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The nurse is providing information about foot care to a client with diabetes. Which instruction would the nurse include?
- A. Wash your feet in hot water every day.
- B. Use a razor to remove corns or calluses.
- C. Be sure to apply a moisturizer to feet daily.
- D. Wear well-fitting comfortable rubber shoes.
Correct Answer: C
Rationale: The nurse should advise the client to apply a moisturizer to the feet daily to prevent dryness and cracking, which can lead to infections. Using warm, not hot, water is recommended to avoid burns due to potential reduced sensation. Razors should be avoided to prevent injury and infection. Well-fitting shoes are important, but rubber shoes can cause perspiration and increase infection risk.
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A client asks why pancreas transplantation is not an option offered to all insulin-dependent clients with diabetes. Which is the best response by the nurse?
- A. Type 1 diabetes can be managed in most clients with insulin.
- B. Pancreas transplant is becoming more common.
- C. There is a long waiting list to receive a new pancreas.
- D. For every transplant, two deceased donors are needed.
Correct Answer: A
Rationale: Type 1 diabetes is manageable with insulin, and the risks of lifelong immunosuppression from transplantation often outweigh benefits. Pancreas transplants are not increasingly common, waiting lists are not the primary issue, and only one donor is needed.
A client newly diagnosed with type 1 diabetes asks the nurse why injection site rotation is important. What is the nurse's best response?
- A. Avoid infection.
- B. Promote absorption.
- C. Minimize discomfort.
- D. Prevent muscle destruction.
Correct Answer: B
Rationale: Rotating injection sites prevents lipodystrophy (fat buildup or breakdown), ensuring consistent insulin absorption. While infection and discomfort are concerns, they are not the primary reasons. Insulin is not injected into muscle, so muscle destruction is irrelevant.
The nurse is explaining glycosylated hemoglobin testing to a diabetic client. Which of the following provides the best reason for this order?
- A. Provides best information on the body's ability to maintain normal blood functioning
- B. Best indicator for the nutritional state of the client.
- C. Is less costly than performing daily blood sugar test
- D. Reflects the amount of glucose stored in hemoglobin over past several months
Correct Answer: D
Rationale: Glycosylated hemoglobin (HbA1c) measures glucose bound to hemoglobin over its 120-day lifespan, reflecting long-term glucose control. It does not assess overall blood functioning, nutritional status, or cost relative to daily testing, which is still necessary for insulin-dependent clients.
A client with diabetes is receiving an oral antidiabetic agent that acts to help the tissues use available insulin more efficiently. Which of the following agents would the nurse expect to administer?
- A. Metformin
- B. Glyburide
- C. Repaglinide
- D. Glipizide
Correct Answer: A
Rationale: Metformin, a biguanide, enhances insulin sensitivity in tissues, improving glucose uptake. Glyburide, glipizide (sulfonylureas), and repaglinide (meglitinide) stimulate insulin release from the pancreas, not tissue sensitivity.
The nurse is preparing a presentation for a group of adults at a local community center about diabetes. Which characteristic would the nurse inform the group is associated with type 2 diabetes?
- A. Onset most common during adolescence
- B. Insulin resistance or insufficient insulin production
- C. Absence of insulin production by beta cells in the islets of Langerhans
- D. Little relation to prediabetes
Correct Answer: B
Rationale: Type 2 diabetes is characterized by insulin resistance or inadequate insulin production, typically seen in adults, not adolescents. Absence of insulin production is specific to type 1 diabetes, and prediabetes is a precursor to type 2 diabetes.