Nokea
The nurse is teaching patients about self-injection of insulin. Which statement is true regarding injection sites?
- A. Avoid the abdomen because absorption there is irregular.
- B. Choose a different site at random for each injection.
- C. Give the injection in the same area each time.
- D. Rotate sites within the same location for about 1 week before rotating to a new location.
Correct Answer: D
Rationale: Rotating insulin injection sites within the same location (e.g., abdomen) for about 1 week ensures consistent absorption while preventing tissue damage. Random rotation or avoiding the abdomen is incorrect.
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The nurse is teaching a group of patients about self-administration of insulin. What content is important to include?
- A. Patients need to use the injection site that is the most accessible.
- B. If two different insulins are ordered, they need to be given in separate injections.
- C. When mixing insulins, the cloudy (such as NPH) insulin is drawn up into the syringe first.
- D. When mixing insulins, the clear (such as regular) insulin is drawn up into the syringe first.
Correct Answer: D
Rationale: When mixing insulins, clear (regular) insulin is drawn up first to prevent contamination with cloudy (NPH) insulin. Rotation of injection sites is necessary, and compatible insulins can be mixed in one syringe.
A patient has been diagnosed with metabolic syndrome and is started on the biguanide metformin. The nurse knows that the purpose of the metformin, in this situation, is which of these?
- A. To increase the pancreatic secretion of insulin
- B. To decrease insulin resistance
- C. To increase blood glucose levels
- D. To decrease the pancreatic secretion of insulin
Correct Answer: B
Rationale: Metformin reduces insulin resistance by decreasing hepatic glucose production and improving insulin sensitivity in tissues, beneficial for metabolic syndrome.
The nurse is teaching a review class to nurses about diabetes mellitus. Which statement by the nurse is correct?
- A. Patients with type 2 diabetes will never need insulin.
- B. Oral antidiabetic drugs are safe for use during pregnancy.
- C. Pediatric patients cannot take insulin.
- D. Insulin therapy is possible during pregnancy if managed carefully.
Correct Answer: D
Rationale: Insulin is the preferred therapy for diabetes in pregnancy due to safety concerns with oral antidiabetic drugs. Type 2 patients may need insulin, and pediatric patients can use insulin.
The nurse is reviewing a patient's medication list and notes that sitagliptin (Januvia) is ordered. The nurse will question an additional order for which drug or drug class?
- A. Glitazone
- B. Insulin
- C. Metformin
- D. Sulfonylurea
Correct Answer: B
Rationale: Sitagliptin, a DPP-4 inhibitor, is not typically combined with insulin due to lack of established safety and efficacy. It can be used with metformin, sulfonylureas, or glitazones.
When monitoring a patient's response to oral antidiabetic drugs, the nurse knows that which laboratory result would indicate a therapeutic response?
- A. Random blood glucose level 180 mg/dL
- B. Blood glucose level of 50 mg/dL after meals
- C. Fasting blood glucose level of 92 mg/dL
- D. Evening blood glucose level below 80 mg/dL
Correct Answer: C
Rationale: A fasting blood glucose level of 80â??130 mg/dL, as per ADA guidelines, indicates a therapeutic response to oral antidiabetic drugs. Other options reflect hyperglycemia or hypoglycemia.