Nokea
A nurse cares for a client who is prescribed pioglitazone (Actos). After 6 months of therapy, the client reports that his urine has become darker since starting the medication. Which action should the nurse take?
- A. Assess for pain or burning with urination.
- B. Review the client's liver function study results.
- C. Instruct the client to increase water intake.
- D. Test a sample of urine for occult blood.
Correct Answer: B
Rationale: Thiazolidinediones like pioglitazone can affect liver function. Dark urine may indicate liver impairment due to increased bilirubin. Reviewing liver function studies is the priority. Assessing for urinary symptoms, increasing water intake, or testing for occult blood are not directly related to this issue.
You may also like to solve these questions
After teaching a client who has diabetes mellitus and proliferative retinopathy, nephropathy, and peripheral neuropathy, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I have so many complications, exercising is not recommended.
- B. I will exercise more frequently because I have so many complications.
- C. I used to run for exercise; I will start training for a marathon.
- D. I should look into swimming or water aerobics to get my exercise.
Correct Answer: D
Rationale: Swimming or water aerobics is a suitable exercise for clients with diabetic complications, as it minimizes foot injury risk. Vigorous exercise like marathon running or avoiding exercise altogether is not recommended.
A nurse teaches a client who is prescribed an insulin pump. Which statement should the nurse include in this client's discharge education?
- A. Test your urine daily for ketones.
- B. Use only buffered insulin in your pump.
- C. Store the insulin in the freezer until you need it.
- D. Change the needle every 3 days.
Correct Answer: D
Rationale: Changing the needle every 3 days reduces infection risk with insulin pumps. Testing urine for ketones, using buffered insulin, or freezing insulin are not recommended practices.
A nurse cares for a client with diabetes mellitus who asks, 'Why do I need to administer more than one injection of insulin each day?' How should the nurse respond?
- A. You need to start with multiple injections until you become more proficient at self-injection.
- B. A single dose of insulin each day would not match your blood insulin levels and your food intake patterns.
- C. A regimen of a single dose of insulin injected each day would require that you eat fewer carbohydrates.
- D. A single dose of insulin would be too large to be absorbed, putting you at risk for insulin shock.
Correct Answer: B
Rationale: Multiple insulin injections are needed to match insulin levels with food intake and activity patterns, preventing wide blood glucose fluctuations. Proficiency in injection, carbohydrate restriction, or absorption issues are not the primary reasons for multiple doses.
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.
A nurse assesses a client with diabetes mellitus who self-administers subcutaneous insulin. The nurse notes a spongy, swelling area at the site the client uses most frequently for insulin injection. Which action should the nurse take?
- A. Apply ice to the site to reduce inflammation.
- B. Consult the provider for a new administration route.
- C. Assess the client for other signs of cellulitis.
- D. Instruct the client to rotate sites for insulin injection.
Correct Answer: D
Rationale: The spongy, swollen area suggests lipohypertrophy from repeated injections at the same site. Rotating injection sites prevents this complication. Ice, a new route, or assessing for cellulitis are not appropriate for lipohypertrophy.