The nurse is speaking with the parents of a child recently diagnosed with diabetes mellitus regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching?
"If my son says he feels shaky, his blood sugar may be low."
"When my son's breath smells fruity, it almost always indicates high blood sugar."
"Flushed skin may be a sign of high blood sugar."
"If I notice changes in my son like sweating or slurred speech his blood sugar may be high."
The Correct Answer is D
A. Shakiness, tremors, anxiety, palpitations, and irritability are early signs of hypoglycemia, which occurs when blood glucose drops below the child’s target range (often <70 mg/dL). Prompt recognition allows immediate intervention, such as administering fast-acting carbohydrates (juice or glucose tablets), preventing progression to seizures or loss of consciousness.
B. Fruity or acetone-smelling breath is a hallmark of hyperglycemia with ketosis, commonly associated with diabetic ketoacidosis (DKA). It occurs because insufficient insulin causes the body to metabolize fat for energy, producing ketones. Other signs include nausea, vomiting, abdominal pain, and rapid breathing. Early recognition is crucial to prevent severe metabolic acidosis.
C. Hyperglycemia can lead to dehydration due to osmotic diuresis. The resulting fluid loss can cause warm, flushed skin, along with increased thirst (polydipsia) and frequent urination (polyuria). These signs often develop gradually, unlike hypoglycemia, which presents more suddenly.
D. Sweating, pallor, tremors, irritability, confusion, slurred speech, and weakness are classic signs of hypoglycemia, not hyperglycemia. Hypoglycemia develops rapidly and can progress to seizures, coma, or death if untreated. Misidentifying these symptoms as hyperglycemia could delay administering glucose and lead to serious complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Slipped capital femoral epiphysis (SCFE) is most commonly seen in obese children, particularly males, during the preadolescent growth spurt (typically ages 10–16). Excess body weight increases stress on the growth plate (epiphysis) of the femoral head, making it more prone to slippage. Recognizing the high-risk population allows the nurse to anticipate complications, provide appropriate monitoring, and prepare for surgical intervention, which is the standard treatment.
B. While SCFE can occur in females, it is less common than in males. Female cases often present slightly later and may be associated with hormonal or endocrine factors, but statistically, preadolescent males are at higher risk.
C. SCFE is not typically associated with a tall, thin body type. This description is more characteristic of other orthopedic conditions, such as Marfan syndrome-related skeletal issues, rather than SCFE.
D. Physical activity alone is not a primary risk factor for SCFE. The condition is largely associated with obesity and rapid growth, not activity level.
Correct Answer is C
Explanation
A. Changes in respiratory rate, such as irregular or slowed breathing, typically occur later in the course of increasing intracranial pressure (ICP), often indicating severe brainstem involvement. It is not the first sign.
B. Bradycardia is a component of Cushing’s triad (bradycardia, hypertension, and irregular respirations) associated with advanced ICP, not an early sign. Relying on heart rate changes alone may delay recognition of ICP.
C. Altered mental status is the earliest and most sensitive indicator of increasing ICP in children. This can include irritability, restlessness, confusion, or decreased responsiveness. Early recognition of changes in level of consciousness allows prompt intervention to prevent further neurological compromise.
D. Tachycardia is not a primary indicator of rising ICP. Heart rate changes are nonspecific and usually occur secondary to pain, anxiety, or systemic stress, rather than as an early ICP sign.
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