Nokea
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.
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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.
A client with type 2 diabetes who is physically active reports recurrent symptoms of weakness and nervousness. Which is the best response from the nurse?
- A. These symptoms are related to added stress.
- B. Maybe you should eat simple carbohydrates.
- C. Sounds like high blood sugar symptoms.
- D. Exercise and activity can lower glucose levels.
Correct Answer: D
Rationale: Weakness and nervousness suggest hypoglycemia, which can be triggered by exercise lowering blood glucose levels. These are not typical of hyperglycemia, stress alone, or a need for simple carbohydrates, which could exacerbate glucose fluctuations.
The nurse is providing information about foot care to a client with diabetes. Which instruction would the nurse include?
- A. Wash your feet in hot water every day.
- B. Use a razor to remove corns or calluses.
- C. Be sure to apply a moisturizer to feet daily.
- D. Wear well-fitting comfortable rubber shoes.
Correct Answer: C
Rationale: The nurse should advise the client to apply a moisturizer to the feet daily to prevent dryness and cracking, which can lead to infections. Using warm, not hot, water is recommended to avoid burns due to potential reduced sensation. Razors should be avoided to prevent injury and infection. Well-fitting shoes are important, but rubber shoes can cause perspiration and increase infection risk.
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.
The nurse is caring for a client receiving insulin isophane suspension (NPH) at breakfast. What is an important dietary consideration for the nurse to keep in mind?
- A. Make sure breakfast is not delayed.
- B. Provide fewer amounts of carbohydrates at lunch meal.
- C. Encourage midday snack.
- D. Delay dinner meal.
Correct Answer: C
Rationale: NPH insulin peaks 4-10 hours after administration, risking hypoglycemia mid-morning to early afternoon. A midday snack helps maintain stable glucose levels. Breakfast timing, reduced lunch carbohydrates, or delayed dinner are not directly related to NPH's action.