A nurse is teaching the family of a 10-year-old child recently diagnosed with Type 1 Diabetes Mellitus.
The nurse explains that the disease is caused by what process?
Complete or partial inability of the body to produce insulin.
Inability of the body cells to use glucose.
Overproduction of insulin by the pancreas.
Inability of the body cells to store glucose as glycogen.
The Correct Answer is A
Choice A rationale
Type 1 diabetes mellitus is characterized by the autoimmune destruction of the beta cells in the islets of Langerhans within the pancreas. This process leads to an absolute deficiency of insulin, meaning the body cannot produce the hormone necessary for glucose transport into cells. Without endogenous insulin, blood glucose levels rise significantly, leading to the clinical manifestations of hyperglycemia and the potential for life-threatening ketoacidosis if left untreated with exogenous replacement.
Choice B rationale
This description primarily refers to the pathophysiology of Type 2 diabetes mellitus rather than Type 1. In Type 2, the primary issue is insulin resistance, where peripheral tissues like muscle and fat do not respond effectively to the insulin that is being produced. While glucose utilization is eventually impaired in Type 1 due to the lack of the signal, the actual cause of the disease is the production failure itself, not a cellular refusal to respond.
Choice C rationale
Overproduction of insulin, or hyperinsulinism, is not the cause of diabetes; instead, it typically results in hypoglycemia, which is low blood sugar. This condition can be seen in cases of insulinomas or during the early stages of metabolic syndrome before the pancreas fails. In Type 1 diabetes, the pancreatic beta cells are destroyed, making it impossible for the organ to overproduce insulin. Therefore, this choice contradicts the basic physiological reality of the disease.
Choice D rationale
The inability to store glucose as glycogen, known as glycogenesis, is a consequence of insulin deficiency rather than the primary cause of the disease. Insulin is the hormone that activates the enzymes responsible for converting glucose into glycogen in the liver and muscles. While this storage failure contributes to high circulating blood sugar levels, it occurs because there is no insulin available to trigger the process, making it a secondary effect of the pancreatic cell destruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Alcohol acts as a potent teratogen that can cross the placental barrier with ease throughout all developmental stages. While the first trimester involves critical organogenesis where structural defects are most likely to occur, the second and third trimesters are periods of rapid brain growth and functional development. Restricting prohibition to only the first trimester ignores the continuous risk of fetal alcohol spectrum disorders and neurodevelopmental impairments that can occur at any stage of gestation.
Choice B rationale
The recommendation for total abstinence is based on the scientific consensus that there is no established safe threshold for alcohol consumption during pregnancy. Alcohol interferes with cellular differentiation and protein synthesis in the developing fetus. Consistent avoidance prevents the risk of fetal alcohol syndrome, which is characterized by growth deficiencies, central nervous system dysfunction, and unique facial features. Maintaining a zero-exposure policy ensures the highest level of protection for the maturing fetal neurological system.
Choice C rationale
Suggesting that any specific amount of alcohol, such as one ounce, is safe is clinically inaccurate and dangerous. Individual metabolism of ethanol varies significantly, and the fetal liver lacks the mature enzymes, such as alcohol dehydrogenase, necessary to detoxify the substance. Even low levels of intake have been linked to subtle behavioral and cognitive deficits. Nurses must provide evidence-based guidance that emphasizes the absence of a proven safe minimum to prevent potential developmental harm.
Choice D rationale
Claiming safety in the second and third trimesters is physiologically incorrect because the fetal brain continues to undergo complex maturation until birth. Exposure during these later stages can lead to reduced brain volume, altered neuronal migration, and placental insufficiency. Alcohol can cause vasoconstriction of the umbilical vessels, leading to hypoxia. Therefore, telling a patient that drinking is safe after the first trimester contradicts modern obstetric standards and increases the risk of poor neonatal outcomes.
Correct Answer is D
Explanation
Choice A rationale
The axillary route is the preferred non-invasive method for infants aged 3 months because it is safe and easily accessible without causing significant distress or risk of injury. In infants, the normal axillary temperature range is typically 36.5 to 37.5 degrees Celsius. This method avoids the risks associated with rectal thermometers, such as mucosal perforation, and provides a reliable assessment of thermal stability in young infants who cannot cooperate with oral or tympanic measurements.
Choice B rationale
The oral route is appropriate for a 10-year-old child because they have developed the cognitive and physical maturity required to hold the probe under the tongue and keep their mouth closed. School-aged children can follow instructions effectively, ensuring the sensor remains in contact with the sublingual artery for an accurate reading. The normal oral temperature range for this age group is 36.4 to 37.0 degrees Celsius, representing a standard and reliable measurement for older pediatric patients.
Choice C rationale
The tympanic route is suitable for a 4-year-old child because it provides a quick and accurate reflection of core body temperature by measuring infrared heat from the eardrum. By age 4, the ear canal is sufficiently developed to allow proper positioning of the probe. This method is often preferred in toddlers and preschoolers as it is less intrusive than other methods. A normal tympanic temperature typically mirrors the core temperature, ranging from 36.4 to 37.5 degrees Celsius.
Choice D rationale
This choice is correct because it encompasses all the developmentally appropriate methods for the respective age groups listed. Selecting the correct thermometry route requires a thorough understanding of pediatric anatomy and behavioral development. Each specified route aligns with clinical standards that prioritize patient safety and diagnostic accuracy. Using age-appropriate methods ensures that the nurse obtains a precise measurement while minimizing physical discomfort and psychological stress for the child, which is essential for effective clinical assessment.
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