A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment is most important for the nurse to obtain?

Understanding of quality control process used to troubleshoot the pump.

Interpretation of fingerstick glucose levels that influence diet selections.

Knowledge of her glycosylated hemoglobin A1c levels for past year.

Ability to program the pump for basal insulin with mealtime boluses.

Answer and Explanation

The Correct Answer is D

A. Understanding the quality control process used to troubleshoot the pump is important, but it is a secondary assessment and educational component. The primary focus should be on the child's ability to operate the pump effectively.

B. Interpretation of fingerstick glucose levels is important for diabetes management, but it does not specifically address the use of an insulin pump.

C. Knowledge of glycosylated hemoglobin A1c levels is valuable for assessing long-term glycemic control but is not the primary assessment needed when considering the transition to an insulin pump.

D Ability to program the pump for basal insulin with mealtime boluses.

When a child with type 1 diabetes mellitus expresses an interest in using an insulin pump, the most important assessment is their ability to program and manage the pump effectively. The nurse should assess whether the child and their family have the knowledge and skills to use the pump, including setting basal insulin rates and delivering mealtime boluses. The successful use of an insulin pump requires a good understanding of its operation and the ability to make adjustments based on the child's specific needs and glucose levels.

The ability to manage the insulin pump effectively is essential to ensure safe and appropriate diabetes management, making it the most important assessment in this context.

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Correct Answer is B

Explanation

A. Jaundice is a common finding in individuals with sickle cell disease due to the breakdown of sickled red blood cells. While jaundice should be monitored and reported, it is not as immediately concerning as chest pain in the context of a sickle cell crisis.

B Chest pain.

Sickle cell disease is characterized by the presence of abnormal hemoglobin that can lead to the formation of sickled red blood cells. During a sickle cell crisis, these abnormal cells can block blood vessels, leading to tissue damage and severe pain. Chest pain in a child with sickle cell disease can be indicative of a potentially life-threatening complication called acute chest syndrome, which is a serious condition that requires immediate medical attention. Acute chest syndrome can lead to impaired oxygen exchange and respiratory distress, making it a medical emergency.

C. Swelling in the hands or feet can be associated with vaso-occlusive episodes in sickle cell disease, but it may not be as immediately concerning as chest pain.

D. Ulcers on the legs can be a complication of sickle cell disease, but they are not typically as acutely life-threatening as chest pain due to acute chest syndrome.

Chest pain should be treated as a medical emergency in a child with sickle cell disease during a sickle cell crisis, and the healthcare provider should be informed immediately to initiate appropriate intervention.

A. Uses 1 word sentences. B. Speaks in simple sentences with four or more words. C. Recognizes most letters and numbers. D. Uses gestures with 1 to 2 word sentences.

Correct Answer is B

Explanation

A. Using 1-word sentences is more characteristic of a child's speech development at around 12-18 months, and by age 3, children are expected to use more words in their sentences.

B. Speaks in simple sentences with four or more words.

At the age of 3, children typically progress in their speech and language development. Speaking in simple sentences with four or more words is considered a normal developmental milestone at this age. It reflects the child's growing ability to form more complex and coherent sentences.

C. Recognizing most letters and numbers is not typically a developmental milestone for a 3-year-old. This skill often develops later, closer to the preschool and kindergarten years.

D. Using gestures with 1 to 2-word sentences may be seen in younger children, but by age 3, children should be progressing to longer and more complex sentences as part of their language development.

It's important to remember that there can be some individual variation in language development, but by the age of 3, children are generally expected to speak in simple sentences with more words and demonstrate growing language skills.

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A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment is most important for the nurse to obtain?

Nursing Test Bank

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