Which sign is the nurse most likely to assess in a child with hypoglycaemia?
Normal sensorium and serum glucose greater than 160 mg/dL
Urine positive for ketones and serum glucose greater than 300 mg/dL
Irritability and serum glucose less than 60 mg/dL
Increased urination and serum glucose less than 120 mg/dL
The Correct Answer is C
Hypoglycaemia is characterized by low blood sugar levels. In children, symptoms of hypoglycaemia can vary, but irritability is a common sign. Other signs and symptoms of hypoglycaemia in children may include sweating, trembling, pale skin, hunger, weakness, confusion, and dizziness.
Normal sensorium and serum glucose greater than 160 mg/dL in (Option A) is incorrect because a normal sensorium (normal level of consciousness) and a serum glucose level greater than 160 mg/dL would not be indicative of hypoglycaemia.
Urine positive for ketones and serum glucose greater than 300 mg/dL in (Option B) is incorrect because it describes characteristics of hyperglycaemia (high blood sugar levels) rather than hypoglycaemia. Positive urine ketones and a serum glucose level greater than 300 mg/dL are commonly seen in diabetic ketoacidosis, a complication of high blood sugar levels in diabetes.
Increased urination and serum glucose less than 120 mg/dL in (Option D) is incorrect because it describes increased urination and a serum glucose level less than 120 mg/dL. While a serum glucose level less than 120 mg/dL could indicate hypoglycaemia, increased urination is not a typical sign of hypoglycaemia. Increased urination may be seen in conditions such as diabetes mellitus when blood sugar levels are consistently high.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Thebehaviourdescribed,wherethechildappearstobestaringinto space,is characteristicof
B.Absenceseizures.
Absence seizures, also known as petit mal seizures, are a type of generalized seizure thatprimarily affects children. These seizures are brief and usually last for a few seconds. Duringan absence seizure, the child may appear to be staring blankly into space, unaware of theirsurroundings.Theymaynot respond to stimuli orengagein anypurposefulactivity.After theseizure ends, the child typically resumes their previous activity without any memory of theseizure.
Atonic seizures in (option A) is incorrect because it involves a sudden loss of muscle tone,leadingtoalimp or "drop"in theperson.
Simple partial seizures in (option C) are focal seizures that affect a specific region of thebrain,causinglocalizedsymptoms suchas twitchingor tinglinginaparticularbodypart.
Tonic-clonic seizures in (option D) also known as grand mal seizures, is incorrect because itinvolves a combination of muscle rigidity (tonic phase) and jerking movements (clonicphase).
Therefore, based on the description provided, the behaviour of staring into space ischaracteristic of B. Absence seizures. It is important for the child to be evaluated by ahealthcare professional for an accurate diagnosis and appropriate management of theirseizures.
Correct Answer is C
Explanation
The most important factor in determining the rate of fluid replacement in a dehydrated child
is urine output. Urine output is a crucial indicator of renal perfusion and hydration status.
Monitoring urine output allows healthcare professionals to assess the child's response to fluid
replacement therapy and adjust the rate accordingly.
The type of dehydration in (Option A) is incorrect. The type of dehydration, is important in
determining the appropriate fluid composition for rehydration but does not directly dictate the
rate of fluid replacement.
The child’s weight in (Option B) is incorrect. The child's weight, is considered when
calculating the maintenance fluid requirements, but it does not solely determine the rate of
fluid replacement for dehydration.
Serum potassium level in (Option D) is incorrect. The serum potassium level, is important to
monitor in a dehydrated child, especially in cases of severe dehydration, as electrolyte
imbalances may occur. However, it is not the most important factor in determining the rate of
fluid replacement. Fluid replacement is primarily guided by assessing the child's hydration
status through parameters such as urine output and clinical assessment.
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