Nokea
A nurse teaches a client with diabetes mellitus who is experiencing numbness and reduced sensation. Which statement should the nurse include in this client's teaching to prevent injury?
- A. Examine your feet using a mirror every day.
- B. Rotate your insulin injection sites every week.
- C. Check your blood glucose level before each meal.
- D. Use a bath thermometer to test the water temperature.
Correct Answer: D
Rationale: Clients with reduced sensation are at risk for burns from hot bathwater. Using a thermometer to check water temperature prevents injury. Daily foot checks, site rotation, and glucose monitoring are important but do not directly prevent burns.
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A nurse assesses a client with diabetes mellitus and notes the client only responds to a sternal rub by moaning, has a capillary blood glucose of 33 mg/dL, and has an intravenous line that is infiltrated with 0.45% normal saline. Which action should the nurse take first?
- A. Administer 1 mg of intramuscular glucagon.
- B. Encourage the client to drink orange juice.
- C. Insert a new intravenous access line.
- D. Administer 25 mL dextrose 50% (D50) IV push.
Correct Answer: A
Rationale: The client's severe hypoglycemia (blood glucose 33 mg/dL) and unresponsiveness require immediate treatment. Intramuscular glucagon is the priority since the IV line is infiltrated, and oral intake is not feasible. Inserting a new IV or administering D50 IV can follow once access is restored.
A nurse cares for a client who has type 1 diabetes mellitus. The client asks, 'Is it okay for me to have an occasional glass of wine?' How should the nurse respond?
- A. Drinking any wine or alcohol will increase your insulin requirements.
- B. Because of poor kidney function, people with diabetes should avoid alcohol.
- C. You should not drink alcohol because it will make you hungry and overeat.
- D. One glass of wine is okay with a meal and is counted as two fat exchanges.
Correct Answer: D
Rationale: Moderate alcohol, like one glass of wine with a meal, is acceptable for well-controlled diabetes and is counted as two fat exchanges. Alcohol does not directly increase insulin needs, affect kidney function in this context, or necessarily cause overeating.
A nurse teaches a client who is diagnosed with diabetes mellitus. Which statement should the nurse include in this client's plan of care to delay the onset of microvascular and macrovascular complications?
- A. Maintain tight glycemic control and prevent hyperglycemia.
- B. Prevent hypoglycemia with insulin.
- C. Restrict your fluid intake to no more than 2 liters a day.
- D. Limit your intake of protein to prevent ketoacidosis.
Correct Answer: A
Rationale: Hyperglycemia is a critical factor in the pathogenesis of long-term diabetic complications. Maintaining tight glycemic control helps delay the onset of microvascular and macrovascular complications. Fluid restriction, preventing hypoglycemia, and limiting protein are not the primary strategies for this goal.
A nurse cares for a client who is diagnosed with acute rejection 2 months after receiving a simultaneous pancreas-kidney transplant. The client states, 'I was doing so well with my new organs, and the thought of having to go back to living on hemodialysis and taking insulin is so depressing.' How should the nurse respond?
- A. Following-Drug regimen more closely would have prevented this.
- B. One acute rejection episode does not mean that you will lose the new organs.
- C. Dialysis is a viable treatment option for you and may save your life.
- D. Since you are on the national registry, you can receive a second transplantation.
Correct Answer: B
Rationale: An acute rejection episode does not necessarily lead to organ loss, as immunosuppressive therapy can often manage it. Blaming the client, emphasizing dialysis, or discussing retransplantation is not supportive or accurate in this context.
A nurse teaches a client about self-monitoring of blood glucose levels. Which statement should the nurse include in this client's teaching to prevent bloodborne infections?
- A. Wash your hands after completing each test.
- B. Do not share your monitoring equipment.
- C. Wipe excess blood from the strip with a cotton ball.
- D. Use gloves when monitoring your blood glucose.
Correct Answer: B
Rationale: Sharing monitoring equipment can transmit bloodborne infections like hepatitis B, which can survive in dried blood. Not sharing equipment is critical. Washing hands before testing, not after, is recommended. Wiping blood with a cotton ball or using gloves is not standard practice for preventing infections.