Question

A group of students are reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration?

Answer 1

Correct Answers:

Glargine/Lantus

Rationale :

♦️ Insulin glargine is a long-acting basal insulin that provides relatively steady insulin coverage for approximately 24 hours or longer.

♦️ It has no pronounced peak, which lowers the risk of sudden hypoglycemia compared with insulins that have distinct peak effects.

♦️ Glargine helps control blood glucose between meals and overnight by simulating the body’s continuous basal insulin secretion.

♦️ It is generally administered once daily at the same time, although some patients may require individualized dosing.

♦️ Glargine should not be mixed with other insulins in the same syringe because its acidic formulation can alter the action of other insulin products.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 2

Correct Answers:

Swimming

Rationale :

🌹 Swimming is a low-impact exercise that promotes joint movement without placing excessive weight or stress on painful joints.

🌹 Water buoyancy supports the child’s body and reduces pressure on inflamed hips, knees, ankles, and other weight-bearing joints.

🌹 The resistance provided by water helps improve muscle strength, endurance, and joint flexibility.

🌹 Warm-water swimming may also reduce joint stiffness and discomfort, making movement easier for the child.

🌹 Regular swimming supports mobility while minimizing the risk of worsening inflammation or causing joint injury.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 3

Correct Answers:

Intravenous immune globulin

Rationale :

🖍️ Intravenous immune globulin, or IVIG, is commonly used to rapidly increase the platelet count in children with significant immune thrombocytopenia.

🖍️ IVIG decreases the destruction of antibody-coated platelets by blocking receptors on macrophages in the spleen.

🖍️ A platelet count of 18,000/mm³ places the child at substantial risk for spontaneous bleeding, especially if bleeding symptoms are present.

🖍️ The treatment often produces a platelet response within 24 to 48 hours, making it useful when a rapid effect is required.

🖍️ The nurse should monitor for adverse effects such as headache, fever, chills, nausea, and infusion reactions during administration.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 4

Correct Matches:

SIADH matches with Water intoxication
Hyperthyroidism matches with Weight loss and hot flashes
Diabetes insipidus matches with Increased urination

Rationale :

SIADH → Water intoxication

✍️ Syndrome of inappropriate antidiuretic hormone secretion causes excessive release or action of antidiuretic hormone.

✍️ Increased antidiuretic hormone causes the kidneys to retain free water, resulting in low urine output and concentrated urine.

✍️ Excess water dilutes the serum sodium level and can produce dilutional hyponatremia.

✍️ Severe water intoxication may cause headache, confusion, seizures, decreased consciousness, and cerebral edema.

✍️ Nursing management commonly includes fluid restriction, neurologic monitoring, seizure precautions, and treatment of the underlying cause.

Hyperthyroidism → Weight loss and hot flashes

✍️ Hyperthyroidism increases the body’s metabolic rate because excessive thyroid hormone stimulates cellular activity.

✍️ Increased metabolism causes weight loss despite a normal or increased appetite.

✍️ Increased heat production produces heat intolerance, excessive sweating, warm skin, and sensations described as hot flashes.

✍️ Additional manifestations may include tachycardia, tremors, nervousness, diarrhea, and difficulty sleeping.

✍️ The child’s weight, heart rate, temperature tolerance, nutrition, and medication response should be closely monitored.

Diabetes insipidus → Increased urination

✍️ Diabetes insipidus results from deficient antidiuretic hormone production or an inadequate renal response to the hormone.

✍️ The kidneys are unable to conserve water, causing excretion of large amounts of dilute urine.

✍️ Polyuria can lead to intense thirst, dehydration, hypernatremia, dry mucous membranes, and weight loss.

✍️ Urine specific gravity is typically low because the urine contains very little solute.

✍️ Treatment may include desmopressin, fluid replacement, daily weights, and careful monitoring of intake and output.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 5

Correct Answers:

"I will decrease checking his blood sugar to twice daily."

Rationale :

👉 Blood glucose should be checked more frequently, not less frequently, when a child with type 1 diabetes is ill.

👉 Infection and physiologic stress stimulate counter-regulatory hormones that can raise blood glucose and increase the risk of diabetic ketoacidosis.

👉 Glucose levels are commonly monitored every 3 to 4 hours, or more often according to the prescribed sick-day plan.

👉 Urine or blood ketones should also be checked when glucose is elevated, vomiting occurs, or the child appears increasingly ill.

👉 This statement indicates a need for further teaching because reducing glucose monitoring could delay recognition of severe hyperglycemia or ketoacidosis.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 6

Correct Answers:

3 copies of trisomy 21 has occurred instead of 2 copies.

Rationale :

✳️ Down syndrome is most commonly caused by trisomy 21, meaning the child has three copies of chromosome 21.

✳️ The extra chromosome usually results from nondisjunction during the formation of a reproductive cell.

✳️ The additional genetic material affects physical growth, cognitive development, muscle tone, and organ formation.

✳️ Associated conditions may include congenital heart defects, hearing loss, thyroid dysfunction, gastrointestinal abnormalities, and increased infection risk.

✳️ Diagnosis can be confirmed through chromosomal analysis, which identifies the extra chromosome 21.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 7

Correct Answers:

The parents report that their son is irritable and not gaining weight.

Rationale :

⚽ Neuroblastoma is a malignant tumor arising from immature cells of the sympathetic nervous system, frequently within the adrenal glands or abdomen.

⚽ A child may develop abdominal swelling or a firm irregular mass that can cross the midline.

⚽ Systemic manifestations often include irritability, poor appetite, weight loss, fatigue, and failure to gain weight.

⚽ Bone or bone marrow metastasis may cause bone pain, limping, pallor, bruising, or periorbital discoloration.

⚽ Irritability combined with poor weight gain and unilateral abdominal swelling therefore strongly supports possible neuroblastoma.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 8

Correct Answers:

"I will apply heat."

Rationale :

🧿 Heat causes vasodilation, which increases blood flow to the injured area and can worsen bleeding.

🧿 A minor bleeding episode should be managed using rest, ice, compression, and elevation, commonly remembered as RICE.

🧿 Cold application promotes vasoconstriction and helps reduce bleeding, swelling, and pain.

🧿 Prescribed clotting factor replacement may be necessary when bleeding continues or involves a joint, muscle, head, neck, or abdomen.

🧿 The parent’s plan to apply heat demonstrates a need for further teaching because heat may prolong the bleeding episode.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 9

Correct Answers:

Reading and writing.

Rationale :

🍊 Dyslexia is a specific learning disorder that primarily affects accurate and fluent word recognition, decoding, and spelling.

🍊 Children may reverse letters, read slowly, omit words, struggle to connect sounds with letters, or have difficulty understanding written material.

🍊 Writing may also be affected because the child has trouble organizing letters, spelling words, and translating language into written form.

🍊 Intelligence is usually normal, and the disorder does not result from poor motivation, inadequate teaching, or visual impairment.

🍊 Early specialized instruction in phonemic awareness, decoding, reading fluency, and structured literacy can improve academic performance.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

Answer 10

Correct Answers:

Eye inflammation

Rationale :

♠️ Pauciarticular juvenile idiopathic arthritis, also called oligoarticular JIA, affects four or fewer joints during the first six months of illness.

♠️ Children with this form have an increased risk of chronic anterior uveitis or iridocyclitis.

♠️ Eye inflammation may initially be asymptomatic, meaning vision damage can occur without redness, pain, or obvious visual complaints.

♠️ Regular slit-lamp ophthalmologic examinations are essential for early detection and prevention of complications such as cataracts, glaucoma, or vision loss.

♠️ The nurse should reinforce adherence to scheduled eye examinations even when the child has no ocular symptoms.

Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

QLexNursing

1 :
A group of students are reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration?

2 :
Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis?

3 :
A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm³. Which medication would the nurse most likely expect to be ordered?

4 :
Match the following disease to the correct clinical manifestations.

Items to Match

Matching Options

5 :
A nurse is caring for a 7-year-old child who has an upper respiratory infection and type 1 diabetes mellitus. Which of the following statements by the mother indicates a need for further instruction?

6 :
A child with a diagnosis of Down syndrome has had which of the following chromosome abnormalities occur?

7 :
A nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?

8 :
A nurse is teaching a parent of a child who has hemophilia how to control a minor bleeding episode. Which of the following statements by the parent indicates a need for further teaching?

9 :
The nurse is reviewing the medical record of a child who has dyslexia. This child will have trouble with:

10 :
The nurse is assessing a child with pauciarticular-type juvenile idiopathic arthritis. What would the nurse expect to assess?

QLexNursing

1 : A group of students are reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration?

2 : Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis?

3 : A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm³. Which medication would the nurse most likely expect to be ordered?

4 : Match the following disease to the correct clinical manifestations.

Items to Match

Matching Options

5 : A nurse is caring for a 7-year-old child who has an upper respiratory infection and type 1 diabetes mellitus. Which of the following statements by the mother indicates a need for further instruction?

6 : A child with a diagnosis of Down syndrome has had which of the following chromosome abnormalities occur?

7 : A nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?

8 : A nurse is teaching a parent of a child who has hemophilia how to control a minor bleeding episode. Which of the following statements by the parent indicates a need for further teaching?

9 : The nurse is reviewing the medical record of a child who has dyslexia. This child will have trouble with:

10 : The nurse is assessing a child with pauciarticular-type juvenile idiopathic arthritis. What would the nurse expect to assess?

1 :
A group of students are reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration?

2 :
Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis?

3 :
A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm³. Which medication would the nurse most likely expect to be ordered?

4 :
Match the following disease to the correct clinical manifestations.

5 :
A nurse is caring for a 7-year-old child who has an upper respiratory infection and type 1 diabetes mellitus. Which of the following statements by the mother indicates a need for further instruction?

6 :
A child with a diagnosis of Down syndrome has had which of the following chromosome abnormalities occur?

7 :
A nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?

8 :
A nurse is teaching a parent of a child who has hemophilia how to control a minor bleeding episode. Which of the following statements by the parent indicates a need for further teaching?

9 :
The nurse is reviewing the medical record of a child who has dyslexia. This child will have trouble with:

10 :
The nurse is assessing a child with pauciarticular-type juvenile idiopathic arthritis. What would the nurse expect to assess?