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

Answer and Explanation

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.

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Correct Answer is A

Explanation

Choice A reason: Complex carbohydrates (e.g., whole grains) and high-fiber foods provide steady glucose release, aiding glycemic control in type 1 diabetes. Fiber slows glucose absorption, reducing postprandial spikes. This supports insulin therapy, promoting stable blood sugar and preventing hypoglycemia or hyperglycemia, making it the optimal dietary measure for children.

Choice B reason: Controlling carbohydrate intake is important in type 1 diabetes, but reducing calories is not universally required, especially in growing children. Complex carbohydrates and fiber are prioritized for stable glucose levels. Calorie restriction may impair growth, making this a less appropriate dietary focus compared to complex carbohydrate emphasis.

Choice C reason: A diet low in fat is beneficial, but low complex carbohydrates are counterproductive in type 1 diabetes. Complex carbohydrates provide sustained glucose for insulin matching, supporting growth and energy needs. Low-carbohydrate diets risk hypoglycemia, making this an incorrect dietary measure for effective diabetes management in children.

Choice D reason: Obtaining most calories from proteins and fats risks ketosis and inadequate glucose for insulin therapy in type 1 diabetes. Complex carbohydrates are essential for stable blood sugar and growth. High-fat/protein diets may cause long-term cardiovascular issues, making this an inappropriate dietary focus for diabetic children.

A. Mucus in stools B. Increased appetite C. Jaundice D. Drooling

Correct Answer is A

Explanation

Choice A reason: Intussusception causes bowel obstruction, leading to mucus in stools, often mixed with blood (“currant jelly” stools) due to mucosal irritation and ischemia. This results from the telescoping of intestinal segments, impairing blood flow and causing tissue damage, making mucus a hallmark sign expected in a toddler with this condition.

Choice B reason: Increased appetite is unlikely in intussusception, as bowel obstruction causes pain, vomiting, and reduced intestinal function, leading to anorexia. The toddler’s discomfort and nausea from ischemia and obstruction suppress appetite, making this an incorrect manifestation compared to mucus, which directly reflects the intestinal pathology.

Choice C reason: Jaundice results from bilirubin accumulation, typically in liver or biliary disorders, not intussusception. This condition affects the intestines, causing obstruction and mucosal bleeding, not hepatic dysfunction. Mucus in stools is a direct consequence of intussusception, making jaundice an unrelated and incorrect expected finding.

Choice D reason: Drooling is associated with upper airway or esophageal issues, like tracheoesophageal fistula, not intussusception. This intestinal condition causes abdominal symptoms like mucus in stools, not salivary pooling. Drooling is irrelevant to the pathophysiology of bowel obstruction, making it an incorrect manifestation for this toddler.

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Which signs may indicate a need for insulin in a child with diabetes?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which general dietary measure should the nurse include in a teaching plan for the child with type 1 diabetes mellitus?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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