A 2-year old is admitted to the pediatric with acute onset of Type 1 diabetes mellitus and diabetic ketoacidosis. Diabetic ketoacidosis results from an excessive accumulation of which of the following?

Release of sodium bicarbonate from renal compensation

Ketone bodies from fat metabolism

Excretion of excess potassium from cellular death

Elevated glucose from elevated insulin

Answer and Explanation

The Correct Answer is B

A. Release of sodium bicarbonate from renal compensation: In response to metabolic acidosis, the kidneys may attempt to compensate by excreting hydrogen ions and retaining bicarbonate ions. However, this mechanism does not contribute to the development of diabetic ketoacidosis.

B. Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus, particularly type 1 diabetes, resulting from a relative or absolute deficiency of insulin. In the absence of sufficient insulin, the body cannot properly utilize glucose for energy, leading to increased lipolysis (breakdown of fat) and subsequent production of ketone bodies (such as acetone, acetoacetate, and beta-hydroxybutyrate) as an alternative fuel source. The accumulation of ketone bodies in the blood lowers the blood pH, leading to metabolic acidosis characteristic of DKA.
C. Excretion of excess potassium from cellular death: Diabetic ketoacidosis can lead to electrolyte imbalances, including hyperkalemia due to shifts of potassium out of cells as acidosis worsens. However, this is a consequence of DKA rather than a primary cause.

D. In type 1 diabetes mellitus, there is an absolute deficiency of insulin, leading to hyperglycemia. Elevated glucose levels contribute to the osmotic diuresis seen in DKA, but they are not the primary cause of ketoacidosis.

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Correct Answer is C

Explanation

C. This statement emphasizes to the child that they are not responsible for the abuse they have experienced, helping to alleviate feelings of guilt or self-blame. This can provide validation and comfort to the child during a traumatic experience.

A. Involving the family in the discussion might not be appropriate if the family member is the perpetrator. The safety and well-being of the child should be the priority

B. This statement may make the child feel more isolated and conflicted about their feelings toward their family. It's important to acknowledge the abuse without placing blame or judgment on the family.

D. This statement undermines the nurse's duty to report suspected cases of child abuse to the appropriate authorities. Confidentiality cannot be guaranteed in cases of suspected abuse, as healthcare professionals are mandated reporters obligated to report any suspicions or evidence of abuse to protect the child's safety and well-being.

A. Tugging on the affected ear lobe B. Pain when manipulating the affected ear lobe C. Erythema and edema of the affected ear D. Clear drainage from the affected ear

Correct Answer is C

Explanation

A. This is a common symptom but bot a sign in children with otitis media. They may tug or pull at their ears due to discomfort or pain caused by the infection.
B. Manipulating the ear lobe can cause pain in children with otitis media because the infection often leads to inflammation and sensitivity in the ear area. This is, however, a symptom.
C. Erythema and edema are typical signs of inflammation, which can occur in the ear with otitis media.
D. While otitis media can cause some fluid buildup in the middle ear, clear drainage is not a common finding and may suggest another condition such as ear canal infection (otitis externa) or a perforated eardrum. Otitis media typically involves more purulent (pus-like) or cloudy fluid due to the infection.

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A 2-year old is admitted to the pediatric with acute onset of Type 1 diabetes mellitus and diabetic ketoacidosis. Diabetic ketoacidosis results from an excessive accumulation of which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a child who has been physically abused by a family member. Which of the following statements should the nurse say to the child?

Correct Answer is C

Explanation

A nurse is caring for a child who has otitis media. Which of the following assessment findings should the nurse expect?

Correct Answer is C

Explanation

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