The client with newly diagnosed type 1 diabetes mellitus is being taught about insulin administration by the nurse. Which statement indicates that the client needs further teaching?
- A. I will inject my insulin into my abdomen for the fastest absorption.
- B. I will rotate injection sites to prevent lipodystrophy.
- C. I will store my insulin in the refrigerator at all times.
- D. I will rotate injection sites to prevent lipodystrophy.
Correct Answer: C
Rationale: The correct answer is C. Insulin should not be stored in the refrigerator at all times; it should be kept at room temperature when in use to avoid irritation at the injection site. Storing insulin in the refrigerator can cause it to thicken and may lead to discomfort upon injection. Choices A and D are correct statements as injecting insulin into the abdomen for faster absorption and rotating injection sites to prevent lipodystrophy are appropriate insulin administration techniques. Therefore, the client does not need further teaching on these aspects.
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The healthcare provider is assessing a client who is receiving total parenteral nutrition (TPN). Which finding requires immediate intervention?
- A. Blood glucose level of 150 mg/dL.
- B. Weight gain of 2 pounds in 24 hours.
- C. Decreased urine output.
- D. Temperature of 100.3°F (37.9°C).
Correct Answer: C
Rationale: Decreased urine output in a client receiving total parenteral nutrition (TPN) requires immediate intervention because it can indicate potential complications such as fluid overload or kidney dysfunction. Monitoring urine output is crucial in assessing renal function and fluid balance in patients on TPN. A blood glucose level of 150 mg/dL is within a normal range and may not require immediate intervention. Weight gain of 2 pounds in 24 hours could be a concern but may not be as urgent as addressing decreased urine output. A temperature of 100.3°F (37.9°C) is slightly elevated but may not be directly related to TPN administration unless there are other symptoms of infection present.
The healthcare professional is developing a health education program for adolescents on the dangers of smoking. Which strategy is most likely to be effective?
- A. showing graphic images of the effects of smoking
- B. inviting former smokers to share their experiences
- C. providing statistical data on smoking-related illnesses
- D. distributing pamphlets on smoking cessation resources
Correct Answer: B
Rationale: Inviting former smokers to share their experiences is the most effective strategy because personal stories can have a powerful impact on adolescents and motivate them to avoid smoking. This approach makes the consequences of smoking more relatable and real, potentially influencing behavior change. Showing graphic images may be too harsh and could lead to desensitization or avoidance of the issue. Providing statistical data may not resonate as strongly with adolescents as personal stories. Distributing pamphlets, while informative, may not have the same emotional impact as hearing real-life experiences.
The healthcare provider is assessing a client who has returned from hemodialysis. Which finding requires immediate intervention?
- A. Weight gain of 1 pound.
- B. Dizziness.
- C. Fatigue.
- D. Muscle cramps.
Correct Answer: D
Rationale: After hemodialysis, muscle cramps can indicate an electrolyte imbalance, such as low potassium or magnesium levels, which requires immediate intervention to prevent potential complications like cardiac arrhythmias. Weight gain of 1 pound, dizziness, and fatigue are common post-hemodialysis symptoms that may not necessarily require immediate intervention unless they are severe or persisting.
In a community clinic where a recent case of tuberculosis (TB) has been diagnosed, which client who attended the clinic is at the highest risk for presenting with TB?
- A. a young adult who works as a daycare worker
- B. an adult who works in a corporate office
- C. an adolescent who attends the community high school
- D. an adult with a history of alcoholism and homelessness
Correct Answer: D
Rationale: Individuals who are homeless and have a history of alcoholism are at the highest risk for presenting with TB in this scenario. Homeless individuals often live in crowded conditions with poor ventilation, increasing the likelihood of TB transmission. Additionally, alcoholism can weaken the immune system, making individuals more susceptible to developing TB. The other options, such as a daycare worker, an office worker, or a high school student, do not inherently carry the same level of risk factors for TB transmission as being homeless with a history of alcoholism.
A community health nurse is addressing the issue of domestic violence in the community. Which intervention should the nurse implement first?
- A. establishing a support group for survivors of domestic violence
- B. developing educational materials on recognizing signs of abuse
- C. partnering with local law enforcement to increase awareness
- D. conducting a community needs assessment to identify resources
Correct Answer: D
Rationale: Conducting a community needs assessment is the most appropriate initial intervention when addressing domestic violence in the community. This step helps the nurse identify existing resources, gaps, and specific needs of the community related to domestic violence. By understanding the community's needs through a needs assessment, the nurse can tailor subsequent interventions effectively. Option A, establishing a support group, may be beneficial later but should not be the first step. Developing educational materials (Option B) and partnering with law enforcement (Option C) are important strategies; however, without understanding the community's specific needs through a needs assessment, the interventions may not be as targeted or effective.
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