would have a child with
Tay-Sachs disease.
b. A screening test can be done to determine if you are a carrier of the
gene.
c. The gene for Tay-Sachs disease is transmitted by the father.
d. The cause of Tay-Sachs disease is thought to be an autoimmune
response to a virus.
ANS: B
Carriers can be identified by screening tests. Tay -Sachs disease has an
autosomal recessive pattern of transmission.
, DIF: Cognitive Level: Comprehension REF: Page 720
OBJ: 2 TOP: Tay-Sachs Disease KEY: Nursing
Process Step: Implementation MSC: NC LEX: Health
Promotion and Maintenance: Prevention and Earl y Detection of
Disease
4. What statement by a parent leads the nurse to determine a parent is
administering levothyroxine (S ynthroid) correctl y?
a. I stopped giving the medication because my daughter was losing her
hair.
b. I am using a different brand now because it costs less money.
c. I dont give the medication on the weekends.
d. I give the medication at 8:00 AM every day.
ANS: D
Synthroid should be given at the same time each day, preferabl y in the
morning.
DIF: Cognitive Level: Comprehension REF: Page 721
TOP: Levothyroxine (S ynthroid ) KEY: Nursing
Process Step: Evaluation MSC: NC LEX: Physiological
Integrit y: Pharmacological Therapies
5. 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
b. Diabetes mellitus
