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A diabetic client who is controlled with insulin complains to the nurse about weight gain. Which response from the nurse explains the most likely cause of the weight increase?
- A. Insulin is an anabolic hormone.
- B. Insulin provides more efficient use of glucose.
- C. Faulty fat metabolism is shut off.
- D. Weight gain is attributed to fluid retention.
Correct Answer: A
Rationale: Insulin, an anabolic hormone, promotes glucose storage as glycogen and fat, contributing to weight gain. While it improves glucose utilization and corrects faulty metabolism, these are secondary to its anabolic effects. Fluid retention is not typically associated with insulin therapy.
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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.
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 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.
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.
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.