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Chapter 31: The Child with a Metabolic Condition

Introduction to Maternity And Pediatric Nursing, 7th Edition by Gloria Leifer

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Chapter 31: The Child with a Metabolic Condition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. A nurse is planning to teach a family about Tay-Sachs disease. What will the nurse relay about the pattern of inheritance for inborn errors of metabolism?
a. They are usually autosomal recessive.
b. They are usually autosomal dominant.
c. They are usually X-linked recessive.
d. They are usually multifactorial.

 

 

ANS:  A

The pattern of inheritance is generally autosomal recessive.

 

DIF:    Cognitive Level: Knowledge            REF:   Page 704        OBJ:   2

TOP:   Tay-Sachs      KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

  1. What occurs as a result 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.

 

 

ANS:  B

When insulin is deficient, the body cannot metabolize carbohydrates for energy. The body is also unable to store and use fat properly. Incomplete fat metabolism produces ketone bodies that accumulate in the blood.

 

DIF:    Cognitive Level: Comprehension     REF:   Page 706        OBJ:   9

TOP:   Diabetes Mellitus                            KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. On what understanding does the nurse plan the care of a child with a new diagnosis of type 1 diabetes mellitus?
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.

 

 

ANS:  A

Type 1 insulin-dependent diabetes mellitus is characterized by an absolute or complete deficiency of insulin.

 

DIF:    Cognitive Level: Comprehension     REF:   Page 707, Table 31-2

OBJ:   5                    TOP:   Diabetes Mellitus

KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A child receives a combination of regular and NPH insulin at 8:00 AM. At 8:45 AM the breakfast trays have not yet arrived from the kitchen. What is the best action by the nurse?
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.

 

 

ANS:  B

A child who receives regular insulin before meals may have an insulin reaction if food is not eaten within 20 minutes. A snack of graham crackers and milk will prevent an episode of hypoglycemia.

 

DIF:    Cognitive Level: Application           REF:   Page 714, Table 31-6

OBJ:   9                    TOP:   Prevention of Hypoglycemia

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Reduction of Risk

 

  1. 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. What should the nurse do 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.

 

 

ANS:  C

The immediate remedy is to give orange juice to raise the blood glucose. Giving more sugar will increase the blood glucose in a hyperglycemic child. Walking exercise will use up even more glucose. The treatment for hyperglycemia is to give the patient more insulin.

 

DIF:    Cognitive Level: Application           REF:   Page 714, Table 31-6

OBJ:   7                    TOP:   Hypoglycemia

KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Pharmacological Therapies

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