which of the following should the nurse include in the insulin administration instruction for the parents of a child being discharged on insulin

ATI LPN

ATI Pediatric Medications Test

1. What should the nurse include in the insulin administration instruction for the parents of a child being discharged on insulin?

A. Insert the needle and aspirate before injecting
B. Inject insulin into the extremity to be exercised to improve absorption
C. The muscles in the abdomen and thigh are the easiest for self-administration
D. Clean the injection site with soap and water and avoid alcohol

Correct answer: C

Rationale: The correct answer is C because the muscles in the abdomen and thigh are the most suitable areas for self-administration of insulin due to consistent absorption. Choices A and B are incorrect as aspirating before injecting insulin is unnecessary, and injecting into an extremity to be exercised does not enhance absorption. Choice D is incorrect as alcohol should be used to clean the injection site instead of soap and water, which can cause skin irritation.

2. Which of the following is an abnormal finding when assessing the abdomen of a newborn?

A. The umbilical cord has two arteries and one vein.
B. The presence of green vomit.
C. The liver is palpable 1 to 2 cm below the costal margin.
D. The abdomen is soft and nondistended.

Correct answer: B

Rationale: The correct answer is B. The presence of green vomit in a newborn is an abnormal finding and indicates a possible intestinal obstruction. This finding requires immediate attention and further investigation. Choices A, C, and D are normal findings in a newborn's abdomen assessment. A newborn typically has an umbilical cord with two arteries and one vein, a liver that may be palpable 1 to 2 cm below the costal margin due to its normal size in a neonate, and a soft, nondistended abdomen as expected in healthy newborns.

3. How will a ventricular septal defect affect blood flow?

A. Blood will shunt left to right, causing increased pulmonary flow and no cyanosis.
B. Blood will shunt right to left, causing decreased pulmonary flow and cyanosis.
C. No shunting occurs due to high pressure in the left ventricle.
D. Increased pressure in the left atrium hinders the circulation of oxygenated blood in the circulating volume.

Correct answer: A

Rationale: A ventricular septal defect allows blood to shunt left to right, leading to increased pulmonary flow. This results in oxygenated blood mixing with deoxygenated blood, causing no cyanosis as the mixed blood is still oxygenated. The shunting from left to right overloads the pulmonary circulation, leading to increased pulmonary flow. Choice B is incorrect because blood does not shunt right to left in a ventricular septal defect. Choice C is incorrect as shunting does occur due to the pressure differences between the ventricles. Choice D is incorrect because the defect affects the ventricles, not the atrium, and does not hinder the circulation of oxygenated blood in the circulating volume.

4. A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of intravenous (IV) infusion?

A. 5% dextrose infusion
B. Normal saline infusion
C. NPH insulin infusion
D. Potassium infusion

Correct answer: B

Rationale: In the management of diabetic ketoacidosis (DKA), the initial intravenous (IV) fluid of choice is normal saline infusion. Normal saline helps to correct dehydration and electrolyte imbalances commonly seen in DKA patients. It does not contain glucose to prevent worsening hyperglycemia or ketoacidosis. NPH insulin infusion is not the initial treatment for DKA; it is typically used after fluid resuscitation. Potassium infusion may be required in DKA to address electrolyte imbalances, but normal saline is the priority for fluid resuscitation.

5. What percentage of total body surface area has been burned in a 5-year-old child who experienced partial-thickness burns to his head, anterior chest, and both upper extremities?

A. 45%
B. 63%
C. 72%
D. 54%

Correct answer: A

Rationale: According to the pediatric rule of nines, the head and neck represent 18%, the anterior chest and abdomen 18%, and each arm 9%. By adding these percentages (18% + 18% + 9% + 9% = 45%), we find that 45% of the total body surface area has been burned in this child.