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A client newly diagnosed with type 1 diabetes asks the nurse why injection site rotation is important. What is the nurse's best response?
- A. Avoid infection.
- B. Promote absorption.
- C. Minimize discomfort.
- D. Prevent muscle destruction.
Correct Answer: B
Rationale: Rotating injection sites prevents lipodystrophy (fat buildup or breakdown), ensuring consistent insulin absorption. While infection and discomfort are concerns, they are not the primary reasons. Insulin is not injected into muscle, so muscle destruction is irrelevant.
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On initial nursing rounds, the diabetic client reports 'not feeling well.' Later, the nurse finds the client to be diaphoretic and in a stuporous state. Which is the immediate action taken by the nurse?
- A. Call the physician.
- B. Obtain a glucometer reading.
- C. Administer fruit juice.
- D. Start an IV of dextrose.
Correct Answer: B
Rationale: A glucometer reading is critical to differentiate between hypoglycemia and diabetic ketoacidosis in a stuporous diabetic client. Administering juice or IV dextrose without confirming hypoglycemia risks worsening hyperglycemia, and calling the physician is secondary to obtaining a glucose level.
Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus?
- A. With diabetes, drinking more results in more urine production.
- B. Increased ketones in the urine promote the manufacturing of more urine.
- C. High sugar pulls fluid into the bloodstream, which results in more urine production.
- D. The body's requirement for fuel drives the production of urine.
Correct Answer: C
Rationale: High blood glucose levels increase blood osmolality, pulling fluid into the vascular system, which leads to increased urine production (polyuria) as the kidneys attempt to excrete excess glucose. This triggers thirst (polydipsia), not vice versa. Ketones and fuel requirements do not directly cause polyuria.
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 controlled type 2 diabetic client states, 'The doctor said if my blood sugars remain stable, I may not need to take any medication.' Which response by the nurse is most appropriate?
- A. Diet, exercise, and weight loss can eliminate the need for medication.
- B. You will be placed on a strict low-sugar diet for better control.
- C. Some doctors do not treat blood sugar elevation until symptoms appear.
- D. You misunderstood the doctor. Let's ask for clarification.
Correct Answer: A
Rationale: Lifestyle interventions like diet, exercise, and weight loss can effectively manage type 2 diabetes, potentially reducing or eliminating the need for medication. A strict low-sugar diet is not typically recommended, and waiting for symptoms or assuming misunderstanding is less appropriate.
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.