Choice A rationale:

The statement mentions that children with a family history of diabetes have an increased risk of developing the condition.

While family history is a risk factor for diabetes, it doesn't explain the causes of diabetes mellitus in children.

It only highlights one of the risk factors.

Choice B rationale:

This statement accurately explains one of the causes of diabetes mellitus in children.

In type 1 diabetes, the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas.

This immune-mediated destruction of beta cells is a key factor in the development of type 1 diabetes in children.

Choice C rationale:

This statement mentions that certain viral infections and dietary factors may trigger the development of diabetes in susceptible individuals.

Choice D rationale:

This statement is more relevant to type 2 diabetes as it mentions a combination of insulin resistance and impaired insulin secretion.

Choice A rationale:

This statement accurately describes the pathophysiology of diabetes mellitus in children.

Insufficient insulin results in elevated blood glucose levels, leading to the characteristic symptoms of diabetes.

In type 1 diabetes, there is a lack of insulin due to the destruction of insulin-producing beta cells by the immune system.

Choice B rationale:

This statement incorrectly suggests that there is a combination of insulin resistance and impaired insulin secretion in type 1 diabetes.

In reality, type 1 diabetes is characterized by a lack of insulin production due to the destruction of beta cells by the immune system.

Choice C rationale:

This statement inaccurately states that in type 2 diabetes, the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas.

This description is more aligned with type 1 diabetes, not type 2 diabetes.

Choice D rationale:

This statement falsely claims that certain viral infections and dietary factors are the sole causes of diabetes in children.

While these factors can contribute to the development of diabetes, they are not the sole causes, and this oversimplification doesn't accurately represent the pathophysiology of diabetes mellitus in children.

Choice A rationale:

Genetic factors play a significant role in increasing the risk of diabetes in children.

If there is a family history of diabetes, the genetic predisposition can contribute to the development of the condition.

Choice B rationale:

Autoimmune destruction of beta cells is a risk factor for type 1 diabetes in children.

In this condition, the immune system attacks and destroys the insulin-producing beta cells in the pancreas, leading to a lack of insulin.

Choice C rationale:

Insulin resistance is a risk factor for type 2 diabetes in children.

It is characterized by the body's reduced response to insulin, leading to elevated blood glucose levels.

Choice D rationale:

Lack of physical activity is a modifiable risk factor for both type 1 and type 2 diabetes.

However, it is more strongly associated with type 2 diabetes, and it's not a primary risk factor for diabetes in children.

Choice E rationale:

Environmental factors can also contribute to the risk of diabetes in children.

These factors may include dietary choices, exposure to certain toxins, and lifestyle factors, among others.

Choice A rationale:

Genetic factors play a significant role in the development of diabetes mellitus, especially when there is a family history of the disease.

People with a family history of diabetes are at a higher risk of developing the condition due to the inheritance of certain genes that predispose them to diabetes.

These genetic factors can influence insulin production, insulin sensitivity, and glucose regulation.

The genetic component of diabetes is well-established, and research has identified specific genes associated with both type 1 and type 2 diabetes.

It's important to educate the client about the importance of monitoring their blood sugar levels and adopting a healthy lifestyle to reduce their risk, given their family history.

Choice B rationale:

Autoimmune destruction of beta cells is more associated with type 1 diabetes rather than a family history of the disease.

Type 1 diabetes is an autoimmune condition in which the body's immune system mistakenly targets and destroys the insulin-producing beta cells in the pancreas.

While this is a critical factor in type 1 diabetes, it is not typically linked to family history as a primary risk factor.

Choice C rationale:

Insufficient insulin is a consequence of diabetes rather than a risk factor.

In diabetes, the problem is usually related to the body's inability to produce enough insulin (in type 1 diabetes) or effectively use the insulin produced (in type 2 diabetes).

Insufficient insulin is a result of the disease, not a contributing factor related to family history.

Choice D rationale:

Lack of physical activity can be a risk factor for diabetes, especially type 2 diabetes, but it is not the primary factor associated with a family history of the disease.

Lack of physical activity may contribute to the development of diabetes in individuals who are already at risk due to genetic factors or other lifestyle-related factors.

It's essential to promote physical activity and a healthy lifestyle, but this is not the primary risk factor in the context of family history.

Choice A rationale:

Stating that viral infections are the primary cause of diabetes in children is inaccurate.

While viral infections can play a role in the development of diabetes, they are not the primary cause.

Diabetes has multifactorial causes, including genetic predisposition, lifestyle factors, and viral infections are only one of several potential triggers.

Choice C rationale:

Suggesting that viral infections only lead to insulin resistance in children is an oversimplification.

Viral infections can have various effects on the development of diabetes, and it's not limited to insulin resistance.

The relationship between viral infections and diabetes is complex and can involve factors like inflammation and autoimmunity.

Choice D rationale:

Diabetes is associated with viral infections, especially in certain cases.

However, stating that diabetes is not associated with viral infections in any way is incorrect.

Viral infections can sometimes trigger an autoimmune response that damages pancreatic beta cells or cause inflammation that affects insulin sensitivity.

Therefore, it's essential to acknowledge the potential link between viral infections and diabetes, particularly in susceptible individuals.

Choice A rationale:

Telling the child to drink less water to control urination is not an appropriate response.

Excessive thirst and increased urination are common symptoms of diabetes, and they occur because the body is trying to get rid of excess glucose through urine.

Dehydration is a concern in diabetes, so advising the child to drink less water is not advisable.

Choice B rationale:

Explaining to the child that these symptoms are due to their body having trouble using glucose properly is an accurate and appropriate response.

Excessive thirst and increased urination are classic symptoms of diabetes mellitus.

When the body cannot use glucose effectively, it tries to eliminate excess glucose through urine, leading to increased urination and subsequent thirst to combat dehydration.

Choice C rationale:

Suggesting that the child should eat more to satisfy their increased hunger is not an appropriate response.

Increased hunger can also be a symptom of diabetes, and advising the child to eat more without addressing the underlying issue of glucose regulation is not helpful.

Choice D rationale:

Weight loss is often an early symptom of diabetes, and it occurs because the body is unable to properly utilize glucose for energy.

A. "Evaluate the child's emotional well-being.”.

D. "Obtain a detailed history, including family history of diabetes.”.

E. "Regularly monitor blood glucose levels to assess glycemic control.”.

Choice A rationale:

Evaluate the child's emotional well-being.

Assessing the emotional well-being of a child with diabetes is crucial because living with a chronic condition can have a significant impact on a child's mental health.

Children may experience stress, anxiety, and other emotional challenges related to their condition.

This assessment helps in providing comprehensive care and support to the child.

Choice B rationale:

Assess for signs of hyperglycemia, such as polyuria.

While assessing for signs of hyperglycemia, such as polyuria, is important in managing diabetes, it is primarily a physical assessment and not a psychosocial assessment.

It focuses on the physiological aspects of the condition.

Choice C rationale:

Monitor growth patterns and assess for any delays.

Monitoring growth patterns and assessing for delays in a child's development is important but is also primarily a physical assessment.

It is not a direct component of the psychosocial assessment, although it may indirectly impact a child's emotional well-being.

Choice D rationale:

Obtain a detailed history, including family history of diabetes.

Obtaining a detailed history, including a family history of diabetes, is a crucial part of the assessment.

Family history can be a significant risk factor for the development of diabetes in a child.

Understanding the family history helps in identifying potential genetic predispositions.

Choice E rationale:

Regularly monitor blood glucose levels to assess glycemic control.

Regularly monitoring blood glucose levels is essential in managing diabetes.

While it is a key aspect of diabetes care, it primarily falls under the category of physiological monitoring rather than a direct component of psychosocial assessment.

"A glucose level ≥200 mg/dL two hours after a glucose load confirms the diagnosis.”.

Choice A rationale:

A glucose level ≥100 mg/dL two hours after a glucose load confirms the diagnosis.

This statement is incorrect.

A glucose level of 100 mg/dL two hours after a glucose load is not sufficient to confirm the diagnosis of diabetes.

The diagnostic criteria for diabetes typically involve higher glucose levels.

Choice B rationale:

A glucose level ≥180 mg/dL one hour after a glucose load indicates diabetes.

This statement is incorrect.

While a glucose level of 180 mg/dL one hour after a glucose load may be elevated, it is not enough to confirm a diagnosis of diabetes.

The diagnostic criteria for diabetes primarily involve glucose levels at the two-hour mark.

Choice C rationale:

A glucose level ≥200 mg/dL two hours after a glucose load confirms the diagnosis.

This statement is correct.

The oral glucose tolerance test (OGTT) is a diagnostic test for diabetes, and the ADA diagnostic criteria specify that a glucose level of 200 mg/dL or higher at the two-hour mark after a glucose load confirms the diagnosis of diabetes.

This threshold is used to ensure accurate diagnosis.

Choice D rationale:

A glucose level ≥250 mg/dL one hour after a glucose load suggests uncontrolled diabetes.

This statement is not part of the diagnostic criteria for diabetes.

While a glucose level of 250 mg/dL one hour after a glucose load is elevated, it is not used to confirm the diagnosis of diabetes.

The diagnostic threshold is typically set at the two-hour mark.

Choice A rationale:

"This hunger is a normal part of growing up.”.

This response is not appropriate.

Increased hunger in a child with diabetes is not a normal part of growing up.

It is essential to provide accurate information and address the child's concerns.

Choice B rationale:

"Increased hunger is a result of the body's inability to utilize glucose properly.”.

This is The correct response.

Increased hunger in diabetes is often due to the body's inability to use glucose properly.

When insulin is deficient or not functioning effectively, the cells cannot take up glucose for energy, leading to increased hunger.

Providing this information helps the child understand the physiological basis of their hunger.

Choice C rationale:

"You should eat smaller, more frequent meals to control your hunger.”.

While this advice can be helpful for managing blood sugar levels in diabetes, it doesn't address the cause of increased hunger.

It is essential to explain the underlying reasons for the symptom.

Choice D rationale:

"This is a side effect of the medication you're taking.”.

This response is not accurate.

Increased hunger in diabetes is primarily related to glucose metabolism and insulin deficiency, not a medication side effect.

Choice A rationale:

"You should avoid any physical activity to keep your blood glucose levels stable.”.

This statement is incorrect.

Physical activity is essential for managing diabetes as it helps lower blood glucose levels.

Advising the child to avoid physical activity is not appropriate.

Choice B rationale:

"Insulin injections are not necessary; you can manage diabetes with diet alone.”.

This statement is misleading and potentially dangerous.

Insulin is a crucial treatment for many individuals with diabetes, and suggesting that it is not necessary can have severe consequences.

Diet alone is not sufficient to manage diabetes for most individuals.

Choice C rationale:

"Regular blood glucose monitoring is important to assess glycemic control.”.

This is The correct response.

Regular blood glucose monitoring is crucial in diabetes management.

It allows the child and their family to assess how well they are managing blood sugar levels and make necessary adjustments to their treatment plan.

Choice D rationale:

"Eating as much sugar as you want won't affect your diabetes.”.

This statement is false.

Consuming excessive sugar can significantly impact blood glucose levels, and individuals with diabetes should be mindful of their sugar intake.

Providing this information is essential for the child and their family to make informed choices.

Choice A rationale:

"The primary treatment for children with diabetes is insulin therapy.”.

This is The correct response.

Insulin therapy is the primary treatment for type 1 diabetes in children and may also be necessary for some with type 2 diabetes.

It is crucial to explain this to the client accurately.

Choice B rationale:

"Children with diabetes can manage their condition solely through dietary modifications.”.

This statement is not accurate.

While diet plays a significant role in diabetes management, it is not the sole treatment.

Insulin or other medications may be necessary, depending on the type and severity of diabetes.

Choice C rationale:

"Regular physical activity is the primary treatment for diabetes in children.”.

While physical activity is essential for diabetes management, it is not the primary treatment.

Insulin therapy or other medications take precedence, and physical activity complements the treatment plan.

Choice D rationale:

"Blood glucose monitoring is not necessary for managing diabetes in children.”.

This statement is incorrect.

Blood glucose monitoring is a crucial part of diabetes management, allowing the child and their healthcare team to make informed decisions about treatment and lifestyle adjustments.

Choice A rationale:

Insulin is a crucial part of managing diabetes, especially in the case of diabetic ketoacidosis (DKA).

It helps lower blood sugar levels and counteracts the effects of high blood glucose, which is characteristic of DKA.

Avoiding insulin at all costs is not an appropriate approach as it can lead to worsening of DKA.

Choice B rationale:

The nurse should emphasize the need for frequent monitoring of blood glucose levels.

This is because DKA is associated with significantly elevated blood glucose levels.

Regular monitoring allows for timely adjustments in insulin and other treatments, reducing the risk of complications.

Monitoring blood glucose levels is a fundamental aspect of diabetes management.

Choice C rationale:

Consuming a high-carbohydrate diet is not advisable in the context of DKA prevention.

High-carbohydrate diets can lead to elevated blood sugar levels, which may exacerbate the risk of DKA.

It's essential to maintain a balanced and controlled carbohydrate intake for individuals with diabetes.

Choice D rationale:

Avoiding follow-up appointments is not a suitable approach for DKA prevention.

Regular follow-up appointments with healthcare providers are essential for monitoring and adjusting the diabetes management plan.

Skipping follow-up appointments can lead to uncontrolled blood sugar levels and an increased risk of DKA.

Choice A rationale:

Eating three large meals per day may not be the best approach for managing blood sugar levels in a child with diabetes.

Spacing meals and snacks throughout the day can help stabilize blood glucose levels and prevent large fluctuations.

It's important to maintain a balanced eating pattern.

Choice B rationale:

Providing snacks every two hours, even if the child is not hungry, may lead to overconsumption and could potentially affect blood sugar levels.

Regular, balanced snacks are essential, but they should be based on the child's hunger and in accordance with the diabetes management plan.

Choice C rationale:

This statement demonstrates a good understanding of the nurse's teaching.

Offering a variety of healthy foods and drinks throughout the day helps maintain stable blood sugar levels and provides necessary nutrients.

It aligns with the principles of diabetes management.

Choice D rationale:

Avoiding sugary foods and drinks is important for DKA prevention, but this statement doesn't directly address the need for regular meals and snacks, which is the main focus of the nurse's teaching.

While avoiding sugary items is crucial, overall dietary balance is essential.

Choice A rationale:

A decrease in the child's blood glucose level from 300 mg/dL to 250 mg/dL would indicate an improvement in DKA.

This is because DKA is characterized by hyperglycemia, and a decrease in blood glucose levels shows that the insulin infusion is working to correct the high blood sugar.

The normal range for blood glucose levels in children is typically 70-140 mg/dL, so 250 mg/dL is still high but represents an improvement.

Choice B rationale:

A decrease in ketones in the urine is another positive sign in the management of DKA.

Ketones in the urine are a sign of metabolic acidosis, which is a hallmark of DKA.

A reduction in ketones indicates that the body is shifting away from using fats for energy and is starting to correct the metabolic derangement.

It's important to note that ketone levels are usually assessed qualitatively as negative, trace, small, moderate, or large, and a decrease from a higher level to a lower level is a positive sign.

Choice C rationale:

An increase in the respiratory rate is not typically an indicator of DKA improvement.

In fact, during DKA, the respiratory rate may increase as the body tries to compensate for the acidosis by blowing off carbon dioxide through rapid breathing.

Therefore, a further increase in respiratory rate may not necessarily be a sign of improvement.

Monitoring the respiratory rate is essential, but it doesn't directly indicate the resolution of DKA.

Choice D rationale:

An increase in pH is a significant indicator of DKA improvement.

In DKA, the blood becomes acidic due to the accumulation of ketones and the decreased pH levels.

An increase in pH levels suggests that the acidosis is being corrected, which is a positive sign in the management of DKA.

Normal blood pH levels for children typically range from 7.35 to 7.45.

Choice E rationale:

A decrease in bicarbonate levels is not a sign of DKA improvement.

In DKA, bicarbonate levels are typically low due to the acidosis.

As treatment progresses and the acidosis resolves, bicarbonate levels may start to increase, indicating improvement.

Therefore, a decrease in bicarbonate levels would not be a positive sign in this context.

Choice B rationale:

Elevating the head of the bed 30 degrees is the most appropriate initial intervention for a child with DKA experiencing cerebral edema.

Cerebral edema is a serious complication of DKA, and it can lead to increased intracranial pressure.

Elevating the head of the bed helps to reduce intracranial pressure by promoting venous drainage from the brain.

This intervention should be initiated promptly to help alleviate the symptoms and prevent further complications.

Administering mannitol (choice A) or oxygen (choice C) can be considered later, but elevating the head of the bed is the priority.

Monitoring vital signs (choice D) is important but not the first action in addressing elevated intracranial pressure.

Choice A rationale:

Teaching parents how to monitor the child's blood glucose levels at home is essential in the discharge plan for a child with DKA.

It empowers parents to manage their child's condition and ensure that blood glucose levels are within a safe range.

Home monitoring is crucial for preventing recurrence and managing diabetes effectively.

Choice B rationale:

Instructing parents on how to give the child insulin injections is another critical aspect of the discharge plan.

Children with DKA often require insulin therapy to manage their blood glucose levels.

Proper administration of insulin is essential to prevent hyperglycemia and DKA recurrence.

Choice C rationale:

Educating parents on what to do if the child develops symptoms of DKA, such as abdominal pain, nausea, and vomiting, is important.

Recognizing the early signs of DKA and seeking medical attention promptly is crucial to prevent the condition from worsening.

Teaching parents to be vigilant for these symptoms can help prevent DKA recurrence.

Choice D rationale:

Preventing the child from developing DKA again in the future is a crucial part of the discharge plan.

While this is a broad goal, it can encompass education on various aspects, such as the importance of insulin compliance, regular medical check-ups, and diabetes management strategies.

Preventing recurrence is a primary objective of DKA management.

Choice E rationale:

Providing information on how to contact the child's healthcare provider if parents have any questions or concerns is essential.

Open communication with healthcare providers is vital for ongoing support, guidance, and adjustments to the child's diabetes management plan.

Choice A rationale:

The nurse should not tell the child's parents that their child's condition is stable and that there is no need for concern.

This is not an accurate assessment, especially when there are recent changes in medication, a diagnosis of diabetes, and a history of previous episodes of Diabetic Ketoacidosis (DKA).

It is important to address the potential issues that might have contributed to the development of DKA.

Choice B rationale:

This is The correct choice.

The nurse should inform the child's parents that the recent changes in their child's medication may have contributed to the situation.

Medication changes can affect blood glucose levels and, in some cases, lead to DKA.

It's essential to consider all possible factors contributing to the condition.

Choice C rationale:

Telling the child's parents that their child's diabetes diagnosis is incorrect is not appropriate, as there is already a confirmed diagnosis of diabetes.

DKA is a complication of diabetes, and addressing the current situation is more important than questioning the diagnosis itself.

Choice D rationale:

Accusing the child of not taking their medication correctly without proper evidence is not a good approach.

It's important to investigate the medication changes and other factors before making such an assumption.

"We'll administer 0.9% saline to restore intravascular volume.”.

Choice A rationale:

The statement "We'll administer 0.9% saline to restore intravascular volume" is correct.

In the management of DKA, fluid resuscitation is a crucial initial step to restore intravascular volume.

Choice A rationale:

Education on insulin therapy is a fundamental aspect of DKA management.

Insulin is a crucial component in treating DKA as it helps lower elevated blood glucose levels and corrects the ketosis and acidosis.

It is essential for the patient and their family to understand how insulin works, how to administer it, and when to administer it.

Proper insulin therapy can prevent further complications and guide the management of DKA.

Choice B rationale:

Focusing solely on dietary recommendations is not appropriate in the initial management of DKA.

While dietary management is important for long-term diabetes care, it is not the primary focus during the acute phase of DKA.

The priority is to address the high blood glucose levels and ketoacidosis, which is best achieved through insulin therapy and fluid resuscitation.

Choice C rationale:

Avoiding discussions about blood glucose monitoring is not recommended.

Blood glucose monitoring is a critical aspect of DKA management.

It helps healthcare providers determine the effectiveness of insulin therapy and the patient's response to treatment.

Avoiding these discussions would be detrimental to the patient's care.

Choice D rationale:

Neglecting to mention the risk of cerebral edema is not appropriate in DKA education.

Cerebral edema is a severe complication of DKA that can be life-threatening.

It is crucial to inform the patient and their family about this risk so they can seek prompt medical attention if symptoms occur.

Neglecting to mention this risk could lead to delayed treatment and potential harm to the patient.

Choice A rationale:

Frequent monitoring is not primarily done to adjust the diet plan.

While monitoring can provide information about the patient's nutritional needs, the primary purpose of monitoring in DKA is to assess the effectiveness of insulin therapy and to guide electrolyte replacement.

Choice B rationale:

Monitoring blood glucose and electrolyte levels helps guide insulin and electrolyte replacement therapy in DKA.

It allows healthcare providers to make necessary adjustments in insulin dosing and electrolyte replacement to ensure the patient's safety and a successful recovery.

Choice C rationale:

Frequent monitoring is not primarily aimed at checking for allergic reactions to insulin.

Allergic reactions to insulin are relatively rare, and monitoring is mainly done to assess treatment effectiveness and the patient's response to therapy.

Choice D rationale:

Monitoring is not a standard procedure for all patients regardless of their condition.

It is essential in DKA management, but it is not universally applicable to all patients.

Monitoring is performed based on the patient's specific condition and treatment needs.

Choice A rationale:

Fluid resuscitation with 0.9% saline is indeed a crucial part of the initial management of diabetic ketoacidosis (DKA).

DKA often results in severe dehydration due to excessive urination and can lead to a state of shock.

The administration of normal saline helps to rehydrate the patient and restore adequate blood volume.

Choice B rationale:

Electrolyte imbalances, especially hypokalemia, are common in DKA.

When a person has DKA, there is a significant loss of fluids and electrolytes through excessive urination.

This loss can lead to low potassium levels, which can be life-threatening.

Therefore, monitoring and correcting electrolyte imbalances, including potassium, is essential in the treatment of DKA.

Choice C rationale:

Insulin therapy is crucial in the treatment of DKA.

This choice is incorrect because insulin helps to reverse the metabolic processes that lead to ketone formation and hyperglycemia in DKA.

By administering insulin, the body can utilize glucose for energy, reduce blood glucose levels, and stop the production of ketones.

Choice D rationale:

Monitoring blood glucose and electrolyte levels is essential during the treatment of DKA.

Frequent monitoring allows healthcare providers to assess the effectiveness of treatment, make necessary adjustments, and ensure the patient's safety.

It helps in tracking the response to insulin therapy and The correction of electrolyte imbalances.

Choice E rationale:

Children with DKA are indeed at risk for complications.

This choice is incorrect because DKA can lead to a range of complications, including cerebral edema, which is more common in children.

Cerebral edema is a severe and potentially life-threatening complication that highlights the importance of vigilant management and monitoring in pediatric DKA cases.

All of these.

Choice A rationale:

Correcting fluid and electrolyte imbalances is an essential part of the care plan for a child with DKA.

This is because DKA often leads to severe dehydration and electrolyte imbalances due to excessive urination.

Restoring fluid and electrolyte balance is crucial to stabilize the patient's condition.

Choice B rationale:

Reducing hyperglycemia is a critical goal in the care of a child with DKA.

Elevated blood glucose levels are a hallmark of DKA, and addressing hyperglycemia is achieved through insulin therapy.

Reducing hyperglycemia helps to stop the production of ketones and normalize metabolic processes.

Choice C rationale:

Preventing complications is an important aspect of managing DKA.

Complications such as cerebral edema and organ dysfunction can occur if DKA is not promptly and effectively treated.

Therefore, monitoring for and taking steps to prevent complications is a fundamental component of the care plan.

Choice D rationale:

The correct answer is "All of these" because the care plan for a child with DKA includes interventions that address fluid and electrolyte imbalances, hyperglycemia, and complications.

These interventions work together to stabilize the patient's condition and prevent further deterioration.

Potassium replacement is done to prevent hypokalemia, which is common in DKA.

Choice A rationale:

Potassium replacement is indeed necessary in DKA treatment.

This choice is incorrect because DKA often leads to hypokalemia (low potassium levels).

Potassium is an essential electrolyte for various bodily functions, including proper heart function, and low levels can be life-threatening.

Therefore, potassium replacement is a vital part of DKA treatment.

Choice B rationale:

The primary reason for potassium replacement in DKA is to prevent hypokalemia.

As mentioned earlier, DKA leads to excessive urination, which results in the loss of potassium and other electrolytes.

Hypokalemia can lead to cardiac arrhythmias and muscle weakness.

Therefore, replenishing potassium is crucial to maintaining normal physiological functions.

Choice C rationale:

Potassium replacement is not done to treat hyperkalemia in DKA.

DKA typically leads to hypokalemia, not hyperkalemia.

Hyperkalemia, or high potassium levels, is a less common complication in DKA.

Treating hyperkalemia may involve different interventions, but it is not the primary reason for potassium replacement in DKA.

Choice D rationale:

Potassium replacement is not done solely based on the client's request.

It is a medical decision made by healthcare providers based on clinical assessment and laboratory values.

Ignoring potassium replacement in DKA could lead to severe complications, so it is not a matter of personal preference.

Choice A rationale:

Carbohydrate counting and portion control.

Carbohydrate counting and portion control are essential dietary principles for glycemic control in children with diabetes.

Carbohydrates have a significant impact on blood sugar levels, so teaching children and their families how to count carbohydrates and control portion sizes helps them manage their blood glucose levels more effectively.

By knowing the amount of carbohydrates in their meals, children can adjust their insulin or medication doses accordingly, promoting better glycemic control.

Choice B rationale:

Unlimited sugar intake for quick energy.

Unlimited sugar intake is not a recommended dietary principle for children with diabetes.

Consuming excessive amounts of sugar can lead to rapid spikes in blood sugar levels, making it difficult to maintain stable glycemic control.

It can also contribute to the development of long-term complications associated with diabetes.

Therefore, it is important to limit sugar intake and choose healthier carbohydrate sources.

Choice C rationale:

High-fat, low-carbohydrate diet.

A high-fat, low-carbohydrate diet is not a suitable dietary recommendation for children with diabetes.

Such a diet may lead to increased fat accumulation and negatively affect glycemic control.

It is important to focus on balanced and moderate carbohydrate intake, as well as selecting healthy fats in the diet.

A diet rich in healthy carbohydrates, lean proteins, and good fats is more appropriate for children with diabetes.

Choice D rationale:

Avoiding all carbohydrates in the diet.

Avoiding all carbohydrates in the diet is not a practical or safe approach for children with diabetes.

Carbohydrates are a primary source of energy, and completely eliminating them from the diet can lead to nutrient deficiencies and other health issues.

The goal is to manage carbohydrate intake, not eliminate it entirely.

Choice E rationale:

Random and irregular meal times.

Random and irregular meal times are not recommended for children with diabetes.

Consistency in meal timing is crucial to maintain stable blood sugar levels.

It helps synchronize food intake with insulin or medication administration, making it easier to control blood glucose.

Irregular meal times can lead to fluctuations in blood sugar levels, which are undesirable for children with diabetes.

Choice A rationale:

"Children with diabetes should never use insulin pumps.”.

This statement is not accurate.

Insulin pumps can be a valuable tool in the management of diabetes in children.

Insulin pumps provide continuous subcutaneous insulin delivery, offering a more flexible and precise way to administer insulin.

They can be particularly beneficial for children who require multiple daily injections or have difficulty with insulin injections.

Choice B rationale:

"Insulin therapy is not a significant part of diabetes management in children.”.

Insulin therapy is a significant and often essential part of diabetes management in children, especially for those with type 1 diabetes.

Children with type 1 diabetes do not produce insulin and require lifelong insulin therapy to survive.

It plays a crucial role in maintaining glycemic control and preventing complications.

Choice C rationale:

"There are different types of insulin, including rapid-acting and long-acting.”.

This statement is accurate.

Children with diabetes may require different types of insulin to manage their blood sugar effectively.

Rapid-acting insulin is used to cover meals and correct high blood sugar levels, while long-acting insulin provides basal insulin to keep blood sugar stable between meals and overnight.

Understanding the different types of insulin and their respective roles is essential for proper diabetes management.

Choice D rationale:

"Children with diabetes only need short-acting insulin.”.

This statement is not accurate.

While short-acting insulin (rapid-acting) is necessary for mealtime coverage, it is not the only type of insulin children may need.

Long-acting insulin is crucial for providing a basal level of insulin throughout the day and night.

Children with diabetes often require both short-acting and long-acting insulin to achieve optimal glycemic control.

Choice A rationale:

"Acute complications like hypoglycemia cannot be prevented in children.”.

Hypoglycemia is an acute complication of diabetes that can be prevented and managed.

Education on recognizing and treating low blood sugar episodes, monitoring blood glucose levels, and adjusting insulin or medications appropriately can significantly reduce the risk of hypoglycemia in children with diabetes.

Choice B rationale:

"Long-term complications such as retinopathy and nephropathy are not a concern for children.”.

Long-term complications like retinopathy (eye problems) and nephropathy (kidney problems) can affect children with diabetes, especially if their blood sugar levels are poorly controlled over time.

It is essential to emphasize the importance of glycemic control and regular medical check-ups to monitor for early signs of these complications and take preventive measures.

Choice C rationale:

"Strategies can be implemented to prevent both acute and long-term complications.”.

This is The correct answer.

Strategies can be implemented to prevent both acute and long-term complications in children with diabetes.

These strategies include maintaining good glycemic control through proper insulin management, following a healthy diet, engaging in regular physical activity, and regular medical follow-ups.

Preventive measures, such as eye and kidney screenings, can also help detect potential issues early and intervene appropriately.

Choice D rationale:

"There is no need for regular follow-up visits to monitor glycemic control.”.

Regular follow-up visits to monitor glycemic control are essential for children with diabetes.

These visits allow healthcare professionals to assess the child's blood sugar management, adjust treatment plans as needed, and provide ongoing education and support.

Skipping follow-up visits can increase the risk of complications and hinder effective diabetes management.

Dehydration.

Choice A rationale:

Hypovolemia Hypovolemia refers to a decreased blood volume and can lead to decreased urine output.

However, in the context of a patient with suspected DKA, the primary concern is dehydration due to excessive loss of fluids and electrolytes through polyuria (excessive urination) and osmotic diuresis.

This leads to dehydration rather than hypovolemia.

Choice B rationale:

Hyperglycemia Hyperglycemia is a characteristic feature of DKA, but it doesn't directly cause decreased urine output.

In fact, hyperglycemia often leads to increased urine output due to the osmotic diuresis caused by high blood glucose levels.

Choice D rationale:

Prolonged capillary refill time Prolonged capillary refill time is a sign of poor perfusion and can be associated with hypovolemia.

However, it is not the primary concern in a patient with suspected DKA who is experiencing dehydration.

The decreased urine output is primarily due to the loss of fluids and electrolytes from hyperglycemia and osmotic diuresis.

Now, let's move on to the next question.

Hyperglycemia.

Choice A rationale:

Hypoglycemia A blood glucose level of 250 mg/dL is not indicative of hypoglycemia.

Hypoglycemia is defined as low blood glucose levels typically below 70 mg/dL.

In DKA, the primary concern is hyperglycemia, and blood glucose levels are significantly higher than normal.

Choice C rationale:

Normoglycemia A blood glucose level of 250 mg/dL is above the normal range, which typically falls between 70 and 100 mg/dL.

Therefore, it does not indicate normoglycemia.

Hyperglycemia is the characteristic feature of DKA.

Choice D rationale:

Ketonuria While ketonuria is often present in DKA, the finding of a blood glucose level of 250 mg/dL primarily indicates hyperglycemia.

Ketonuria is assessed through urinalysis and relates to the presence of ketones in the urine, which is a common feature of DKA along with hyperglycemia.

Choice A rationale:

Initiating potassium replacement once urine output is established and serum potassium levels are known is the appropriate approach in managing hypokalemia in a client with diabetic ketoacidosis (DKA).

Hypokalemia is a common complication in DKA due to excessive loss of potassium through osmotic diuresis.

The first step is to ensure adequate urine output, as potassium replacement can potentially lead to kidney damage in the absence of diuresis.

Once urine output is established, the nurse can then monitor serum potassium levels and administer potassium as necessary to correct the imbalance.

Choice B rationale:

Delaying potassium replacement until blood glucose levels stabilize is not the best approach.

Hypokalemia in DKA should be addressed promptly to prevent complications such as cardiac dysrhythmias, which can be aggravated by low potassium levels.

Correcting hypokalemia is an essential part of DKA management and should not be postponed.

Choice C rationale:

Waiting for the client to complain of muscle weakness before replacing potassium is not advisable.

Muscle weakness is a late sign of severe hypokalemia, and by the time it occurs, the client may already be at risk of life-threatening complications.

It is essential to monitor laboratory values and replace potassium proactively when necessary.

Choice D rationale:

Asserting that potassium replacement is not necessary in DKA management is incorrect.

Hypokalemia is a well-recognized complication in DKA, and addressing it is a vital part of the overall treatment plan.

Failure to replace potassium in a timely manner can lead to serious health risks, including cardiac arrhythmias.

Blood glucose levels.

B. Electrolyte levels.

C. Respiratory rate.

E. Skin color.

Choice A rationale:

Monitoring blood glucose levels is essential in managing a child with diabetic ketoacidosis (DKA).

Hyperglycemia is a hallmark of DKA, and effective insulin therapy is necessary to lower blood glucose levels to normal or near-normal ranges.

Frequent blood glucose monitoring helps adjust insulin infusion rates, preventing both hyperglycemia and hypoglycemia.

Choice B rationale:

Electrolyte levels, including potassium, sodium, and chloride, should be closely monitored in a child with DKA.

DKA can lead to electrolyte imbalances, such as hypokalemia and hyponatremia, which can be life-threatening.

Monitoring electrolytes ensures that appropriate replacements are administered to correct these imbalances.

Choice C rationale:

Respiratory rate monitoring is vital to detect signs of impending respiratory distress in a child with DKA.

As DKA progresses, metabolic acidosis can result in Kussmaul respirations, which are deep and rapid.

Monitoring respiratory rate can help identify respiratory distress early and prompt timely intervention.

Choice E rationale:

Monitoring skin color is important to assess perfusion and oxygenation.

In severe cases of DKA, there may be impaired tissue perfusion, resulting in pallor or cyanosis.

Skin color changes can be an early indicator of circulatory compromise, and prompt action can help prevent complications associated with inadequate tissue perfusion.

Choice D rationale:

Cardiac output is not typically monitored as a routine measure in managing DKA.

While DKA can affect cardiac function indirectly by causing electrolyte imbalances, monitoring cardiac output is not a direct preventive measure for DKA complications.

Instead, the focus should be on correcting the underlying metabolic and electrolyte imbalances.

Choice A rationale:

In DKA management, insulin is typically administered intravenously as a continuous infusion.

This approach allows for precise control of insulin delivery, making it possible to titrate the insulin dose according to the patient's response.

Intravenous insulin is preferred because it provides rapid onset and offset of action and can be adjusted as needed to address changes in the patient's condition.

Choice B rationale:

Administering insulin as a single, large dose is not the standard practice in DKA management.

Large bolus doses of insulin can lead to rapid reductions in blood glucose levels, potentially causing hypoglycemia.

Continuous intravenous infusions are favored for gradual correction of hyperglycemia while avoiding rapid fluctuations in blood glucose levels.

Choice C rationale:

Oral insulin is not preferred for the treatment of DKA.

In this acute condition, the absorption of oral medications can be unpredictable and slow, which may not provide the rapid and consistent control of blood glucose levels required in DKA management.

Choice D rationale:

Insulin injections are typically given subcutaneously for routine diabetes management, but in the case of DKA, intravenous administration is the preferred route.

Subcutaneous injections have a slower onset of action and may not be suitable for addressing the acute and severe hyperglycemia characteristic of DKA.