A nurse is caring for a 10-year-old boy who has a new diagnosis of diabetes mellitus and is eager to return to school and participate in social events. The mother tells the nurse she is afraid to let him take part in physical activities at school. Which of the following responses should the nurse make?
You sound overwhelmed. Let’s talk about this some more.
I agree. His well-being is the most important.
Tell me more about how you are feeling about your son’s activities.
You might want to use tutors to home-school him.
The Correct Answer is C
Choice A reason: You sound overwhelmed. Let’s talk about this some more. This response acknowledges the mother’s feelings and opens the door for further discussion. However, it does not directly address her specific concerns about physical activities. While it is empathetic, it lacks the focus needed to explore her worries about her son’s participation in school activities.
Choice B reason: I agree. His well-being is the most important. This response validates the mother’s concern but may inadvertently reinforce her fears without providing a balanced perspective. It does not encourage a discussion about the benefits of physical activity for children with diabetes or how to manage his condition safely during such activities.
Choice C reason: Tell me more about how you are feeling about your son’s activities. This response is the most appropriate as it invites the mother to express her specific concerns and feelings. It shows empathy and a willingness to understand her perspective, which can lead to a more productive conversation about managing her son’s diabetes while allowing him to participate in physical activities.
Choice D reason: You might want to use tutors to home-school him. This response suggests an alternative that may not be necessary or beneficial. Home-schooling might isolate the child and prevent him from enjoying social interactions and physical activities that are important for his overall development. It does not address the mother’s concerns directly and may not be the best solution.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Free T4
In primary hypothyroidism, the thyroid gland is underactive and does not produce enough thyroid hormones. As a result, free T4 levels are typically low, not elevated. Free T4 is a direct measure of the active thyroid hormone available in the blood. Therefore, an elevation in free T4 is not expected in primary hypothyroidism.
Choice B reason: Thyroid-stimulating hormone (TSH)
Thyroid-stimulating hormone (TSH) is elevated in primary hypothyroidism due to the lack of negative feedback from low thyroid hormone levels. The pituitary gland produces more TSH in an attempt to stimulate the thyroid gland to produce more hormones. This is a hallmark finding in primary hypothyroidism and is used as a key diagnostic indicator.
Choice C reason: Serum T3
Serum T3 levels can be variable in primary hypothyroidism. While they may be low, they are often maintained within the normal range until the condition becomes severe. This is because T3 is produced in smaller quantities and has a shorter half-life compared to T4. Therefore, an elevation in serum T3 is not typically seen in primary hypothyroidism.
Choice D reason: Serum T4
Similar to free T4, serum T4 levels are usually low in primary hypothyroidism. The thyroid gland’s reduced ability to produce thyroid hormones results in decreased levels of both free and total T4. Thus, an elevation in serum T4 is not expected in primary hypothyroidism.
Correct Answer is B
Explanation
Choice A reason: Babinski’s sign
Babinski’s sign is a reflex action where the big toe moves upward or toward the top surface of the foot and the other toes fan out when the sole of the foot is stimulated. This sign is used to assess neurological function, particularly in the context of central nervous system disorders. It is not related to hypocalcemia, which is the likely cause of the tingling sensation in this scenario.
Choice B reason: Chvostek’s sign
Chvostek’s sign is a clinical indicator of hypocalcemia. It is elicited by tapping the facial nerve at the angle of the jaw, which causes twitching of the facial muscles. Hypocalcemia is a common complication following thyroidectomy due to potential damage or removal of the parathyroid glands, which regulate calcium levels. The tingling sensation reported by the client is a classic symptom of hypocalcemia, making Chvostek’s sign the most relevant assessment.
Choice C reason: Brudzinski’s sign
Brudzinski’s sign is used to assess for meningitis. It involves flexing the client’s neck and observing for involuntary flexion of the hips and knees. This sign is not related to hypocalcemia or the symptoms described by the client following thyroidectomy.
Choice D reason: Kernig’s sign
Kernig’s sign is another test for meningitis. It involves flexing the client’s hip and knee, then straightening the knee. Pain and resistance to straightening the knee indicate a positive Kernig’s sign. This sign is not relevant to the assessment of hypocalcemia or the symptoms described by the client.
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