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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.
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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.
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 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.
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.
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.