Which signs may indicate a need for insulin in a child with diabetes?
Confusion and lethargy
Headache and pallor
Diaphoresis and tremors
Polydipsia and polyuria
The Correct Answer is C
Choice A reason: Confusion and lethargy in diabetes can result from severe hypoglycemia or hyperglycemia, such as diabetic ketoacidosis, due to inadequate cerebral glucose or metabolic acidosis. These symptoms are less specific than sympathetic responses like sweating and shaking, which directly indicate acute hypoglycemia, requiring immediate insulin adjustment or glucose to prevent neurological complications like seizures.
Choice B reason: Headache and pallor may occur in hypoglycemia due to catecholamine release or cerebral hypoperfusion but are non-specific, as they can stem from dehydration or stress. Diaphoresis and tremors are more direct indicators of low blood glucose, reflecting sympathetic activation, making them more specific for urgent insulin or glucose intervention in diabetic children.
Choice C reason: Diaphoresis and tremors are hallmark signs of hypoglycemia (<70 mg/dL) in diabetes, triggered by sympathetic nervous system activation to counter low glucose levels. These symptoms signal an acute need for insulin adjustment or glucose administration to restore normoglycemia, preventing seizures or coma, making them the most specific indicators for immediate intervention.
Choice D reason: Polydipsia and polyuria indicate hyperglycemia in diabetes, caused by osmotic diuresis from elevated blood glucose. These reflect chronic poor glycemic control rather than an acute need for insulin, as they do not signal immediate hypoglycemia. Diaphoresis and tremors are more urgent, indicating a need for rapid glucose correction to prevent complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Droplet precautions are used for diseases like influenza, spread by large respiratory droplets over short distances. Varicella is transmitted via airborne particles and direct contact, requiring airborne precautions with negative pressure rooms to prevent viral spread, making droplet precautions insufficient for this highly contagious infection.
Choice B reason: Indirect transmission precautions are not a standard category; contact precautions address indirect spread via fomites. Varicella spreads primarily through airborne routes and direct contact, requiring airborne precautions with specialized ventilation. This option is incorrect, as it does not fully address varicella’s transmission modes in a hospital setting.
Choice C reason: Varicella (chickenpox) is highly contagious, spread via airborne viral particles and direct contact. Airborne precautions, including negative pressure rooms and N95 masks, prevent inhalation of infectious aerosols. This is essential in hospitals to protect patients and staff, making it the correct precaution for a child with active varicella.
Choice D reason: Contact precautions address direct or fomite transmission, as in MRSA. Varicella requires airborne precautions due to its primary spread via respiratory aerosols. While contact precautions are relevant, they are insufficient alone, as airborne transmission is the dominant mode, making this an incomplete precaution for varicella.
Correct Answer is B
Explanation
Choice A reason: A respiratory rate of 24/min is normal for a 3-year-old but does not specifically indicate rehydration success. Dehydration may cause tachypnea due to acidosis, but a normal rate is non-specific. Urine specific gravity better reflects fluid status, as it directly measures renal response to rehydration in diarrhea.
Choice B reason: Urine specific gravity of 1.015 indicates normal hydration, as kidneys produce appropriately concentrated urine after rehydration therapy corrects fluid loss in diarrhea. Values above 1.020 suggest persistent dehydration. This finding confirms effective restoration of fluid balance, making it the best indicator of successful oral rehydration in this child.
Choice C reason: Capillary refill greater than 3 seconds indicates poor perfusion, suggesting ongoing dehydration despite therapy. Effective rehydration restores perfusion, reducing refill time to less than 2 seconds. This finding suggests therapy failure, making it an incorrect indicator of successful oral rehydration in a child with diarrhea.
Choice D reason: A heart rate of 130/min suggests tachycardia, indicating persistent dehydration or stress in a 3-year-old, where normal rates are 80-120/min. Effective rehydration lowers heart rate by restoring volume. Urine specific gravity better confirms hydration status, making tachycardia an incorrect indicator of therapy success.
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