Diabetes (Adult and Pediatric)84
Complete Solutions.
Diabetes (Adult and Pediatric)84
Complete Solutions.
A school-age child with type 1 diabetes mellitus has soccer practice and the school nurse provides
instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell
the child to do?
a. Eat twice the amount normally eaten at lunchtime.
b. Take half the amount of prescribed insulin on practice days.
c. Take the prescribed amount insulin at noontime rathe than in the morning.
d. Eat a small box of raisins or drink a cup of orange juice before soccer practice. - ANSWER d. Eat a small
box of raisins or drink a cup of orange juice before soccer practice.
The mother of a 6-year-old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse
that the child has been sick. The mother reports that she checked the child's urine and it was positive for
ketones. The nurse should instruct the mother to take which action?
a. Hold the next dose of insulin.
b. Come to the clinic immediately.
c. Encourage the child to drink liquids.
d. Administer an additional dose of regular insulin. - ANSWER c. Encourage the child to drink liquids.
The nurse is caring for an obese client on a weight loss program. Which method should the nurse use to
most accurately assess the program's effectiveness? (pg. 52)
a. Weight the client.
b. Monitor intake and output.
c. Check serum protein levels.
d. Calculate daily caloric intake. - ANSWER a. Weight the client.
An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for
treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note?
,Diabetes (Adult and Pediatric)84
Complete Solutions.
a. Sweating and tremors.
b. Hunger and hypertension.
c. Cold, Clammy skin irritability.
d. Fruity breath odor, and decreasing level of consciousness. - ANSWER d. Fruity breath odor and
decreasing level of consciousness
A mother brings her 3-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test
indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and
makes which interpretation?
a. it is positive.
b. Its is negative.
c. It is inconclusive.
d. It requires rescreening at age 6 weeks. - ANSWER b. It is negative.
A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states
that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is
diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV)
infusion?
a. Potassium infusion.
b. NPH insulin infusion.
c. 5% dextrose infusion.
d. Normal Salin infusion. - ANSWER d. Normal saline infusion
The nurse has just administered ibuprofen to a child with a temperature of 102°F (38.8°C). The nurse
should also take which action?
a. Withhold oral fluids for 8 hours.
b. Sponge the child with cold water.
c. Plan to administer salicylate (aspirin) in 4 hours.
d. Remove excess clothing and blankets from the child. - ANSWER d. Remove excess clothing and
blankets from the child.
,Diabetes (Adult and Pediatric)84
Complete Solutions.
A child has fluid volume deficit. The nurse performs an assessment and determines that the child is
improving and the deficit is resolving if which finding is noted?
a. The child has no tears.
b. Urine specific gravity is 1.030.
c. Urine output is less than 1 ml/kg/hour.
d. Capillary refill is less than 2 seconds. - ANSWER d. Capillary refill is less than 2 seconds.
The nurse should implement which interventions for a child older than 2 years with type 1 diabetes
mellitus who has a blood glucose level of 60 mg/dL (3.4 mmol/L)? Select all that apply.
a. Administer regular insulin.
b. Encourage the child to ambulate.
c. Give the child a teaspoon of honey.
d. Provide electrolyte replacement therapy intravenously.
e. Wait 30 minutes and confirm the blood glucose reading.
f. Prepare to administer glucagon subcutaneously if unconsciousness occurs. - ANSWER c. Give the child
a teaspoon of honey.
f. Prepare to administer glucagon subcutaneously if unconsciousness occurs.
The home care nurse is developing a plan of care for an older client with type 1 diabetes mellitus who
has gastroenteritis. To maintain food and fluid intake to prevent dehydration, which action should the
nurse take? (pg. 88)
a. Offer water only until the client is able to tolerate solid foods.
b. Withhold all fluids until vomiting has ceased for at least four hours.
c. Encourage the client to take 8 -12 ounces of fluid every hour while awake.
d. Maintain a clear liquid diet for at least 5 days before advancing to solids to allow inflammation of the
bowel to dissipate. - ANSWER c. Encourage the client to take 8 -12 ounces of fluid every hour while
awake.
, Diabetes (Adult and Pediatric)84
Complete Solutions.
Rationale: Dehydration needs to be prevented in the client with type 1 diabetes mellitus because of the
risk of diabetic ketoacidosis (DKA).
A home care nurse is teaching an adolescent with type 1 diabetes mellitus about insulin administration
and rotation sites. Which statement, if made by the adolescent, would indicate effective teaching?
a. "I should use only my stomach and my thighs for injections."
b. "I need to use a different major site for each insulin injection."
c. "I need to use one major site for 2 to 3 weeks before changing major sites."
d. "I need to use the same major site for 1 month before rotating to another site." - ANSWER C. "I need
to use one major site for 2 to 3 weeks before changing major sites."
A 6-year-old child with diabetes mellitus and the child's mother come to the health care clinic for a
routine examination. The nurse evaluates the data collected during this visit to determine if the child
has been euglycemic since the last visit. Which information is the most significant indicator of
euglycemia?
a. Daily glucose monitor log
b. Glycosylated hemoglobin (hemoglobin A1c)
c. Dietary history for the previous week
d. Fasting blood glucose performed on the day of the clinic visit - ANSWER B. Glycosylated hemoglobin
(hemoglobin A1c)
A child's fasting blood glucose levels range between 100 and 120 mg/dL (5.7 and 6.9 mmol/L) daily. The
before-dinner blood glucose levels are between 120 and 130 mg/dL (6.9 and 7.4 mmol/L), with no
reported episodes of hypoglycemia. Mixed insulin is administered before breakfast and before dinner.
The nurse should make which interpretation about these findings?
a. Exercise should be increased to reduce blood glucose levels.
b. Insulin doses are appropriate for food ingested and activity level.
c. Dietary needs are being met for adequate growth and development.
d. Dietary intake should be increased to avoid hypoglycemic reactions. - ANSWER B. Insulin doses are
appropriate for food ingested and activity level.
Complete Solutions.
Diabetes (Adult and Pediatric)84
Complete Solutions.
A school-age child with type 1 diabetes mellitus has soccer practice and the school nurse provides
instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell
the child to do?
a. Eat twice the amount normally eaten at lunchtime.
b. Take half the amount of prescribed insulin on practice days.
c. Take the prescribed amount insulin at noontime rathe than in the morning.
d. Eat a small box of raisins or drink a cup of orange juice before soccer practice. - ANSWER d. Eat a small
box of raisins or drink a cup of orange juice before soccer practice.
The mother of a 6-year-old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse
that the child has been sick. The mother reports that she checked the child's urine and it was positive for
ketones. The nurse should instruct the mother to take which action?
a. Hold the next dose of insulin.
b. Come to the clinic immediately.
c. Encourage the child to drink liquids.
d. Administer an additional dose of regular insulin. - ANSWER c. Encourage the child to drink liquids.
The nurse is caring for an obese client on a weight loss program. Which method should the nurse use to
most accurately assess the program's effectiveness? (pg. 52)
a. Weight the client.
b. Monitor intake and output.
c. Check serum protein levels.
d. Calculate daily caloric intake. - ANSWER a. Weight the client.
An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for
treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note?
,Diabetes (Adult and Pediatric)84
Complete Solutions.
a. Sweating and tremors.
b. Hunger and hypertension.
c. Cold, Clammy skin irritability.
d. Fruity breath odor, and decreasing level of consciousness. - ANSWER d. Fruity breath odor and
decreasing level of consciousness
A mother brings her 3-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test
indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and
makes which interpretation?
a. it is positive.
b. Its is negative.
c. It is inconclusive.
d. It requires rescreening at age 6 weeks. - ANSWER b. It is negative.
A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states
that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is
diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV)
infusion?
a. Potassium infusion.
b. NPH insulin infusion.
c. 5% dextrose infusion.
d. Normal Salin infusion. - ANSWER d. Normal saline infusion
The nurse has just administered ibuprofen to a child with a temperature of 102°F (38.8°C). The nurse
should also take which action?
a. Withhold oral fluids for 8 hours.
b. Sponge the child with cold water.
c. Plan to administer salicylate (aspirin) in 4 hours.
d. Remove excess clothing and blankets from the child. - ANSWER d. Remove excess clothing and
blankets from the child.
,Diabetes (Adult and Pediatric)84
Complete Solutions.
A child has fluid volume deficit. The nurse performs an assessment and determines that the child is
improving and the deficit is resolving if which finding is noted?
a. The child has no tears.
b. Urine specific gravity is 1.030.
c. Urine output is less than 1 ml/kg/hour.
d. Capillary refill is less than 2 seconds. - ANSWER d. Capillary refill is less than 2 seconds.
The nurse should implement which interventions for a child older than 2 years with type 1 diabetes
mellitus who has a blood glucose level of 60 mg/dL (3.4 mmol/L)? Select all that apply.
a. Administer regular insulin.
b. Encourage the child to ambulate.
c. Give the child a teaspoon of honey.
d. Provide electrolyte replacement therapy intravenously.
e. Wait 30 minutes and confirm the blood glucose reading.
f. Prepare to administer glucagon subcutaneously if unconsciousness occurs. - ANSWER c. Give the child
a teaspoon of honey.
f. Prepare to administer glucagon subcutaneously if unconsciousness occurs.
The home care nurse is developing a plan of care for an older client with type 1 diabetes mellitus who
has gastroenteritis. To maintain food and fluid intake to prevent dehydration, which action should the
nurse take? (pg. 88)
a. Offer water only until the client is able to tolerate solid foods.
b. Withhold all fluids until vomiting has ceased for at least four hours.
c. Encourage the client to take 8 -12 ounces of fluid every hour while awake.
d. Maintain a clear liquid diet for at least 5 days before advancing to solids to allow inflammation of the
bowel to dissipate. - ANSWER c. Encourage the client to take 8 -12 ounces of fluid every hour while
awake.
, Diabetes (Adult and Pediatric)84
Complete Solutions.
Rationale: Dehydration needs to be prevented in the client with type 1 diabetes mellitus because of the
risk of diabetic ketoacidosis (DKA).
A home care nurse is teaching an adolescent with type 1 diabetes mellitus about insulin administration
and rotation sites. Which statement, if made by the adolescent, would indicate effective teaching?
a. "I should use only my stomach and my thighs for injections."
b. "I need to use a different major site for each insulin injection."
c. "I need to use one major site for 2 to 3 weeks before changing major sites."
d. "I need to use the same major site for 1 month before rotating to another site." - ANSWER C. "I need
to use one major site for 2 to 3 weeks before changing major sites."
A 6-year-old child with diabetes mellitus and the child's mother come to the health care clinic for a
routine examination. The nurse evaluates the data collected during this visit to determine if the child
has been euglycemic since the last visit. Which information is the most significant indicator of
euglycemia?
a. Daily glucose monitor log
b. Glycosylated hemoglobin (hemoglobin A1c)
c. Dietary history for the previous week
d. Fasting blood glucose performed on the day of the clinic visit - ANSWER B. Glycosylated hemoglobin
(hemoglobin A1c)
A child's fasting blood glucose levels range between 100 and 120 mg/dL (5.7 and 6.9 mmol/L) daily. The
before-dinner blood glucose levels are between 120 and 130 mg/dL (6.9 and 7.4 mmol/L), with no
reported episodes of hypoglycemia. Mixed insulin is administered before breakfast and before dinner.
The nurse should make which interpretation about these findings?
a. Exercise should be increased to reduce blood glucose levels.
b. Insulin doses are appropriate for food ingested and activity level.
c. Dietary needs are being met for adequate growth and development.
d. Dietary intake should be increased to avoid hypoglycemic reactions. - ANSWER B. Insulin doses are
appropriate for food ingested and activity level.
