A nurse is educating a parent and child on the new diagnosis of type 1 diabetes mellitus.
Which of the following manifestations are associated with hypoglycemia?
Abdominal pain and double vision.
Nightmares and sweating.
Excessive urination and fruity breath odor.
Flushed skin and dry mucous membranes.
The Correct Answer is B
Choice A rationale
Abdominal pain can be a symptom of both hypoglycemia and hyperglycemia, but it is not a hallmark sign of hypoglycemia. Double vision, or diplopia, is also a less common and non-specific neurological symptom. The primary manifestations of hypoglycemia are related to the body's counter-regulatory stress response and neuroglycopenia, or insufficient glucose to the brain.
Choice B rationale
Nightmares and sweating are classic autonomic and neuroglycopenic symptoms of hypoglycemia. The body releases catecholamines, such as epinephrine, in response to low blood glucose, which triggers sweating, palpitations, and anxiety. The central nervous system's lack of glucose causes neurological symptoms like nightmares, confusion, and behavioral changes.
Choice C rationale
Excessive urination (polyuria) and a fruity breath odor are classic symptoms of hyperglycemia. Polyuria occurs as the kidneys excrete excess glucose, pulling water with it. Fruity breath odor is caused by the presence of ketones, which are a byproduct of fat metabolism when the body cannot use glucose for energy, a state known as diabetic ketoacidosis.
Choice D rationale
Flushed, warm skin and dry mucous membranes are indicative of dehydration, which is a symptom of hyperglycemia due to the osmotic diuresis caused by high blood glucose levels. Hypoglycemia, on the other hand, is characterized by pale, cool, and clammy skin as a result of the compensatory vasoconstriction and sweating initiated by the sympathetic nervous system. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A temperature of 37.9° C is considered a low-grade fever and is not a contraindication to receiving the MMR vaccine. Minor illnesses with or without a fever are not a reason to withhold vaccination. The immune system is fully capable of responding to the vaccine antigens, and there is no evidence of an increased risk of adverse events from vaccination in this scenario.
Choice B rationale
A family history of sudden unexpected infant death (SUID) is not a contraindication for the MMR immunization. SUID is a tragic event with an unknown etiology and is not causally linked to vaccine administration. There is no evidence that a family history of SUID increases the risk of vaccine-related adverse events, and immunizations remain a critical component of preventative care.
Choice C rationale
Taking an antihistamine for seasonal allergies is not a contraindication for the MMR vaccine. Antihistamines do not interfere with the body's immune response to the vaccine antigens. The vaccine can be safely administered to a child with seasonal allergies who is currently taking antihistamine medication. The medication does not impact vaccine efficacy or safety.
Choice D rationale
Receiving high-dose systemic corticosteroids like prednisone for nephrotic syndrome is a contraindication to receiving a live-attenuated vaccine like MMR. Corticosteroids are immunosuppressive agents, and their use can compromise the child's ability to mount an appropriate immune response to the vaccine, potentially leading to an uncontrolled replication of the weakened virus and causing a vaccine-associated illness. .
Correct Answer is C
Explanation
Choice A rationale
Stating that the parent "should give the treatment a chance to work" is dismissive of their concerns and feelings. This response is judgmental and paternalistic, invalidating the parent's autonomy and their right to make healthcare decisions for their child. The nurse's role is to support and educate, not to pressure or shame the parent.
Choice B rationale
Telling the parent to discuss their concerns with the provider is a valid option but is not the best initial response. This approach defers the conversation and does not address the parent's immediate emotional state or their reasons for the decision. The nurse's first step should be to explore the parent's feelings and understanding.
Choice C rationale
Asking the parent about their reasons for the decision is the most therapeutic and patient-centered response. This open-ended question encourages the parent to express their feelings, fears, and rationale.
It demonstrates respect for their autonomy and opens a channel for a non-judgmental discussion, allowing the nurse to provide targeted support and education.
Choice D rationale
Offering to assist with gathering belongings is premature and non-therapeutic. This response assumes the parent has made a final, irreversible decision and immediately facilitates their departure without exploring the underlying reasons. It closes the door to further dialogue and does not fulfill the nurse's role as a patient advocate.
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