Nokea
A nurse cares for a client who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 0700. At which time should the nurse assess the client for potential problems related to the NPH insulin?
- A. 800
- B. 1600
- C. 2000
- D. 2300
Correct Answer: B
Rationale: NPH insulin peaks 4"?12 hours after administration (0700), so 1600 is within the peak time for potential hypoglycemia. 0800 is too early, and 2000/2300 are too late.
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A nurse prepares to administer insulin to a client at 1800. The client's medication administration record contains the following information: Insulin glargine: 12 units daily at 1800, Regular insulin: 6 units QID at 0600, 1200, 1800, 2400. Based on the client's medication administration record, which action should the nurse take?
- A. Draw up and inject the insulin glargine first, and then draw up and inject the regular insulin.
- B. Draw up and inject the insulin glargine first, wait 20 minutes, and then draw up and inject the regular insulin.
- C. Draw up the dose of regular insulin, then draw up the dose of insulin glargine in the same syringe, mix, and inject the two insulins together.
- D. Inject first the glargine and then the regular insulin right afterward.
Correct Answer: A
Rationale: Insulin glargine cannot be mixed with other insulins. Administering glargine first, followed by regular insulin as separate injections, is correct to avoid mixing and ensure proper action.
When teaching a client recently diagnosed with type 1 diabetes mellitus, the client states, 'I will never be able to stick myself with a needle.' How should the nurse respond?
- A. I can give your injections to you while you are here in the hospital.
- B. Everyone gets used to giving themselves injections. It really does not hurt.
- C. Your disease will not be managed properly if you refuse to administer the shots.
- D. Tell me what it is about the injections that are concerning you.
Correct Answer: D
Rationale: Exploring the client's concerns about injections promotes understanding and tailored education, supporting self-care. Offering to give injections, minimizing concerns, or warning about poor management are less effective.
After teaching a client with type 2 diabetes mellitus, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
- A. I need to have an annual appointment even if my glucose levels are in good control.
- B. Since my diabetes is controlled with diet and exercise, I must be seen only if I am sick.
- C. I can still develop complications even though I do not have to take insulin at this time.
- D. If I have surgery or get very ill, I may have to receive insulin injections for a short time.
Correct Answer: B
Rationale: Clients with type 2 diabetes need annual checkups to monitor for complications, regardless of control method. The other statements are accurate regarding complication risks and potential insulin needs.
An emergency department nurse assesses a client with ketoacidosis. Which clinical manifestation should the nurse correlate with this condition?
- A. Increased rate and depth of respiration.
- B. Extremity tremors followed by seizure activity.
- C. Oral temperature of 102°F (38.9°C).
- D. Severe orthostatic hypotension.
Correct Answer: A
Rationale: Kussmaul respirations (rapid, deep breathing) are a hallmark of diabetic ketoacidosis as the body attempts to compensate for metabolic acidosis by eliminating carbon dioxide. Tremors, fever, or orthostatic hypotension are not primary manifestations.
A nurse assesses a client who is being treated for hyperglycemic-hyperosmolar state (HHS). Which clinical manifestation indicates to the nurse that the therapy needs to be adjusted?
- A. Serum potassium level has increased.
- B. Blood osmolarity has decreased.
- C. Glasgow Coma Scale score is unchanged.
- D. Urine remains negative for ketone bodies.
Correct Answer: C
Rationale: An unchanged Glasgow Coma Scale score indicates no improvement in consciousness, suggesting inadequate fluid replacement in HHS. Increased potassium, decreased osmolarity, and negative ketones are expected or not indicative of treatment failure.