INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 286
Chapter 31: The Child with a Metabolic Condition
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 720
TOP: Tay-Sachs KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
2. 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 722
TOP: Diabetes Mellitus KEY: Nursing Process Step: Implementation
NURSINGTB.COM
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. 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 723
OBJ: 5 TOP: Diabetes Mellitus
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. 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 730
NURSINGTB.COM
, INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 287
OBJ: 9 TOP: Prevention of Hypoglycemia
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
5. 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 730
OBJ: 7 TOP: Hypoglycemia
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
6. Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus
and exercise?
a. I carry a piece of hard candy with me in case I start to feel shaky.
b. I make sure I have emergency money when I have soccer practice or a game.
c. Sometimes I skip my breakfast when I have a game in the morning.
d. I play in soccer games that are scheduled after dinner.
ANS: C
Blood glucose is high after meals. The child with type 1 diabetes mellitus who skips a meal before exercise is
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at risk for hypoglycemia.
DIF: Cognitive Level: Comprehension REF: Page 727
OBJ: 9 TOP: Diabetes Mellitus
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
7. Which statement made by a 7-year-old child with type 1 diabetes mellitus indicates a need for more
teaching?
a. My pancreas is sick and needs insulin until it is well.
b. I will need to take my insulin every day.
c. I need to keep a piece of candy in my pocket in case I start to feel shaky.
d. My mom has to give me insulin shots twice a day.
ANS: A
The child with type 1 diabetes mellitus has an insulin deficiency and will require lifelong management of this
disease. Insulin does not cure the pancreas.
DIF: Cognitive Level: Comprehension REF: Page 726
TOP: Diabetes Mellitus KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
8. Which general dietary measure should the nurse include in a teaching plan for the child with type 1 diabetes
mellitus?
a. Control intake of carbohydrates and consume fewer calories.
b. Focus on complex carbohydrates and eat foods high in fiber.
c. Obtain most calories from proteins and fats.
d. Eat a diet low in fat and low in complex carbohydrates.
NURSINGTB.COM
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 286
Chapter 31: The Child with a Metabolic Condition
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 720
TOP: Tay-Sachs KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
2. 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 722
TOP: Diabetes Mellitus KEY: Nursing Process Step: Implementation
NURSINGTB.COM
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
3. 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 723
OBJ: 5 TOP: Diabetes Mellitus
KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. 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 730
NURSINGTB.COM
, INTRODUCTION TO MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK
Test Bank - Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 287
OBJ: 9 TOP: Prevention of Hypoglycemia
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk
5. 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 730
OBJ: 7 TOP: Hypoglycemia
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
6. Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus
and exercise?
a. I carry a piece of hard candy with me in case I start to feel shaky.
b. I make sure I have emergency money when I have soccer practice or a game.
c. Sometimes I skip my breakfast when I have a game in the morning.
d. I play in soccer games that are scheduled after dinner.
ANS: C
Blood glucose is high after meals. The child with type 1 diabetes mellitus who skips a meal before exercise is
NURSINGTB.COM
at risk for hypoglycemia.
DIF: Cognitive Level: Comprehension REF: Page 727
OBJ: 9 TOP: Diabetes Mellitus
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
7. Which statement made by a 7-year-old child with type 1 diabetes mellitus indicates a need for more
teaching?
a. My pancreas is sick and needs insulin until it is well.
b. I will need to take my insulin every day.
c. I need to keep a piece of candy in my pocket in case I start to feel shaky.
d. My mom has to give me insulin shots twice a day.
ANS: A
The child with type 1 diabetes mellitus has an insulin deficiency and will require lifelong management of this
disease. Insulin does not cure the pancreas.
DIF: Cognitive Level: Comprehension REF: Page 726
TOP: Diabetes Mellitus KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
8. Which general dietary measure should the nurse include in a teaching plan for the child with type 1 diabetes
mellitus?
a. Control intake of carbohydrates and consume fewer calories.
b. Focus on complex carbohydrates and eat foods high in fiber.
c. Obtain most calories from proteins and fats.
d. Eat a diet low in fat and low in complex carbohydrates.
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