Question

A nurse is teaching a school-age child who has diabetes mellitus about insulin administration. Which of the following should the nurse include in the teaching?

Answer 1

Correct Answers:

"You should give four to six injections in one area before switching sites."

Rationale :

🟢 Rotating injection sites is essential to prevent lipodystrophy, but the child should administer multiple injections in the same general area (like the thigh or abdomen) before switching to another area.

🟢 This practice ensures consistent insulin absorption by avoiding areas of scar tissue or altered fat distribution.

🟢 Teaching site rotation within a region, not random switching, enhances predictable insulin action.

🟢 Children benefit from consistency and routine in managing their diabetes safely and effectively.

🟢 This instruction also minimizes discomfort and maintains skin integrity.

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Answer 2

Correct Answers:

"l give my child aspirin to reduce his fever."

Rationale :

🔴 Aspirin is contraindicated in children with viral illnesses such as influenza due to the risk of Reye syndrome.

🔴 Reye syndrome is a rare but fatal condition causing liver dysfunction and cerebral edema.

🔴 Parents should be educated to use acetaminophen or ibuprofen instead, under appropriate guidance.

🔴 Fever management must also include adequate hydration and rest to reduce complications.

🔴 The nurse must correct this medication error immediately to prevent life-threatening outcomes.

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Answer 3

Correct Answers:

Pre renal disorders.

Rationale :

🟣 Pre-renal disorders are caused by factors that decrease blood flow to the kidneys, impairing filtration without intrinsic kidney damage.

🟣 Severe burns, dehydration, and prolonged anesthesia can lead to hypovolemia or hypotension, causing decreased perfusion.

🟣 If uncorrected, this can progress to acute kidney injury (AKI).

🟣 Identifying and correcting pre-renal causes early helps prevent irreversible renal damage.

🟣 These are the most common type of AKI in critically ill patients.

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Answer 4

Correct Answers:

Albuterol (SABA).

Rationale :

🔵 Albuterol is a short-acting beta-agonist (SABA) used as a rescue inhaler to treat acute symptoms or prevent exercise-induced bronchospasm.

🔵 It acts within minutes to relax bronchial smooth muscles and improve airflow.

🔵 SABAs are the first-line agents for quick relief in asthma.

🔵 The nurse should reinforce proper inhaler technique and timing prior to physical activity.

🔵 Daily maintenance medications differ and do not provide immediate symptom relief.

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Answer 5

Correct Answers:

Facial edema

Rationale :

🟡 Nephrotic syndrome is characterized by massive proteinuria, hypoalbuminemia, and edema, especially facial or periorbital swelling.

🟡 The loss of protein in urine reduces oncotic pressure, causing fluid to shift into interstitial spaces.

🟡 Children may also experience weight gain, fatigue, and decreased urine output.

🟡 Monitoring fluid balance and assessing for complications of edema is essential.

🟡 Edema is a classic diagnostic clue and should always prompt evaluation of renal function.

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Answer 6

Correct Answers:

Administer antibiotics when available.

Rationale :

🔶 Bacterial meningitis is a medical emergency requiring immediate administration of antibiotics to reduce mortality.

🔶 While seizure precautions and environmental control are important, early antimicrobial therapy saves lives.

🔶 Delays in antibiotic administration increase the risk of sepsis, brain damage, and death.

🔶 Nurses should always prioritize interventions that reduce disease progression in acute infections.

🔶 Time-sensitive action improves outcomes dramatically in pediatric clients with suspected meningitis.

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Answer 7

Correct Answers:

Blood protein 5.0 g/dL

Rationale :

◼ Hypoproteinemia is a key indicator of worsening nephrotic syndrome, as it reflects ongoing protein loss in the urine.

◼ A normal serum protein is typically 6.0–8.0 g/dL; levels this low require medical attention and possible intervention.

◼ This lab finding correlates with symptoms such as edema and fatigue.

◼ The nurse should notify the provider promptly to adjust treatment plans or medications.

◼ Monitoring protein levels helps track the effectiveness of corticosteroids or diuretics in managing the condition.

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Answer 8

Correct Answers:

Encourage oral fluids.

Rationale :

✳️ A post-lumbar puncture headache occurs due to CSF leakage, and increasing oral fluids helps replenish volume and restore pressure.

✳️ Caffeine and hydration can reduce symptoms and promote healing.

✳️ Lying flat may also be recommended, but fluids are a non-invasive first-line strategy.

✳️ High-Fowler’s position is not appropriate as it may worsen the headache.

✳️ The nurse must encourage conservative measures before considering pharmacologic or invasive treatments.

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Answer 9

Correct Answers:

"The biopsy can be uncomfortable, but I will try to keep you as comfortable as possible."

Rationale :

💠 This response acknowledges the client's concern while providing honest reassurance and emotional support.

💠 It is a therapeutic communication technique that balances realism with empathy.

💠 The nurse avoids dismissing or exaggerating the pain, promoting trust and preparation.

💠 Clients under conscious sedation may still have awareness during parts of the procedure.

💠 Supportive responses help clients emotionally prepare and reduce anxiety.

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Answer 10

Correct Answers:

Explain to the parents that the issue will self-resolve.

Rationale :

🟢 A hydrocele is a painless scrotal swelling due to fluid accumulation that typically resolves on its own in infants.

🟢 It usually does not require intervention unless it persists past 1 to 2 years of age or causes complications.

🟢 Surgery is reserved for persistent or communicating hydroceles.

🟢 Nurses should reassure parents and educate on monitoring and follow-up.

🟢 This approach avoids unnecessary procedures and promotes evidence-based pediatric care.

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Custom 2N 2025 Spring-2025

No.

1 :
A nurse is teaching a school-age child who has diabetes mellitus about insulin administration. Which of the following should the nurse include in the teaching?

2 :
A nurse is caring for a child who has influenza. The nurse should identify that which of the following statements by the parent indicates the child has an increased risk for Reye syndrome?

3 :
Dehydration, prolonged anesthesia, severe burns can all contribute towards what kind of renal disorders?

4 :
A nurse is teaching an adolescent about the appropriate use of his asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise?

5 :
A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect?

6 :
A nurse is caring for a child who has a suspected diagnosis of bacterial meningitis. Which of the following actions is the nurse's priority?

7 :
A nurse is caring for a preschooler who has nephrotic syndrome. Which of the following findings should the nurse report to the provider?

8 :
A nurse is caring for a client who reports a severe headache following a lumbar puncture. Which of the following actions should the nurse take?

9 :
A nurse is caring for a client who is going to have a bone marrow biopsy under conscious sedation. The client expresses fear about the procedure and asks the nurse if the biopsy will hurt. Which of the following responses should the nurse make?

10 :
A nurse is caring for an infant who has a hydrocele. Which of the following actions should the nurse take?

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Custom 2N 2025 Spring-2025

No.

1 : A nurse is teaching a school-age child who has diabetes mellitus about insulin administration. Which of the following should the nurse include in the teaching?

2 : A nurse is caring for a child who has influenza. The nurse should identify that which of the following statements by the parent indicates the child has an increased risk for Reye syndrome?

3 : Dehydration, prolonged anesthesia, severe burns can all contribute towards what kind of renal disorders?

4 : A nurse is teaching an adolescent about the appropriate use of his asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise?

5 : A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect?

6 : A nurse is caring for a child who has a suspected diagnosis of bacterial meningitis. Which of the following actions is the nurse's priority?

7 : A nurse is caring for a preschooler who has nephrotic syndrome. Which of the following findings should the nurse report to the provider?

8 : A nurse is caring for a client who reports a severe headache following a lumbar puncture. Which of the following actions should the nurse take?

9 : A nurse is caring for a client who is going to have a bone marrow biopsy under conscious sedation. The client expresses fear about the procedure and asks the nurse if the biopsy will hurt. Which of the following responses should the nurse make?

10 : A nurse is caring for an infant who has a hydrocele. Which of the following actions should the nurse take?

1 :
A nurse is teaching a school-age child who has diabetes mellitus about insulin administration. Which of the following should the nurse include in the teaching?

2 :
A nurse is caring for a child who has influenza. The nurse should identify that which of the following statements by the parent indicates the child has an increased risk for Reye syndrome?

3 :
Dehydration, prolonged anesthesia, severe burns can all contribute towards what kind of renal disorders?

4 :
A nurse is teaching an adolescent about the appropriate use of his asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise?

5 :
A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect?

6 :
A nurse is caring for a child who has a suspected diagnosis of bacterial meningitis. Which of the following actions is the nurse's priority?

7 :
A nurse is caring for a preschooler who has nephrotic syndrome. Which of the following findings should the nurse report to the provider?

8 :
A nurse is caring for a client who reports a severe headache following a lumbar puncture. Which of the following actions should the nurse take?

9 :
A nurse is caring for a client who is going to have a bone marrow biopsy under conscious sedation. The client expresses fear about the procedure and asks the nurse if the biopsy will hurt. Which of the following responses should the nurse make?

10 :
A nurse is caring for an infant who has a hydrocele. Which of the following actions should the nurse take?