Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is teaching a school-age child and their parents about managing diabetes mellitus during illness. The nurse should determine that the teaching has been effective when the parents indicate they will provide which of the following when the child is ill?
A. Decreased calories
Decreased calories:During illness, it's important to ensure adequate calorie intake to meet the body's increased energy demands for fighting off infection. Decreasing calories is not appropriate and can lead to hypoglycemia in a child with diabetes mellitus.
B. Increased fluids
Increased fluids:This is the correct option. During illness, the body's fluid requirements increase due to fever, sweating, and increased urination. Providing increased fluids helps prevent dehydration, which can exacerbate hyperglycemia. Parents should encourage the child to drink plenty of water or other sugar-free fluids to stay hydrated.
C. Blood glucose monitoring every 8 hr
Blood glucose monitoring every 8 hr: During illness, blood glucose levels may fluctuate more than usual due to changes in food intake, activity level, and the body's response to stress. Therefore, more frequent blood glucose monitoring is necessary, typically every 2-4 hours or as directed by the healthcare provider, rather than every 8 hours.
D. Urine testing for leukocytes
Urine testing for leukocytes:Urine testing for leukocytes is not directly related to managing diabetes mellitus during illness. It may be done to assess for urinary tract infections, which can occur more frequently in individuals with diabetes, but it is not a routine part of diabetes management during illness.
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Full Explanation
A. Decreased calories:
During illness, it's important to ensure adequate calorie intake to meet the body's increased energy demands for fighting off infection. Decreasing calories is not appropriate and can lead to hypoglycemia in a child with diabetes mellitus.
B. Increased fluids:
This is the correct option. During illness, the body's fluid requirements increase due to fever, sweating, and increased urination. Providing increased fluids helps prevent dehydration, which can exacerbate hyperglycemia. Parents should encourage the child to drink plenty of water or other sugar-free fluids to stay hydrated.
C. Blood glucose monitoring every 8 hr:
During illness, blood glucose levels may fluctuate more than usual due to changes in food intake, activity level, and the body's response to stress. Therefore, more frequent blood glucose monitoring is necessary, typically every 2-4 hours or as directed by the healthcare provider, rather than every 8 hours.
D. Urine testing for leukocytes:
Urine testing for leukocytes is not directly related to managing diabetes mellitus during illness. It may be done to assess for urinary tract infections, which can occur more frequently in individuals with diabetes, but it is not a routine part of diabetes management during illness.
Similar Questions
A charge nurse is assisting a newly licensed nurse with the preoperative assessment of a 2-year-old child who has a Wilms' tumor. Which of the following actions by the newly licensed nurse indicates an understanding of the needed care?
A. Measuring the child's abdominal circumference
Measuring the child's abdominal circumference:This is the correct action. Assessing the child's abdominal circumference is essential in monitoring the size of the Wilms' tumor and evaluating for any signs of abdominal distention or growth. Changes in abdominal circumference can provide valuable information about the progression of the tumor and any potential complications.
B. Palpating the child's abdomen
Palpating the child's abdomen:Palpating the child's abdomen is an essential part of the physical examination to assess for the presence of a mass or any tenderness. However, in the case of a child with a known Wilms' tumor, palpation should be performed gently to avoid causing discomfort or disturbing the tumor.
C. Providing clear liquids up to 1 hr prior to surgery
Providing clear liquids up to 1 hr prior to surgery: Providing clear liquids up to 1 hour prior to surgery is not appropriate for a child undergoing surgery, especially if anesthesia is involved. Preoperative fasting guidelines typically require clear liquids to be stopped a few hours before surgery to reduce the risk of aspiration.
D. Continuously monitoring the child's oxygen saturation
Continuously monitoring the child's oxygen saturation:Continuous monitoring of the child's oxygen saturation is an essential aspect of perioperative care, but it is not specific to the preoperative assessment for a child with Wilms' tumor. Oxygen saturation monitoring is typically performed throughout the perioperative period to ensure adequate oxygenation during surgery and recovery.
Full Explanation
A. Measuring the child's abdominal circumference:
This is the correct action. Assessing the child's abdominal circumference is essential in monitoring the size of the Wilms' tumor and evaluating for any signs of abdominal distention or growth. Changes in abdominal circumference can provide valuable information about the progression of the tumor and any potential complications.
B. Palpating the child's abdomen:
Palpating the child's abdomen is an essential part of the physical examination to assess for the presence of a mass or any tenderness. However, in the case of a child with a known Wilms' tumor, palpation should be performed gently to avoid causing discomfort or disturbing the tumor.
C. Providing clear liquids up to 1 hr prior to surgery:
Providing clear liquids up to 1 hour prior to surgery is not appropriate for a child undergoing surgery, especially if anesthesia is involved. Preoperative fasting guidelines typically require clear liquids to be stopped a few hours before surgery to reduce the risk of aspiration.
D. Continuously monitoring the child's oxygen saturation:
Continuous monitoring of the child's oxygen saturation is an essential aspect of perioperative care, but it is not specific to the preoperative assessment for a child with Wilms' tumor. Oxygen saturation monitoring is typically performed throughout the perioperative period to ensure adequate oxygenation during surgery and recovery.
A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions should the nurse take?
A. Obtain a daily weight.
Obtain a daily weight:This is an appropriate action. Monitoring daily weights can help assess fluid balance and detect fluid retention, which is common in children with kidney disorders like acute glomerulonephritis. Sudden weight gain or fluid overload may indicate worsening kidney function and the need for intervention.
B. Strain the urine.
Strain the urine:Straining the urine may be indicated to monitor for the presence of blood or protein, which are common findings in acute glomerulonephritis. Straining the urine is not necessary, as hematuria is a common finding and does not indicate kidney damage.
C. Monitor blood glucose level every 4 hr.
Monitor blood glucose level every 4 hr: Monitoring blood glucose levels every 4 hours is not directly related to the care of a child with acute glomerulonephritis. Blood glucose monitoring is more relevant in conditions such as diabetes mellitus. However, monitoring electrolyte levels, including blood glucose, may be part of routine laboratory testing in children with kidney disorders.
D. Recommend strict bed rest.
Recommend strict bed rest:Strict bed rest is not typically recommended for children with acute glomerulonephritis unless there are specific complications or severe symptoms requiring immobilization. While some activity restriction may be recommended during the acute phase of the illness, strict bed rest may lead to complications such as deconditioning and venous thromboembolism.
Full Explanation
A. Obtain a daily weight:
This is an appropriate action. Monitoring daily weights can help assess fluid balance and detect fluid retention, which is common in children with kidney disorders like acute glomerulonephritis. Sudden weight gain or fluid overload may indicate worsening kidney function and the need for intervention.
B. Strain the urine:
Straining the urine may be indicated to monitor for the presence of blood or protein, which are common findings in acute glomerulonephritis. Straining the urine is not necessary, as hematuria is a common finding and does not indicate kidney damage.
C. Monitor blood glucose level every 4 hr:
Monitoring blood glucose levels every 4 hours is not directly related to the care of a child with acute glomerulonephritis. Blood glucose monitoring is more relevant in conditions such as diabetes mellitus. However, monitoring electrolyte levels, including blood glucose, may be part of routine laboratory testing in children with kidney disorders.
D. Recommend strict bed rest:
Strict bed rest is not typically recommended for children with acute glomerulonephritis unless there are specific complications or severe symptoms requiring immobilization. While some activity restriction may be recommended during the acute phase of the illness, strict bed rest may lead to complications such as deconditioning and venous thromboembolism.
A nurse is assessing a child who has sickle cell anemia and is experiencing a vasoocclusive crisis. Which of the following clinical manifestations should the nurse expect?
A. Weight gain
Weight gain:Weight gain is not typically associated with vasoocclusive crisis in sickle cell anemia. In fact, individuals may experience dehydration and weight loss due to increased metabolic demands during a crisis.
B. Bradypnea
Bradypnea:Bradypnea, or slow breathing, is not a characteristic feature of vasoocclusive crisis in sickle cell anemia. Respiratory rate may be normal or increased due to pain or compensatory mechanisms.
C. Pain
Pain: This is the correct option. Pain is the hallmark manifestation of vasoocclusive crisis in sickle cell anemia. The pain can occur anywhere in the body but most commonly affects the bones, joints, abdomen, and chest. The severity of pain can vary from mild to severe and may require hospitalization for pain management.
D. Diarrhea
Diarrhea:Diarrhea is not typically associated with vasoocclusive crisis in sickle cell anemia. Gastrointestinal symptoms such as abdominal pain and nausea may occur, but diarrhea is not a common manifestation of vasoocclusive crisis.
Full Explanation
A. Weight gain:
Weight gain is not typically associated with vasoocclusive crisis in sickle cell anemia. In fact, individuals may experience dehydration and weight loss due to increased metabolic demands during a crisis.
B. Bradypnea:
Bradypnea, or slow breathing, is not a characteristic feature of vasoocclusive crisis in sickle cell anemia. Respiratory rate may be normal or increased due to pain or compensatory mechanisms.
C. Pain:
This is the correct option. Pain is the hallmark manifestation of vasoocclusive crisis in sickle cell anemia. The pain can occur anywhere in the body but most commonly affects the bones, joints, abdomen, and chest. The severity of pain can vary from mild to severe and may require hospitalization for pain management.
D. Diarrhea:
Diarrhea is not typically associated with vasoocclusive crisis in sickle cell anemia. Gastrointestinal symptoms such as abdominal pain and nausea may occur, but diarrhea is not a common manifestation of vasoocclusive crisis.