A nurse is teaching a school-age child and their parents about managing diabetes mellitus during illness. The nurse should determine that the teaching has been effective when the parents indicate they will provide which of the following when the child is ill?

Decreased calories

Increased fluids

Blood glucose monitoring every 8 hr

Urine testing for leukocytes

Answer and Explanation

The Correct Answer is B

A. Decreased calories:

During illness, it's important to ensure adequate calorie intake to meet the body's increased energy demands for fighting off infection. Decreasing calories is not appropriate and can lead to hypoglycemia in a child with diabetes mellitus.

B. Increased fluids:

This is the correct option. During illness, the body's fluid requirements increase due to fever, sweating, and increased urination. Providing increased fluids helps prevent dehydration, which can exacerbate hyperglycemia. Parents should encourage the child to drink plenty of water or other sugar-free fluids to stay hydrated.

C. Blood glucose monitoring every 8 hr:

During illness, blood glucose levels may fluctuate more than usual due to changes in food intake, activity level, and the body's response to stress. Therefore, more frequent blood glucose monitoring is necessary, typically every 2-4 hours or as directed by the healthcare provider, rather than every 8 hours.

D. Urine testing for leukocytes:

Urine testing for leukocytes is not directly related to managing diabetes mellitus during illness. It may be done to assess for urinary tract infections, which can occur more frequently in individuals with diabetes, but it is not a routine part of diabetes management during illness.

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Correct Answer is A

Explanation

A. Report of diplopia

Diplopia, or double vision, can be a symptom of increased intracranial pressure (ICP) due to its effects on cranial nerve function. Therefore, it is a manifestation that the nurse should recognize as indicating the presence of increased ICP.

B. Hyperactivity

Hyperactivity is not typically associated with increased ICP. Instead, manifestations of increased ICP often include altered level of consciousness, lethargy, or even coma.

C. Nuchal rigidity

Nuchal rigidity, or stiffness in the neck, is not a direct manifestation of increased ICP. It is more commonly associated with meningitis or other conditions affecting the meninges.

D. Report of sore throat

A sore throat is not typically associated with increased ICP unless it is related to complications such as pharyngeal injury or infection.

A. "What are your reasons for making this decision today?" B. "You should discuss your concerns with your child's provider." C. "You should give the treatment a chance to work before giving up." D. "Do you need assistance gathering your child's belongings to return home?"

Correct Answer is A

Explanation

A. "What are your reasons for making this decision today?"

This response demonstrates active listening and allows the parent to express their reasons for wanting to discontinue treatment. It opens up a dialogue between the nurse and the parent, which is important for understanding their perspective.

B. "You should discuss your concerns with your child's provider."

While it's important for the parent to communicate with the child's healthcare provider, this response may come across as dismissive of the parent's concerns and decision-making process.

C. "You should give the treatment a chance to work before giving up."

This response may seem judgmental and dismissive of the parent's feelings and autonomy. It does not address the parent's concerns and may further strain the nurse-parent relationship.

D. "Do you need assistance gathering your child's belongings to return home?"

This response is practical but does not address the underlying reasons for the parent's desire to discontinue treatment. It's important for the nurse to engage in therapeutic communication and explore the parent's concerns further.

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A nurse is teaching a school-age child and their parents about managing diabetes mellitus during illness. The nurse should determine that the teaching has been effective when the parents indicate they will provide which of the following when the child is ill?

Nursing Test Bank

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