A nurse is reinforcing teaching with a school-age child who has type 1 diabetes mellitus and his parent about illness management. Which of the following instructions should the nurse include?
Withhold insulin dose if feeling nauseous.
Test the urine for ketones.
Limit fluid intake during meal time.
Notify the provider if blood glucose levels are over 350 mg/dL.
The Correct Answer is B
Choice A rationale
Withholding insulin when feeling nauseous is not recommended. Insulin is necessary for the body to use glucose for energy. Without insulin, glucose stays in the bloodstream, leading to high blood sugar levels.
Choice B rationale
Testing the urine for ketones is important in managing type 1 diabetes. When the body does not have enough insulin, it breaks down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.
Choice C rationale
Limiting fluid intake during mealtime is not specifically related to the management of type 1 diabetes. It’s important to stay hydrated, but it doesn’t directly affect blood glucose levels.
Choice D rationale
Notifying the provider if blood glucose levels are over 350 mg/dL is not the only time medical advice should be sought. Any persistent, unusual, or extreme blood glucose reading should be discussed with a healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A urine specific gravity of 1.034 is higher than the normal range (1.002-1.030), indicating that the urine is more concentrated due to a lack of hydration.
Choice B rationale
A bounding pulse is not typically associated with dehydration. Dehydration more commonly results in a weak, rapid pulse.
Choice C rationale
A blood pressure reading of 46/94 mm Hg is not indicative of dehydration. Dehydration often leads to low blood pressure.
Choice D rationale
Distended neck veins are not a typical sign of dehydration. Dehydration can lead to decreased blood volume, which would not cause distension of the neck veins.
Correct Answer is D
Explanation
Choice A rationale
Bluish-green discharge from the ear canal is not a typical finding in otitis media. This could suggest a different condition, such as an external ear infection or a ruptured eardrum.
Choice B rationale
Erythema and edema of the affected auricle (outer part of the ear) are not typical findings in otitis media. These symptoms are more commonly associated with conditions affecting the external ear, such as otitis externa.
Choice C rationale
An increase in appetite is not typically associated with otitis media. In fact, children with otitis media may have a decreased appetite due to discomfort or pain while swallowing.
Choice D rationale
Tugging on the affected ear lobe is a common sign of otitis media in infants and young children. This is often due to the pain and discomfort caused by the infection.
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