,NUR 203 Exam 4 | Pediatric Nursing (2026) Actual
Q&A PDF | Fortis College
1. A child with type 1 diabetes mellitus is prescribed insulin glargine and insulin
lispro. Which statement by the parent indicates correct understanding of
administration?
A) "I will give the glargine before meals and the lispro at bedtime."
B) "I will give the lispro before meals and the glargine once daily at bedtime."
C) "I will mix the glargine and lispro in the same syringe before meals."
D) "I will give both insulins only when the child's blood glucose is elevated."
Correct Answer: "I will give the lispro before meals and the glargine once daily at
bedtime."
Rationale: Insulin lispro is rapid-acting and should be given before meals to cover
postprandial glucose elevations. Insulin glargine is long-acting and provides basal
coverage, typically given once daily at bedtime. Glargine should never be mixed with
other insulins. Insulin should be administered regardless of current glucose levels to
maintain glycemic control.
2. A 7-year-old child with type 1 diabetes has a blood glucose level of 58 mg/dL and
is alert and cooperative. Which action should the nurse take first?
A) Administer 15 grams of a fast-acting carbohydrate.
B) Administer the scheduled insulin dose.
C) Notify the healthcare provider immediately.
D) Recheck the blood glucose in 30 minutes.
Correct Answer: Administer 15 grams of a fast-acting carbohydrate.
,Rationale: A blood glucose of 58 mg/dL indicates hypoglycemia. For a conscious
child, the first intervention is to provide 15 grams of a fast-acting carbohydrate, such
as 4 ounces of juice or glucose tablets. Administering insulin would worsen
hypoglycemia. The healthcare provider should be notified if the child is unresponsive
or if hypoglycemia persists.
3. A child with type 1 diabetes is admitted with diabetic ketoacidosis. Which
assessment finding should the nurse expect?
A) Bradycardia and hypertension
B) Deep, rapid respirations and fruity breath
C) Warm, dry skin and polyuria
D) Weight gain and peripheral edema
Correct Answer: Deep, rapid respirations and fruity breath
Rationale: Diabetic ketoacidosis presents with Kussmaul respirations (deep, rapid
breathing) and fruity breath odor due to ketone production. Bradycardia,
hypertension, warm dry skin, and weight gain are not characteristic of DKA.
Immediate treatment includes IV fluids, insulin, and electrolyte replacement.
4. A 10-year-old child with type 1 diabetes is sick with gastroenteritis and cannot
keep food down. Which instruction should the nurse give the parent?
A) "Withhold insulin until the child can eat again."
B) "Check blood glucose and ketones every 4 hours."
C) "Encourage the child to drink only water."
D) "Stop checking blood glucose until the illness resolves."
Correct Answer: "Check blood glucose and ketones every 4 hours."
, Rationale: During illness, stress hormones increase blood glucose levels, so
insulin should not be withheld. Blood glucose and ketones should be monitored
frequently (every 3 to 4 hours) to detect DKA early. The child should be encouraged
to drink fluids containing carbohydrates and electrolytes, not just water.
5. A parent of a 4-year-old child with growth hormone deficiency asks when the child
will grow taller. Which response by the nurse is most accurate?
A) "Growth will begin immediately after starting therapy."
B) "It may take 6 to 12 months to see noticeable growth."
C) "Growth will stop once the child reaches age 10."
D) "The medication will make the child grow to a normal height within weeks."
Correct Answer: "It may take 6 to 12 months to see noticeable growth."
Rationale: Growth hormone therapy typically takes 6 to 12 months to produce
measurable increases in height velocity. Immediate growth is not expected. Therapy
continues until epiphyseal closure. Parents should be counseled on realistic
expectations and the importance of adherence.
6. A child with diabetes insipidus is prescribed desmopressin. Which finding indicates
a therapeutic response?
A) Increased urine output
B) Decreased serum sodium
C) Decreased urine output and increased urine specific gravity
D) Hypernatremia and dilute urine
Correct Answer: Decreased urine output and increased urine specific gravity
Q&A PDF | Fortis College
1. A child with type 1 diabetes mellitus is prescribed insulin glargine and insulin
lispro. Which statement by the parent indicates correct understanding of
administration?
A) "I will give the glargine before meals and the lispro at bedtime."
B) "I will give the lispro before meals and the glargine once daily at bedtime."
C) "I will mix the glargine and lispro in the same syringe before meals."
D) "I will give both insulins only when the child's blood glucose is elevated."
Correct Answer: "I will give the lispro before meals and the glargine once daily at
bedtime."
Rationale: Insulin lispro is rapid-acting and should be given before meals to cover
postprandial glucose elevations. Insulin glargine is long-acting and provides basal
coverage, typically given once daily at bedtime. Glargine should never be mixed with
other insulins. Insulin should be administered regardless of current glucose levels to
maintain glycemic control.
2. A 7-year-old child with type 1 diabetes has a blood glucose level of 58 mg/dL and
is alert and cooperative. Which action should the nurse take first?
A) Administer 15 grams of a fast-acting carbohydrate.
B) Administer the scheduled insulin dose.
C) Notify the healthcare provider immediately.
D) Recheck the blood glucose in 30 minutes.
Correct Answer: Administer 15 grams of a fast-acting carbohydrate.
,Rationale: A blood glucose of 58 mg/dL indicates hypoglycemia. For a conscious
child, the first intervention is to provide 15 grams of a fast-acting carbohydrate, such
as 4 ounces of juice or glucose tablets. Administering insulin would worsen
hypoglycemia. The healthcare provider should be notified if the child is unresponsive
or if hypoglycemia persists.
3. A child with type 1 diabetes is admitted with diabetic ketoacidosis. Which
assessment finding should the nurse expect?
A) Bradycardia and hypertension
B) Deep, rapid respirations and fruity breath
C) Warm, dry skin and polyuria
D) Weight gain and peripheral edema
Correct Answer: Deep, rapid respirations and fruity breath
Rationale: Diabetic ketoacidosis presents with Kussmaul respirations (deep, rapid
breathing) and fruity breath odor due to ketone production. Bradycardia,
hypertension, warm dry skin, and weight gain are not characteristic of DKA.
Immediate treatment includes IV fluids, insulin, and electrolyte replacement.
4. A 10-year-old child with type 1 diabetes is sick with gastroenteritis and cannot
keep food down. Which instruction should the nurse give the parent?
A) "Withhold insulin until the child can eat again."
B) "Check blood glucose and ketones every 4 hours."
C) "Encourage the child to drink only water."
D) "Stop checking blood glucose until the illness resolves."
Correct Answer: "Check blood glucose and ketones every 4 hours."
, Rationale: During illness, stress hormones increase blood glucose levels, so
insulin should not be withheld. Blood glucose and ketones should be monitored
frequently (every 3 to 4 hours) to detect DKA early. The child should be encouraged
to drink fluids containing carbohydrates and electrolytes, not just water.
5. A parent of a 4-year-old child with growth hormone deficiency asks when the child
will grow taller. Which response by the nurse is most accurate?
A) "Growth will begin immediately after starting therapy."
B) "It may take 6 to 12 months to see noticeable growth."
C) "Growth will stop once the child reaches age 10."
D) "The medication will make the child grow to a normal height within weeks."
Correct Answer: "It may take 6 to 12 months to see noticeable growth."
Rationale: Growth hormone therapy typically takes 6 to 12 months to produce
measurable increases in height velocity. Immediate growth is not expected. Therapy
continues until epiphyseal closure. Parents should be counseled on realistic
expectations and the importance of adherence.
6. A child with diabetes insipidus is prescribed desmopressin. Which finding indicates
a therapeutic response?
A) Increased urine output
B) Decreased serum sodium
C) Decreased urine output and increased urine specific gravity
D) Hypernatremia and dilute urine
Correct Answer: Decreased urine output and increased urine specific gravity
