Deck 15: Metabolism

Question 1

When caring for a child with diabetes mellitus, what lab value should be checked every 3 to 6 months to reassess the insulin regimen and troubleshoot changes in the child's needs?

A) Urinalysis
B) Serum glucose
C) Hemoglobin A_1c
D) Hemoglobin/hematocrit

Answer 1

C

Question 2

If you are managing the care of a 14-year-old diabetic teenager, which of the following hemoglobin A_1c values would be ideal for a patient in this age group?

A) 7.3%
B) 7.8%
C) 8.2%
D) 8.7%

Answer 2

A

Question 3

As a pediatric nurse, what advice would you give to the parent of a diabetic child who experienced a transient uptick in the hemoglobin A_1c level?

A) The child needs to minimize intake of carbohydrates.
B) The child may need to be switched from oral medication to insulin injections.
C) This uptick may indicate stress or a growth spurt.
D) The uptick may indicate a need to test blood sugar more often throughout the day.

Answer 3

C

Question 4

As a pediatric nurse, what education would you provide to a parent of a child who suffers from type 1 diabetes?

A) Go to the emergency room immediately if blood sugar level is in excess of 200 mg/dL.
B) Have child screened annually for autoimmune thyroid disease and celiac disease.
C) Because diabetes is a risk factor for heart disease, the child should be screened for other heart disease risk factors.
D) Because diabetes mellitus has a genetic component, the parent should be screened for diabetes mellitus.

Question 5

If a patient is suffering from Dawn phenomenon, which is elevated blood glucose between 5 and 6 a.m, what action would you take to correct this condition?

A) Educate the patient not to eat after midnight.
B) Make sure the patient takes oral diabetic medication first thing in the morning.
C) Increase the dose of long-acting or basal insulin.
D) Increase the dose of oral diabetes medications.

Question 6

If a child with persistent hyperglycemia presents with acanthosis nigricans, where on the child's body would this abnormal pigmentation be found?

A) Arms
B) Legs
C) Back
D) Neck

Question 7

The family of a diabetic child is confused because their child is experiencing the Somogyi effect, which is hyperglycemia in the morning in response to hypoglycemia during the night (rebound high). Which action would you suggest to prevent this confusing phenomenon from occurring?

A) Educate the patient not to eat after midnight.
B) Make sure the patient takes oral diabetic medication first thing in the morning.
C) Increase the dose of long-acting or basal insulin.
D) Give the child a bedtime snack along with insulin.

Question 8

If a child presents with diabetic ketoacidosis, as a pediatric nurse, what is the goal for normalizing this child's blood glucose level?

A) Normalize it as quickly as possible
B) Normalize is as slowly and steadily as possible
C) Reduce blood glucose levels by 25 mg/dL per hour
D) Reduce blood glucose levels by 50 mg/dL per hour

Question 9

When treating a child in severe diabetic ketoacidosis, the child is placed in the intensive care unit on an insulin IV drip of what concentration?

A) 1 unit regular insulin per 1 mL of 0.9% normal saline
B) 1 unit rapid-acting insulin per 1 mL of 0.9% normal saline
C) 10 units regular insulin per 1mL of 0.9% normal saline
D) 1 unit rapid-acting insulin per 10 mL of 0.9% normal saline

Question 10

You are caring for an infant with galactosemia. What education would you provide to the family regarding management of this medical condition?

A) Infant is to be nourished with milk only
B) Infant is never to be bottle fed, only breast fed
C) Infant should be nourished with soy-based formulas
D) Infant should be nourished with clear liquids and vitamin supplementation