Deck 31: The Child with a Metabolic Condition

Question 1

The nurse caring for a child with a new diagnosis of type 1 diabetes mellitus plans the care based on the understanding that:

A) there is an absolute deficiency of insulin.
B) insufficient quantities of insulin are produced by the pancreas.
C) oral hypoglycemic agents can control it.
D) insulin deficiency is caused by another disease affecting the pancreas.

Answer 1

there is an absolute deficiency of insulin.

Question 2

Although the child with type 1 diabetes had her prescribed insulin at 7:30 AM, the child is complaining of hunger and thirst and is drowsy at 10:30 AM. The nurse should first:

A) walk the patient in the hall for 10 minutes.
B) allow the patient a short nap.
C) give her a cup of orange juice.
D) test her blood with a glucometer and give insulin according to the sliding scale.

Answer 2

give her a cup of orange juice.

Question 3

The nurse teaching parents of a child with diabetes insipidus about water intoxication would tell the parents to be alert for:

A) polyuria.
B) cough.
C) weight loss.
D) lethargy.

Answer 3

lethargy.

Question 4

When teaching a 12-year-old how to administer insulin, the nurse instructs the child to:

A) make sure injection sites are 6 inches apart.
B) select an injection site that was recently exercised.
C) inject the needle at a 90-degree angle.
D) give the injection deep into the muscle.

Question 5

The nurse planning to teach a family about Tay-Sachs disease understands the pattern of inheritance for inborn errors of metabolism is usually:

A) autosomal recessive.
B) autosomal dominant.
C) X-linked recessive.
D) multifactorial.

Question 6

The parents of a child newly diagnosed with diabetes mellitus tell the nurse, "Our son's body is resistant to insulin." The nurse recognizes this description as consistent with:

A) type 1, insulin-dependent diabetes mellitus.
B) type 2, non-insulin-dependent diabetes mellitus.
C) maturity-onset diabetes of youth.
D) drug-induced diabetes.

Question 7

What would be the most appropriate nursing response to a woman who says, "My sister had a child with Tay-Sachs disease, and I want to know if I could have a child with this condition."

A) "The disease is rare. It is unlikely that you would have a child with Tay-Sachs disease."
B) "A screening test can be done to determine if you are a carrier of the gene."
C) "The gene for Tay-Sachs disease is transmitted by the father."
D) "The cause of Tay-Sachs disease is thought to be an autoimmune response to a virus."

Question 8

The general dietary measure to include in a teaching plan for the child with type 1 diabetes mellitus is to:

A) control intake of carbohydrates and consume fewer calories.
B) focus on complex carbohydrates and eat foods high in fiber.
C) obtain most calories from proteins and fats.
D) eat a diet low in fat and low in complex carbohydrates.

Question 9

The statement made by a 7-year-old child with type 1 diabetes mellitus that indicates a need for more teaching is:

A) "My pancreas is sick and needs insulin until it is well."
B) "I will need to take my insulin every day."
C) "I need to keep a piece of candy in my pocket in case I start to feel shaky."
D) "My mom has to give me insulin shots twice a day."

Question 10

The nurse determines a parent is administering levothyroxine (Synthroid) correctly when she states:

A) "I stopped giving the medication because my daughter was losing her hair."
B) "I am using a different brand now because it costs less money."
C) "I don't give the medication on the weekends."
D) "I give the medication at 8:00 AM every day."

Question 11

The condition the nurse suspects when a child with type 1 diabetes mellitus has hyperglycemia, diaphoresis, and headaches in the morning is:

A) dawn phenomenon.
B) Somogyi phenomenon.
C) honeymoon effect.
D) ketoacidosis.

Question 12

A child with diabetes is brought to the emergency department. He is flushed and drowsy, and his skin is dry. His father states that the child has been feeling progressively worse since the morning. This child is most likely experiencing:

A) Somogyi phenomenon.
B) dawn syndrome.
C) ketoacidosis.
D) water intoxication.

Question 13

A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The nurse recognizes that these signs are characteristic of:

A) hypothyroidism.
B) hyperthyroidism.
C) type 1 diabetes mellitus.
D) Tay-Sachs disease.

Question 14

A child receives a combination of regular and NPH insulin at 8:00 AM At 8:45 AM, when the breakfast trays have not yet arrived from the kitchen, the nurse should:

A) notify the charge nurse.
B) give the patient a snack of graham crackers and milk.
C) ambulate the patient in the hall for a short time.
D) give the patient more insulin according to the sliding scale.

Question 15

The laboratory result indicating good metabolic control for a child with type 1 diabetes mellitus is:

A) glycosylated hemoglobin value of 8%.
B) fasting blood glucose level less than 140 mg/dL.
C) glucose tolerance test result of 190 mg/dL.
D) no glucose or ketones present in the urine.

Question 16

The nurse explains that because of an inadequate secretion of insulin:

A) protein synthesis is increased.
B) increased fat breakdown leads to ketonemia.
C) serum glucose levels are markedly decreased.
D) more rapid conversion and storage of carbohydrates to glucose occurs.

Question 17

Following a closed head injury, the unconscious 10-year-old child begins to excrete copious amounts of pale urine with an attendant drop in blood pressure (BP). Based on these symptoms, the nurse suspects the development of:

A) diabetes insipidus.
B) diabetes mellitus.
C) hypothyroidism.
D) hyperthyroidism.

Question 18

An important consideration for the school-age child taking DDAVP for diabetes insipidus would be:

A) observing for signs of water deprivation.
B) restricting his physical education program.
C) arranging for the child to use the bathroom when needed.
D) limiting fluid intake other than during the lunch period.

Question 19

The nurse discussed treatment of hypoglycemia with an adolescent. The nurse determined the adolescent understood the instructions when she verbalized that if her blood glucose is low or if she begins to feel hungry and weak, she will:

A) eat six LifeSavers.
B) give herself Lispro insulin.
C) have a slice of cheese.
D) drink a diet soda.

Question 20

The comment made by a school-age child indicating that he needs more teaching about diabetes mellitus and exercise is:

A) "I carry a piece of hard candy with me in case I start to feel shaky."
B) "I make sure I have emergency money when I have soccer practice or a game."
C) "Sometimes I skip my breakfast when I have a game in the morning."
D) "I play in soccer games that are scheduled after dinner."

Question 21

The nurse instructs the 11-year-old diabetic child to use the side of the finger for blood testing because the side of the finger:

A) has fewer capillaries.
B) is easier to puncture.
C) is less likely to become infected.
D) has fewer nerve endings.

Question 22

The nurse warns that keeping diabetes in control in an adolescent is made difficult by what? Select all that apply.

A) Hormonal changes
B) Developmental conflicts
C) Preference for fast food
D) Growth spurts
E) Denial of disease
F) None of the above

Question 23

The nurse explains that the diagnosis of diabetes is made when the fasting blood glucose level is _______ mg/dL on two separate occasions, and the history is positive for indication of the disease.

Question 24

The nurse explains that the endocrine system is primarily responsible for controlling which process(es)? Select all that apply.

A) Maturation
B) Reproduction
C) Stress response
D) Sexual identity
E) Growth

Question 25

The home health nurse is monitoring an 8-month-old child with hypothyroidism taking levothyroxine (Synthroid). The nurse recognizes signs of overdose when the assessment reveals which symptom(s)? Select all that apply.

A) Tachycardia
B) Irritability
C) Vomiting
D) Weight gain
E) Diaphoresis

Question 26

The nurse reminds the parents of a diabetic with an insulin pump that the tubing of the pump should be changed aseptically every ______ hours.

Question 27

The nurse explains that the function of an insulin pump is to:

A) release insulin as blood glucose rises.
B) provide continuous infusion of insulin.
C) decrease need for painful glucose monitoring.
D) deliver a prescribed amount of insulin twice a day.

Question 28

The nurse reminds the adolescent with diabetes that soluble fiber in the diet can reduce what? Select all that apply.

A) Blood glucose
B) Serum cholesterol
C) Incidence of infections
D) Absorption of sugar
E) Insulin requirements

Question 29

The nurse assessing a glycosylated hemoglobin (HbA?c) test is aware that this test can evaluate average glucose levels over a period of _____ to _____ months.

Question 30

Which food sources are high in soluble fiber? Select all that apply.

A) Raw fruits
B) Cooked vegetables
C) Beans
D) Lean meat
E) Bran cereal