Nokea
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.
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The nurse is admitting a client with the diagnosis of hyperosmolar hyperglycemic nonketotic syndrome (HHNKS) following steroid therapy. Which sign(s) and symptom(s) would the nurse likely note? Select all that apply.
- A. High blood pressure
- B. Extreme thirst
- C. Bradycardia
- D. Poor skin turgor
- E. Acidosis
- F. Hypoglycemia
Correct Answer: B,D
Rationale: HHNKS presents with extreme thirst and dehydration (poor skin turgor) due to severe hyperglycemia and fluid shifts. High blood pressure is unlikely (hypotension is more common), bradycardia is incorrect (tachycardia occurs), acidosis is not typical (unlike DKA), and hypoglycemia is not associated with HHNKS.
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 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.
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.
Which assessment finding is most important in determining nursing care for a client with diabetes mellitus?
- A. Respirations of 12 breaths/minute
- B. Cloudy urine
- C. Blood sugar 170 mg/dL
- D. Fruity breath
Correct Answer: D
Rationale: Fruity breath indicates rising ketones and potential diabetic ketoacidosis, a life-threatening condition requiring immediate intervention to prevent complications like acidosis or renal shutdown. A blood sugar of 170 mg/dL is elevated but less critical, cloudy urine may suggest a UTI, and normal respirations are not a priority.