Nokea
The nurse is teaching an older client how to self-administer insulin. Which of the following would be most helpful to the client who is having difficulty drawing up the correct dosage of insulin in the syringe?
- A. Syringe magnifier
- B. Insulin pen
- C. Jet injector
- D. Insulin pump
Correct Answer: A
Rationale: A syringe magnifier is a cost-effective and simple tool to help older clients with visual or dexterity issues accurately draw insulin doses. Insulin pens require precise dialing, which may be challenging, and jet injectors and insulin pumps are more complex and costly, potentially unsuitable for older clients.
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A client with type 2 diabetes is informed of being unable to have a pancreatic transplant and asks the nurse why this is. Which reason would the nurse provide to the client?
- A. Increased risk for urologic complications
- B. Need for exocrine enzymatic drainage
- C. Underlying problem of insulin resistance
- D. Need for lifelong immunosuppressive therapy
Correct Answer: C
Rationale: Clients with type 2 diabetes have insulin resistance, which a pancreas transplant does not address, as the issue lies in tissue response rather than insulin production. Urologic complications and exocrine drainage are not primary reasons, and while immunosuppressive therapy is required, it is not specific to type 2 diabetes.
The client asks the nurse if dipstick of urine can be used for monitoring glucose levels. Which is the best response by the nurse?
- A. Yes, it is a cheaper method of monitoring glucose and ketones in the urine.
- B. This test can detect ketones but not glucose levels.
- C. The most accurate way to monitor glucose levels is by blood testing.
- D. Dipstick of urine will only indicate lower levels of glucose and ketones.
Correct Answer: C
Rationale: Blood testing via glucometer is the most accurate method for monitoring glucose levels, as urine dipsticks only detect glucose above the renal threshold, which is less precise. Urine dipsticks can detect both glucose and ketones but are not the preferred method for ongoing management.
A controlled type 2 diabetic client states, 'The doctor said if my blood sugars remain stable, I may not need to take any medication.' Which response by the nurse is most appropriate?
- A. Diet, exercise, and weight loss can eliminate the need for medication.
- B. You will be placed on a strict low-sugar diet for better control.
- C. Some doctors do not treat blood sugar elevation until symptoms appear.
- D. You misunderstood the doctor. Let's ask for clarification.
Correct Answer: A
Rationale: Lifestyle interventions like diet, exercise, and weight loss can effectively manage type 2 diabetes, potentially reducing or eliminating the need for medication. A strict low-sugar diet is not typically recommended, and waiting for symptoms or assuming misunderstanding is less appropriate.
On initial nursing rounds, the diabetic client reports 'not feeling well.' Later, the nurse finds the client to be diaphoretic and in a stuporous state. Which is the immediate action taken by the nurse?
- A. Call the physician.
- B. Obtain a glucometer reading.
- C. Administer fruit juice.
- D. Start an IV of dextrose.
Correct Answer: B
Rationale: A glucometer reading is critical to differentiate between hypoglycemia and diabetic ketoacidosis in a stuporous diabetic client. Administering juice or IV dextrose without confirming hypoglycemia risks worsening hyperglycemia, and calling the physician is secondary to obtaining a glucose level.
Which is the best nursing explanation for the symptom of polyuria in a client with diabetes mellitus?
- A. With diabetes, drinking more results in more urine production.
- B. Increased ketones in the urine promote the manufacturing of more urine.
- C. High sugar pulls fluid into the bloodstream, which results in more urine production.
- D. The body's requirement for fuel drives the production of urine.
Correct Answer: C
Rationale: High blood glucose levels increase blood osmolality, pulling fluid into the vascular system, which leads to increased urine production (polyuria) as the kidneys attempt to excrete excess glucose. This triggers thirst (polydipsia), not vice versa. Ketones and fuel requirements do not directly cause polyuria.