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When teaching a client recently diagnosed with type 1 diabetes mellitus, the client states, 'I will never be able to stick myself with a needle.' How should the nurse respond?
- A. I can give your injections to you while you are here in the hospital.
- B. Everyone gets used to giving themselves injections. It really does not hurt.
- C. Your disease will not be managed properly if you refuse to administer the shots.
- D. Tell me what it is about the injections that are concerning you.
Correct Answer: D
Rationale: Exploring the client's concerns about injections promotes understanding and tailored education, supporting self-care. Offering to give injections, minimizing concerns, or warning about poor management are less effective.
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A preoperative nurse assesses a client who has type 1 diabetes mellitus prior to a surgical procedure. The client's blood glucose level is 160 mg/dL. Which action should the nurse take?
- A. Document the finding in the client's chart.
- B. Administer a bolus of regular insulin IV.
- C. Call the surgeon to cancel the procedure.
- D. Draw blood gases to assess the metabolic state.
Correct Answer: A
Rationale: A blood glucose of 160 mg/dL is within the acceptable range (140"?180 mg/dL) for perioperative management in type 1 diabetes, supporting better outcomes. The nurse should document the finding and proceed. Insulin, cancellation, or blood gases are not indicated.
A nurse cares for a client who has diabetes mellitus. The nurse administers 6 units of regular insulin and 10 units of NPH insulin at 0700. At which time should the nurse assess the client for potential problems related to the NPH insulin?
- A. 800
- B. 1600
- C. 2000
- D. 2300
Correct Answer: B
Rationale: NPH insulin peaks 4"?12 hours after administration (0700), so 1600 is within the peak time for potential hypoglycemia. 0800 is too early, and 2000/2300 are too late.
After teaching a client who is newly diagnosed with type 2 diabetes mellitus, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
- A. I should increase my intake of vegetables with higher amounts of dietary fiber.
- B. My intake of saturated fats should be no more than 10% of my total calories.
- C. I should decrease my intake of protein and eliminate carbohydrates from my diet.
- D. My intake of water is not restricted by my treatment plan or medication regimen.
Correct Answer: C
Rationale: Eliminating carbohydrates is incorrect; complex carbohydrates should be included in a diabetic diet. Protein reduction may be needed with microalbuminuria, but not elimination. The other statements are correct.
A nurse cares for a client with diabetes mellitus who asks, 'Why do I need to administer more than one injection of insulin each day?' How should the nurse respond?
- A. You need to start with multiple injections until you become more proficient at self-injection.
- B. A single dose of insulin each day would not match your blood insulin levels and your food intake patterns.
- C. A regimen of a single dose of insulin injected each day would require that you eat fewer carbohydrates.
- D. A single dose of insulin would be too large to be absorbed, putting you at risk for insulin shock.
Correct Answer: B
Rationale: Multiple insulin injections are needed to match insulin levels with food intake and activity patterns, preventing wide blood glucose fluctuations. Proficiency in injection, carbohydrate restriction, or absorption issues are not the primary reasons for multiple doses.
A nurse cares for a client who is prescribed pioglitazone (Actos). After 6 months of therapy, the client reports that his urine has become darker since starting the medication. Which action should the nurse take?
- A. Assess for pain or burning with urination.
- B. Review the client's liver function study results.
- C. Instruct the client to increase water intake.
- D. Test a sample of urine for occult blood.
Correct Answer: B
Rationale: Thiazolidinediones like pioglitazone can affect liver function. Dark urine may indicate liver impairment due to increased bilirubin. Reviewing liver function studies is the priority. Assessing for urinary symptoms, increasing water intake, or testing for occult blood are not directly related to this issue.