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A school nurse is assessing an adolescent who reports feeling shaky and is having difficulty speaking and concentrating on the Questions the nurse is asking. The nurse checks the adolescent’s blood glucose level and identifies a value of 55 mg/dL. Which of the following findings should the nurse expect?

A.

Polyuria.

B.

Dry, flushed skin.

C.

Deep, rapid respirations.

D.

Tachycardia.

Answer and Explanation

The Correct Answer is D

Choice A rationale

 

Polyuria, or excessive urination, is typically associated with hyperglycemia rather than hypoglycemia. In the context of diabetes, polyuria occurs when high blood glucose levels lead to increased urine production as the body attempts to excrete excess glucose. Since the adolescent’s blood glucose level is 55 mg/dL, which indicates hypoglycemia, polyuria is not an expected finding.

 

Choice B rationale

 

Dry, flushed skin is a common symptom of hyperglycemia, not hypoglycemia. When blood glucose levels are high, the body becomes dehydrated, leading to dry skin and a flushed appearance. In contrast, hypoglycemia often presents with symptoms such as sweating, pallor, and shakiness due to the body’s response to low blood glucose levels.

 

Choice C rationale

 

Deep, rapid respirations, also known as Kussmaul respirations, are typically associated with diabetic ketoacidosis (DKA), a complication of hyperglycemia. DKA occurs when the body produces high levels of ketones due to insufficient insulin. Since the adolescent’s blood glucose level is 55 mg/dL, which indicates hypoglycemia, deep, rapid respirations are not an expected finding.

 

Choice D rationale

 

Tachycardia, or an increased heart rate, is a common symptom of hypoglycemia. When blood glucose levels drop, the body releases catecholamines (such as adrenaline) to raise blood glucose levels. This response leads to symptoms such as shakiness, sweating, and tachycardia. Therefore, tachycardia is an expected finding in an adolescent with a blood glucose level of 55 mg/dL.


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View Related questions

Correct Answer is ["A","D","E"]

Explanation

Choice A rationale

The Measles, Mumps, and Rubella (MMR) vaccine is recommended for children at 12-15 months of age. This vaccine protects against three serious diseases: measles, mumps, and rubella. Measles can cause severe respiratory illness and encephalitis, mumps can lead to meningitis and hearing loss, and rubella can cause congenital rubella syndrome in unborn babies if a pregnant woman is infected.

Choice B rationale

The Rotavirus (RV) vaccine is typically given to infants at 2, 4, and sometimes 6 months of age. It is not recommended for children older than 8 months.

Choice C rationale

The Human Papillomavirus (HPV) vaccine is recommended for preteens starting at age 11 or 12. It is not given to 1-year-old children.

Choice D rationale

The Varicella (VAR) vaccine is recommended for children at 12-15 months of age to protect against chickenpox, which can cause severe skin infections, pneumonia, and encephalitis.

Choice E rationale

The Diphtheria, Tetanus, and Acellular Pertussis (DTaP) vaccine is part of the routine immunization schedule for children, with doses given at 2, 4, 6, and 15-18 months of age. This vaccine protects against three serious diseases: diphtheria, which can cause breathing problems and heart failure; tetanus, which can cause muscle stiffness and lockjaw; and pertussis (whooping cough), which can cause severe coughing spells and pneumonia.

Correct Answer is A

Explanation

Choice A rationale

Slightly yellow sclera, or jaundice, is a common finding in children with sickle cell anemia. The breakdown of sickled red blood cells leads to increased bilirubin levels in the blood, which can cause jaundice. This yellowing is often most noticeable in the sclera of the eyes. Jaundice is a result of hemolysis, a hallmark of sickle cell anemia, where red blood cells are destroyed faster than they can be produced.

Choice B rationale

Depigmented areas on the abdomen are not typically associated with sickle cell anemia. Sickle cell anemia primarily affects the blood and organs, leading to complications such as pain crises, anemia, and organ damage. Skin changes like depigmentation are not characteristic of this condition and may indicate other underlying issues.

Choice C rationale

Enlarged mandibular growth is not a common finding in sickle cell anemia. While children with sickle cell anemia may experience growth delays and skeletal abnormalities due to chronic anemia and bone marrow hyperactivity, mandibular enlargement is not a typical feature. Skeletal changes in sickle cell anemia are more likely to involve long bones and vertebrae.

Choice D rationale

Increased growth of long bones is not a characteristic finding in sickle cell anemia. In fact, children with sickle cell anemia may experience growth delays and shorter stature due to chronic anemia and the body’s increased demand for red blood cell production. The condition can lead to skeletal abnormalities, but these typically involve bone infarctions and deformities rather than increased growth.

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