Tara is an 11-year-old girl diagnosed with type 1 diabetes mellitus (DM). She asks her attending nurse why she can't take a pill rather than shots like her grandmother does. Which of the following would be the nurse's best reply?

Correct Answer: C

Rationale: The nurse's best reply would be option C, "Your body does not make insulin, so the insulin injections help to replace it." This response directly addresses Tara's question about why she needs insulin injections instead of pills. In type 1 diabetes mellitus, the body's immune system mistakenly attacks the beta cells in the pancreas that produce insulin. As a result, individuals with type 1 DM do not produce insulin, so they require insulin injections to replace the missing hormone. Unlike type 2 diabetes where oral medications can be used to manage the condition, individuals with type 1 diabetes rely on insulin injections to regulate their blood glucose levels.

Correct Answer: C

Rationale: Digoxin is a medication commonly used to treat heart failure. One of the cardinal manifestations of digoxin toxicity is extreme bradycardia, which is characterized by a slower than normal heart rate. This can be a serious and potentially life-threatening symptom of digoxin toxicity, as it indicates that the medication is affecting the heart's electrical conduction system. Other symptoms of digoxin toxicity can include nausea, vomiting, vision changes, and confusion, but extreme bradycardia is a prominent sign that Nurse Tony should be vigilant for in his patient Clay, who has been diagnosed with heart failure.

Correct Answer: C

Rationale: When assessing a child with croup who is drooling and agitated, the nurse should be aware that examining the throat using a tongue depressor can potentially precipitate a complete airway obstruction. Croup is characterized by upper airway inflammation, particularly around the larynx and trachea, leading to a barking cough, hoarseness, and respiratory distress. In a child with croup who is already showing signs of airway compromise such as drooling and agitation, any manipulation in the throat area can cause further swelling and lead to a complete obstruction of the airway. This can be a life-threatening emergency requiring immediate intervention to secure the airway and ensure adequate oxygenation. Therefore, utmost caution should be taken when performing any procedures that may exacerbate the child's respiratory distress in this situation.

Correct Answer: B

Rationale: Tetralogy of Fallot is a heart defect that involves four specific abnormalities in the heart's structure. One of these abnormalities is a ventricular septal defect, which results in a mixing of oxygenated and deoxygenated blood. This leads to inadequate oxygenation of tissues because some of the blood that is pumped out to the body is not fully oxygenated. As a result, the child may experience fatigue and poor activity tolerance due to the reduced oxygen supply to the tissues and organs. This is why the nurse would expect to see these symptoms in a 3-year-old with tetralogy of Fallot.

Correct Answer: D

Rationale: The correct information that the nurse should include in the teaching is that clothing should always fit loosely over the harness. This is important to prevent restriction of movement and ensure comfort for the child wearing the Pavlik harness. Tight clothing can cause discomfort, skin irritation, and interfere with the effectiveness of the harness in positioning the hip properly. Parents should be advised to choose clothing that is loose-fitting and does not put pressure on the harness or the child's skin.