Nokea
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.
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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.
After teaching a young adult client who is newly diagnosed with type 1 diabetes mellitus, the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the need for eye examinations?
- A. At my age, I should continue seeing the ophthalmologist as I usually do.
- B. I will see the eye doctor when I have a vision problem and yearly after age 40.
- C. My vision will change quickly, I should see the ophthalmologist twice a year.
- D. Diabetes can cause blindness, so I should see the ophthalmologist yearly.
Correct Answer: D
Rationale: Diabetic retinopathy is a leading cause of blindness in North America. All clients with diabetes, regardless of age, should be examined by an ophthalmologist at diagnosis and at least yearly thereafter to monitor for retinopathy.
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.
A nurse assesses a client with diabetes mellitus 3 hours after a surgical procedure and notes the client's breath has a fruity odor. Which action should the nurse take?
- A. Encourage the client to use an incentive spirometer.
- B. Increase the client's intravenous fluid flow rate.
- C. Consult the provider to test for ketoacidosis.
- D. Perform meticulous pulmonary hygiene care.
Correct Answer: C
Rationale: A fruity breath odor is a sign of ketoacidosis, common post-surgery due to stress-induced insulin suppression. Consulting the provider to test for ketoacidosis is the priority. Spirometry, increasing fluids, or pulmonary hygiene do not address this issue.
A nurse reviews laboratory results for a client with diabetes mellitus who presents with polyuria, lethargy, and a blood glucose of 500 mg/dL. Which laboratory result should the nurse correlate with the client's polyuria?
- A. Serum sodium: 116 mg/dL.
- B. Serum creatinine: 1.6 mg/dL.
- C. Presence of urine ketone bodies.
- D. Serum osmolarity: 375 mOsm/kg.
Correct Answer: D
Rationale: Hyperglycemia causes hyperosmolarity of extracellular fluid, leading to polyuria from osmotic diuresis. The client's serum osmolarity is high, which correlates with polyuria. Serum sodium would be expected to be high due to dehydration, not low. Serum creatinine and urine ketone bodies are not directly related to polyuria in this context.