The nurse is preparing to discharge an 11 year old patient newly diagnosed with type 1 diabetes. Which of the following statements by the parents indicate that they are safe for discharge? Select ALL that apply
We will make sure that we have enough metformin when we go on vacation
We may have to check blood sugars more frequently when he is sick
We should rotate insulin injection sites frequently to reduce scar tissue forming
We will check glucose levels once he starts to eat
We will always need to check ketones when his blood sugar is above 100
Correct Answer : B,C
Rationale:
A. We will make sure that we have enough metformin when we go on vacation: Metformin is an oral antidiabetic medication used for type 2 diabetes, not type 1. A child with type 1 diabetes will require insulin for glucose control.
B. We may have to check blood sugars more frequently when he is sick: Illness can raise blood glucose levels due to stress hormones, so more frequent monitoring helps guide insulin adjustments and prevent complications like diabetic ketoacidosis (DKA).
C. We should rotate insulin injection sites frequently to reduce scar tissue forming: Repeated injections in the same location can cause lipodystrophy (scar tissue or fat changes) which can impair insulin absorption. Rotating sites helps maintain consistent medication effectiveness.
D. We will check glucose levels once he starts to eat: Glucose monitoring for type 1 diabetes is often done before meals, not just after eating. Pre-meal checks guide insulin dosing and help maintain better blood glucose control.
E. We will always need to check ketones when his blood sugar is above 100: This is incorrect because ketone testing is not needed at such a low blood sugar threshold. Ketone testing is typically done when glucose levels are above 240 mg/dL or if the child is ill, to monitor for DKA risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. A high-pitched "click" is heard with hip flexion or extension: A soft or high-pitched click may occur in many healthy newborns due to ligament laxity and is not specific to developmental dysplasia of the hip (DDH). It is generally considered a benign finding.
B. A distinct "clunk" is heard with Barlow and Ortolani maneuvers: This is a hallmark finding for DDH. The “clunk” indicates the femoral head is either dislocating from or relocating into the acetabulum during these maneuvers, confirming hip instability and potential dislocation.
C. The thigh and gluteal folds are symmetric: Symmetric skin folds suggest normal hip alignment. Asymmetry of these folds is more concerning for DDH, so symmetry would not confirm the diagnosis.
D. Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis): This degree of hip motion can be within normal limits, especially in the absence of instability. Restricted abduction is more consistent with DDH in older infants.
Correct Answer is D
Explanation
Rationale:
A. The infant's eye appears to be protruding: Protrusion of the eye, or proptosis, is more often linked to orbital tumors, severe infections, or trauma rather than retinoblastoma. Retinoblastoma primarily affects the retina inside the eye, not surrounding orbital structures.
B. The infant tugs and pulls at one ear: Ear pulling is more commonly associated with otitis media or ear discomfort. This behavior is not connected to retinoblastoma and would not be expected in a history related to an intraocular tumor.
C. The infant always keeps her eyes tightly closed: Persistent eye closure could be a sign of photophobia, eye irritation, or pain from corneal abrasions or infections, but it is not the hallmark presentation of retinoblastoma.
D. One pupil appears white: A white reflex in the pupil, known as leukocoria, is a classic finding in retinoblastoma. Parents may notice this when light shines in the child’s eye, where one pupil appears white instead of the normal red reflex.
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