NCLEX RN Practice Question 645
NCLEX RN Exaim Prepration.
Practice Question # 645.
NCLEX RN Practice Question # 645
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1. Question
The mother of a 6-year-old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child’s urine and it was positive for ketones. The nurse should instruct the mother to take which action?
CorrectAnswer: Option C is the correct answer,
Rationale: When the child is sick, the mother should test for urinary ketones with each voiding. If ketones are present, liquids are essential to aid in clearing the ketones. The child should be encouraged to drink liquids. Bringing the child to the clinic immediately is unnecessary. Insulin doses should not be adjusted or changed.
Test-Taking Strategy: Use general medication guidelines. Eliminate options 1 and 4, noting that they are comparable or alike. Recall that insulin doses should not be adjusted or changed. From the remaining options, note the words positive for ketones in the question. Recalling that liquids are essential to aid in clearing the ketones will direct you to the correct option.
Review: Sick day rules for the diabetic child Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Pediatrics—Metabolic/Endocrine
Priority Concepts: Clinical Judgment; Glucose Regulation
Reference: Hockenberry, Wilson (2015), pp. 1529, 1536.
IncorrectAnswer: Option C is the correct answer,
Rationale: When the child is sick, the mother should test for urinary ketones with each voiding. If ketones are present, liquids are essential to aid in clearing the ketones. The child should be encouraged to drink liquids. Bringing the child to the clinic immediately is unnecessary. Insulin doses should not be adjusted or changed.
Test-Taking Strategy: Use general medication guidelines. Eliminate options 1 and 4, noting that they are comparable or alike. Recall that insulin doses should not be adjusted or changed. From the remaining options, note the words positive for ketones in the question. Recalling that liquids are essential to aid in clearing the ketones will direct you to the correct option.
Review: Sick day rules for the diabetic child Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Pediatrics—Metabolic/Endocrine
Priority Concepts: Clinical Judgment; Glucose Regulation
Reference: Hockenberry, Wilson (2015), pp. 1529, 1536.
Urine ketone testing should be performed during illness and whenever the client with type 1 diabetesmellitus has persistently elevated blood glucose levels (higher than 240 mg/dL [13.7 mmol/L] or as prescribed for 2 consecutive testing periods).