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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.
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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.
A nurse cares for a client who has a family history of diabetes mellitus. The client states, 'My father has type 1 diabetes mellitus. Will I develop this disease as well?' How should the nurse respond?
- A. Your risk of diabetes is higher than the general population, but it may not occur.
- B. No genetic risk is associated with the development of type 1 diabetes mellitus.
- C. The risk for becoming diabetic is 50% because of how it is inherited.
- D. Female children do not inherit diabetes mellitus, but male children will.
Correct Answer: A
Rationale: Risk for type 1 diabetes is influenced by inheritance of genes coding for HLA-DR and HLA-DQ tissue types. Having a parent with type 1 diabetes increases the risk, but environmental factors also play a role, so not everyone with these genes develops diabetes. The other statements are inaccurate.
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.
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.
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.