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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The nurse should report chest pain to the healthcare provider immediately when caring for a child with sickle cell disease who is experiencing a sickle cell crisis. Chest pain can be a sign of acute chest syndrome, a potentially life-threatening complication of sickle cell disease that requires prompt treatment.
Swelling in the hands or feet, ulcers on the legs, and jaundice are common symptoms of sickle cell disease and do not require immediate reporting to the healthcare provider.
Correct Answer is A
Explanation
Answer: A. Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread.
Rationale:
A) Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread: This is the primary reason why surgery is performed before a biopsy in cases of Wilms tumor. The tumor is usually encapsulated, and performing a biopsy could risk breaking the capsule, leading to the dissemination of cancer cells into surrounding tissues, which can worsen the prognosis.
B) Metal clips are surgically applied at the tumor site for exact marking for radiation: While marking the tumor site for radiation is important, it is not the primary reason for performing surgery before a biopsy. The main concern is about the potential for cancer cell spread during a biopsy procedure.
C) Surgery is necessary to stage the tumor and determine metastasis to other sites: Although staging is a critical aspect of cancer management, the urgency of avoiding tumor rupture and subsequent spread is more pressing in this context. The surgery may assist in staging, but that is not the primary reason for immediate surgical intervention.
D) The surgery provides a visualization of other pathology and dysfunction of the kidney: While the surgical procedure may provide additional information about the kidney's condition, the most significant concern regarding Wilms tumor is preventing tumor rupture and the consequent spread of cancer cells, making this option less relevant.
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