Nokea
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.
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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 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 assesses a client who has a 15-year history of diabetes and notes decreased tactile sensation in both feet. Which action should the nurse take first?
- A. Document the finding in the client's chart.
- B. Assess tactile sensation in the client's hands.
- C. Examine the client's feet for signs of injury.
- D. Notify the health care provider.
Correct Answer: C
Rationale: Diabetic neuropathy is common in long-standing diabetes, increasing the risk of injury in areas with decreased sensation, such as the feet. Examining the feet for signs of injury is the priority to prevent complications like infections or ulcers. Documentation, assessing hand sensation, and notifying the provider should follow after the initial assessment.
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.
A nurse assesses a client who has diabetes mellitus and notes the client is awake and alert, but shaky, diaphoretic, and weak. Five minutes after administering a half-cup of orange juice, the client's clinical manifestations have not changed. Which action should the nurse take next?
- A. Administer another half-cup of orange juice.
- B. Administer a half-ampule of dextrose 50%.
- C. Administer 10 units of regular insulin subcutaneously.
- D. Administer 1 mg of glucagon intramuscularly.
Correct Answer: A
Rationale: The client has mild hypoglycemia, and since the initial orange juice did not resolve symptoms, repeating the oral glucose treatment is appropriate. Intravenous dextrose, insulin, or glucagon are not indicated for mild, unresolved symptoms in an alert client.