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A client is admitted to the unit with diabetic ketoacidosis (DKA). Which insulin would the nurse expect to administer intravenously?
- A. Glargine
- B. Regular
- C. NPH
- D. Lente
Correct Answer: B
Rationale: Regular insulin is used intravenously for DKA due to its rapid onset and ability to be infused continuously. Glargine, NPH, and Lente are long- or intermediate-acting insulins administered subcutaneously, unsuitable for acute DKA management.
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A child is brought into the emergency department with vomiting, drowsiness, and blowing respirations. The child's parent reports that the symptoms have been progressing throughout the day. The nurse suspects diabetic ketoacidosis (DKA). Which action should the nurse take first in the management of DKA?
- A. Give prescribed antiemetics.
- B. Begin fluid replacements.
- C. Administer prescribed dose of insulin.
- D. Administer bicarbonate to correct acidosis.
Correct Answer: B
Rationale: In DKA, correcting dehydration and electrolyte imbalances with fluid replacement is the first priority to stabilize the patient before addressing hyperglycemia with insulin. Antiemetics and bicarbonate are secondary, and insulin requires a physician's order.
A client reports taking oral medication for control of sugar problems. Which is the best nursing interpretation of this verbal accounting?
- A. Lack of knowledge of disease process
- B. Client has type 2 diabetes mellitus.
- C. Client has prediabetes mellitus.
- D. Lack of knowledge on medication regime
Correct Answer: B
Rationale: Oral antidiabetic medications are typically prescribed for type 2 diabetes, indicating the client likely has this condition. Prediabetes is not treated with medication, and there is insufficient information to assume a lack of knowledge about the disease or medication.
A diabetic client maintains glucose control with the use of long-acting and short-acting insulin. Which nursing instruction would be considered a priority instruction for this client?
- A. Mix short-acting and long-acting insulin.
- B. Monitor blood glucose levels immediately following injection.
- C. Use stomach for nighttime injections.
- D. If using Lantus or Levemir, give in separate syringe.
Correct Answer: D
Rationale: Lantus and Levemir (long-acting insulins) must be administered in separate syringes, as mixing with other insulins can alter their action. Monitoring should occur before injections, and the stomach is not specifically preferred for nighttime doses; thighs are often used for slower absorption.
A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?
- A. Metformin
- B. Glyburide
- C. Repaglinide
- D. Glipizide
Correct Answer: A
Rationale: Metformin, a biguanide, enhances insulin sensitivity in tissues, improving glucose uptake. Glyburide, glipizide (sulfonylureas), and repaglinide (meglitinide) stimulate insulin release from the pancreas, not tissue sensitivity.
The client with diabetes asks the nurse why shoes and socks are removed at each office visit. The nurse gives which assessment finding as the explanation for the inspection of feet?
- A. Autonomic neuropathy
- B. Retinopathy
- C. Sensory neuropathy
- D. Nephropathy
Correct Answer: C
Rationale: Sensory neuropathy from poor glucose control reduces foot sensation, increasing injury risk. Regular foot inspections detect issues early. Autonomic neuropathy affects organs, retinopathy affects eyes, and nephropathy affects kidneys, not directly related to foot injuries.