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A client asks why pancreas transplantation is not an option offered to all insulin-dependent clients with diabetes. Which is the best response by the nurse?
- A. Type 1 diabetes can be managed in most clients with insulin.
- B. Pancreas transplant is becoming more common.
- C. There is a long waiting list to receive a new pancreas.
- D. For every transplant, two deceased donors are needed.
Correct Answer: A
Rationale: Type 1 diabetes is manageable with insulin, and the risks of lifelong immunosuppression from transplantation often outweigh benefits. Pancreas transplants are not increasingly common, waiting lists are not the primary issue, and only one donor is needed.
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A client with type 1 diabetes mellitus is receiving short-acting insulin to maintain control of blood glucose levels. In providing glucometer instructions, the nurse would instruct the client to use which site for most accurate findings?
- A. Finger
- B. Upper arm
- C. Thigh
- D. Forearm
Correct Answer: A
Rationale: The fingertip provides the most accurate blood glucose readings due to its rich blood supply and minimal lag in glucose levels compared to alternate sites like the arm or thigh, which are less reliable for tight glucose control.
The nurse is taking the history of a client with diabetes who is experiencing autonomic neuropathy. Which would the nurse expect the client to report?
- A. Skeletal deformities
- B. Paresthesias
- C. Erectile dysfunction
- D. Soft tissue ulceration
Correct Answer: C
Rationale: Autonomic neuropathy affects organ function, including sexual function. Up to 50% of men with diabetes may develop erectile dysfunction due to impaired nerve function. Skeletal deformities and soft tissue ulceration are associated with motor neuropathy, while paresthesias are linked to sensory neuropathy.
A client with diabetes comes to the clinic for a follow-up visit. The nurse reviews the client's glycosylated hemoglobin test results. Which result would indicate to the nurse that the client's blood glucose level has been well controlled?
- A. 5.50%
- B. 6.50%
- C. 8.80%
- D. 7.80%
Correct Answer: A
Rationale: A glycosylated hemoglobin level below 7% (e.g., 5.5%) indicates good blood glucose control over the past 2-3 months. Levels of 7.5% or higher (e.g., 7.8%, 8.8%) suggest suboptimal control, with 7% correlating to an average blood glucose of 150 mg/dL.
A client with type 2 diabetes is informed of being unable to have a pancreatic transplant and asks the nurse why this is. Which reason would the nurse provide to the client?
- A. Increased risk for urologic complications
- B. Need for exocrine enzymatic drainage
- C. Underlying problem of insulin resistance
- D. Need for lifelong immunosuppressive therapy
Correct Answer: C
Rationale: Clients with type 2 diabetes have insulin resistance, which a pancreas transplant does not address, as the issue lies in tissue response rather than insulin production. Urologic complications and exocrine drainage are not primary reasons, and while immunosuppressive therapy is required, it is not specific to type 2 diabetes.
The nurse is describing the action of insulin in the body to a client newly diagnosed with type 1 diabetes. Which of the following would the nurse explain as being the primary action?
- A. It carries glucose into body cells
- B. It aids in the process of gluconeogenesis.
- C. It stimulates the pancreatic hormone cells.
- D. It decreases the intestinal absorption of glucose.
Correct Answer: A
Rationale: Insulin's primary role is to facilitate glucose transport into cells for energy use and promote glycogen storage in the liver, inhibiting glycogen breakdown. It does not promote gluconeogenesis, stimulate pancreatic hormone cells, or affect intestinal glucose absorption.