An adolescent with type 1 diabetes mellitus will become a member of the school's football cheerleader team. The adolescent excitedly reports to the school nurse to obtain information regarding adjustments needed in the treatment plan for the diabetes. The school nurse would explain to the adolescent to take which action?

Take the prescribed insulin 30 minutes before practice or game time rather than in the morning.

Eat half the amount of food normally eaten at lunchtime.

Eat six graham crackers or drink a cup of orange juice before practice or game time.

Take two times the amount of prescribed insulin on practice and game days.

Answer and Explanation

The Correct Answer is C

A. Take the prescribed insulin 30 minutes before practice or game time rather than in the morning. Insulin timing should generally be consistent with meal times to match insulin action with food intake. Adjusting timing without medical advice can lead to imbalanced blood sugar levels.
B. Eat half the amount of food normally eaten at lunchtime. Eating less food than usual can lead to hypoglycemia during prolonged physical activity and is not recommended.
C. Eat six graham crackers or drink a cup of orange juice before practice or game time. This action helps to prevent hypoglycemia during physical activity by providing quick-acting carbohydrates that can be readily absorbed and utilized by the body.
D. Take two times the amount of prescribed insulin on practice and game days. Doubling insulin doses without medical supervision can lead to hypoglycemia and is not appropriate for managing blood sugar during physical activity.

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Explanation

i. Pain:

Priority: Pain is a critical factor that needs immediate attention, especially since the adolescent reports a high pain level of 9/10, which indicates severe discomfort. Unmanaged pain can lead to increased stress, anxiety, and potentially worsen the patient’s condition. The adolescent is guarding the abdomen, which indicates severe pain possibly due to an underlying issue such as appendicitis or another serious abdominal pathology. The right lower quadrant pain and positive obturator sign suggest an acute abdomen, which could be life-threatening and requires urgent attention.

ii. Heart rate:

Priority: After addressing pain, the nurse should focus on the heart rate, which is elevated at 124 beats per minute (tachycardia). Tachycardia in this context could be a response to pain or an indication of infection, dehydration, or another serious underlying condition. Given that the temperature is slightly elevated (38°C or 100.4°F), there is a possibility of an infectious process, which could be contributing to both pain and the elevated heart rate.

Other Considerations:

Nausea: Addressing nausea is important but secondary to the more urgent need to manage severe pain and evaluate cardiovascular stability.
Bowel Movement: The last bowel movement was yesterday, and the patient does not report significant changes in bowel habits, making this less urgent than the acute symptoms.
WBC Count: While it’s important to assess WBC count to check for infection, it’s part of a broader diagnostic workup that follows after addressing immediate symptoms.
Decreased Appetite: This is a symptom of the underlying condition but is not as immediate a concern as pain and heart rate in the acute setting.

A. "Has your child had any diarrhea?" B. "Have you noticed any rashes on your child?" C. "Did your child sustain any injuries to the kidney area?" D. "Did your child recently complain of a sore throat?"

Correct Answer is D

Explanation

A. "Has your child had any diarrhea?" Diarrhea is not typically associated with glomerulonephritis.
B. "Have you noticed any rashes on your child?" Rashes are not typically associated with glomerulonephritis.
C. "Did your child sustain any injuries to the kidney area?" Direct kidney trauma is not a common cause of glomerulonephritis in children.
D. "Did your child recently complain of a sore throat?" Poststreptococcal glomerulonephritis (a common cause of acute glomerulonephritis in children) often follows a streptococcal throat or skin infection. Asking about a recent sore throat can provide important information about a possible streptococcal infection.

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Naxlex Comprehensive Predictor Exams

A nurse is assisting in the care of an adolescent who reports abdominal pain. Exhibits Complete the following sentence by using the list of options. The nurse should first address the client's dropdown followed by the client’s dropdown.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Explanation

The nurse is collecting data on a child recently diagnosed with glomerulonephritis. Which question to the parent would elicit information about the cause of this disease?

Correct Answer is D

Explanation

A nurse is caring for a child who has had watery diarrhea for the past 3 days. Which of the following is an action for the nurse to take?

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