The formula used to calculate daily insulin requirements in children younger than 12 years who have type 1 diabetes mellitus is:

Rationale:
A. Ear pain alone may persist during the first few days of effective antibiotic therapy and is not an immediate indication to switch antibiotics.
B. Persistent redness of the tympanic membrane can also remain for several days, even with effective treatment.
C. Mobility of the tympanic membrane during pneumatic otoscopy suggests that fluid is not under high pressure, which is not an indication to change therapy.
D. A persistent high fever (≥102°F) after 48–72 hours of antibiotic therapy may indicate treatment failure or infection with a resistant organism. In such cases, the nurse practitioner should consider switching to an alternative antimicrobial or further evaluation.

Rationale:
A. A bulb syringe delivers low pressure and is less effective for thoroughly cleansing an open wound, especially if debris is present.
B. A 20-mL catheter tip syringe allows controlled irrigation with sufficient pressure (approximately 8 psi) to effectively remove debris and contaminants without damaging healthy tissue. This is considered the standard method for wound irrigation.
C. Using an IV bag without pressure may not provide adequate force to flush out debris and contaminants.
D. Gauze compresses can clean the wound surface but do not provide the irrigation pressure necessary for thorough cleansing.