A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts?

Correct Answer: D

Rationale: The correct concept that should be reinforced in the teaching plan is to systematically rotate injection sites. Rotating injection sites helps prevent lipodystrophy - changes in fat tissue due to repeated injections in the same spot. This can ensure that the insulin is properly absorbed and prevent complications. It is important for the child and their family to understand the importance of rotating injection sites to maintain good insulin absorption and reduce the risk of complications.

Correct Answer: D

Rationale: Tetralogy of Fallot is a congenital heart defect characterized by four primary abnormalities: pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Due to the pulmonary stenosis, less blood reaches the lungs to be oxygenated, resulting in deoxygenated blood entering the systemic arterial circulation. This leads to cyanosis, which is often referred to as "Tet spells" in these patients. Cyanosis is the bluish discoloration of the skin and mucous membranes caused by the presence of deoxygenated hemoglobin. The other conditions listed do not typically result in deoxygenated blood entering the systemic arterial circulation and causing cyanosis.

Correct Answer: C

Rationale: In status asthmaticus, a severe and prolonged asthma attack can lead to inadequate ventilation due to airway obstruction. This results in retention of carbon dioxide (CO2) in the blood, leading to respiratory acidosis. As the CO2 levels rise, it combines with water in the blood to form carbonic acid, lowering the blood pH levels. Symptoms of respiratory acidosis can include shortness of breath, confusion, lethargy, and potentially life-threatening complications. Treatment for status asthmaticus aims to improve ventilation and restore normal blood gas levels to alleviate respiratory acidosis.

Correct Answer: C

Rationale: Infants with congenital heart disease who have been admitted with heart failure may have difficulty feeding due to increased work of breathing and poor energy reserves. Offering small, frequent feedings can help prevent fatigue and provide adequate nutrition to support the infant's growth and recovery. It also helps to prevent overloading the heart with a large volume of fluids at once. This approach allows the infant to receive enough calories while reducing the risk of aspiration and conserving energy for feeding and breathing. Positioning the infant flat on the back may worsen respiratory distress, encouraging nutritional fluids alone may not address the feeding challenges faced by the infant, and measuring the head circumference is important for growth monitoring but may not be the priority when managing heart failure in this case.

Correct Answer: C

Rationale: Corticosteroids, such as prednisone, are commonly used in the treatment of juvenile rheumatoid arthritis (JRA) to reduce inflammation and pain. However, one of the complications associated with corticosteroid use is immune suppression. Corticosteroids can suppress the immune system by reducing the activity and effectiveness of white blood cells, making individuals more susceptible to infections. It is important for healthcare providers, including nurses, to educate adolescents and their families about the risks and possible complications of corticosteroid therapy, including immune suppression.