A nurse is providing teaching to a school-age child who has a diagnosis of type 1 diabetes mellitus. Which of the following statements by the child indicates a need for additional teaching?
"I should not take my regular insulin when I am sick."
"I will rotate injections sites within my abdominal area."
"I will test my blood sugar before meals and at bedtime."
"I should eat a snack before I play soccer."
The Correct Answer is A
A. "I should not take my regular insulin when I am sick." Regular insulin should not be withheld during illness, as blood glucose levels can increase during times of stress or infection. This statement indicates the child needs further education on managing diabetes during illness.
B. "I will rotate injections sites within my abdominal area." Rotating injection sites within a specific area helps to prevent lipodystrophy and ensures consistent absorption of insulin. This statement shows appropriate understanding.
C. "I will test my blood sugar before meals and at bedtime." Frequent monitoring of blood glucose is essential in managing type 1 diabetes. This statement indicates correct knowledge of monitoring practices.
D. "I should eat a snack before I play soccer." Eating a snack before physical activity helps to prevent hypoglycemia. This statement indicates a proper understanding of diabetes management related to exercise.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "Has your child had any diarrhea?" Diarrhea is not typically associated with glomerulonephritis.
B. "Have you noticed any rashes on your child?" Rashes are not typically associated with glomerulonephritis.
C. "Did your child sustain any injuries to the kidney area?" Direct kidney trauma is not a common cause of glomerulonephritis in children.
D. "Did your child recently complain of a sore throat?" Poststreptococcal glomerulonephritis (a common cause of acute glomerulonephritis in children) often follows a streptococcal throat or skin infection. Asking about a recent sore throat can provide important information about a possible streptococcal infection.
Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}
Explanation
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Immediate priority: The child is febrile (38.9°C) with tachycardia. Fever and low Hgb and platelets suggest possible serious underlying hematologic disorder (e.g., leukemia, bone marrow suppression). Infection is life-threatening in this context. So temperature (fever) should be addressed first.
Next concern: The lab values (low Hgb, Hct, platelets) show significant hematologic abnormalities that explain the fatigue, bruising, and petechiae and will guide further treatment (possible transfusion, infection risk management).
Incorrect answers:
- Pain: Although pain management is important for comfort and to improve quality of life, in this scenario, the child’s pain is rated as a 3 on the FLACC scale, which is moderate. Immediate pain does not seem to be the primary or most urgent concern compared to the high fever and potential underlying conditions.
- Bruising: The presence of bruising in various stages of healing and petechiae suggests a possible underlying hematologic issue or trauma. While concerning and needing further investigation, it does not require immediate intervention compared to the fever.
- Heart rate: The heart rate is elevated at 150 beats per minute, which could be a response to the fever, pain, or anxiety. Addressing the fever may help in normalizing the heart rate.
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