A nurse is assessing a 7-year-old child who has diabetes mellitus. Which of the following findings should the nurse identify as a manifestation of hypoglycemia?
Increased capillary refill.
Decreased appetite.
Thirst.
Shakiness.
The Correct Answer is D
Choice A rationale
Increased capillary refill time is not typically associated with hypoglycemia. It may indicate poor peripheral circulation but is not a common sign of low blood sugar levels.
Choice B rationale
Decreased appetite is not typically associated with hypoglycemia. Hypoglycemia usually causes symptoms such as shakiness, sweating, and confusion.
Choice C rationale
Thirst is not typically associated with hypoglycemia. It is more commonly a symptom of hyperglycemia (high blood sugar levels).
Choice D rationale
Shakiness or tremors are common signs of hypoglycemia. When blood sugar levels drop, the body responds by releasing adrenaline, which can cause shakiness.
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Correct Answer is A
Explanation
Choice A rationale
The tumbling E chart is used for visual acuity assessment in children who cannot read letters, such as those who are too young or have language barriers. It involves identifying the direction of the letter “E” in various orientations.
Choice B rationale
Testing the child without glasses before testing with glasses is not the standard procedure for visual acuity assessment. The correct approach is to test with the child’s usual corrective lenses if they have them.
Choice C rationale
The standard distance for visual acuity testing using a chart is 3 meters (10 feet) for children, not 4.6 meters (15 feet).
Choice D rationale
Assessing each eye separately first, then both eyes together, is the correct procedure for visual acuity testing. This ensures accurate measurement of each eye’s visual acuity.
Correct Answer is C
Explanation
Choice A rationale
Offering a prize for not crying can create undue pressure and anxiety for the child.
Choice B rationale
Telling the child the medicine will fix them can be misleading and does not provide accurate information about the procedure.
Choice C rationale
Allowing the child to choose which leg to receive the injection in gives them a sense of control and can reduce anxiety.
Choice D rationale
Telling the child they will only feel a little stick can be misleading and may not adequately prepare them for the discomfort.