The nurse is caring for an adolescent with type 1 diabetes mellitus presenting with an HbA1c of 11% (97 mmol/mol), thirst, and blurred vision. Which action should the nurse take first?

Review prior insulin prescriptions.

Obtain point-of-care glucose.

Assess urine for ketones.

Check blood pressure.

Answer and Explanation

The Correct Answer is B

The adolescent's symptoms suggest that their blood glucose levels may be very high. Obtaining a point-of- care glucose reading is the first step in assessing the adolescent's current blood glucose levels and determining the appropriate course of action.

Reviewing prior insulin prescriptions, assessing urine for ketones, and checking blood pressure are also important interventions but should occur after the blood glucose level has been determined.

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Correct Answer is B

Explanation

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend that the first dose of MMR vaccine be given at 12-15 months of age.

A. 6 months is too early for the MMR vaccine.

D. 2 months is also too early for the MMR vaccine.

C. 24 months is slightly beyond the recommended range for the first dose of MMR vaccine, which is given between 12-15 months of age.

A. Refer the child to the healthcare provider and schedule evaluation of blood pressure in two weeks. B. Measure the child's blood pressure three times during the visit and determine the highest of the readings. C. Conduct a head-to-toe assessment and omit repeated blood pressures during the examination. D. Take the blood pressure two more times during the visit and determine the average of the three readings.

Correct Answer is D

Explanation

If a child's systolic blood pressure is greater than the 90th percentile during a routine clinic visit, the nurse should take the blood pressure two more times during the visit and determine the average of the three readings. This will provide a more accurate assessment of the child's blood pressure. Referring the child to the healthcare provider and scheduling an evaluation of blood pressure in two weeks

A. may be necessary if the child's blood pressure remains elevated, but it is not the next action that should be taken. Measuring the child's blood pressure three times during the visit and determining the highest of the readings

B. is not recommended because it may overestimate the child's blood pressure. Conducting a head-to-toe assessment and omitting repeated blood pressures during the examination

C. is not appropriate because it does not provide an accurate assessment of the child's blood pressure.

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The nurse is caring for an adolescent with type 1 diabetes mellitus presenting with an HbA1c of 11% (97 mmol/mol), thirst, and blurred vision. Which action should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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