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A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus. Which of the following statements from the client indicates to the nurse the teaching is effective?

A.

“I will freeze unopened insulin vials.”.

B.

“I should increase my insulin when I exercise.”.

C.

“I should inject the insulin into my abdominal area.”.

D.

“I will shake the insulin vial vigorously to mix.”.

Answer and Explanation

The Correct Answer is C

Choice A rationale

 

Freezing unopened insulin vials is incorrect. Insulin should be stored in the refrigerator at a temperature between 36°F and 46°F (2°C and 8°C) until it is opened. Freezing insulin can cause it to lose its potency and effectiveness. Once opened, insulin vials can be kept at room temperature for up to 28 days, but they should never be frozen.

 

Choice B rationale

 

Increasing insulin when exercising is incorrect. Exercise generally lowers blood glucose levels, so clients with type 1 diabetes may need to decrease their insulin dose or consume additional carbohydrates to prevent hypoglycemia during and after physical activity. It is important for clients to monitor their blood glucose levels closely and adjust their insulin and carbohydrate intake accordingly.

 

Choice C rationale

 

Injecting insulin into the abdominal area is correct. The abdominal area is one of the recommended sites for insulin injection because it has a large surface area and provides consistent absorption. Other recommended sites include the upper outer arms, thighs, and buttocks. Rotating injection sites within the same area helps prevent lipodystrophy and ensures better insulin absorption.

 

Choice D rationale

 

Shaking the insulin vial vigorously to mix is incorrect. Insulin vials should be gently rolled between the hands to mix the contents. Shaking the vial vigorously can cause air bubbles to form, which can lead to inaccurate dosing. Proper mixing ensures that the insulin is evenly distributed and effective.


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Correct Answer is C

Explanation

Choice A rationale

A high-purine diet can lead to the formation of uric acid stones, which are a type of kidney stone. However, it is not the most common risk factor for urolithiasis. Urolithiasis is more commonly associated with factors such as dehydration, which leads to concentrated urine and promotes stone formation.

Choice B rationale

Female gender is not a significant risk factor for urolithiasis. In fact, men are more likely to develop kidney stones than women. The higher incidence in men is thought to be related to differences in diet, fluid intake, and urinary tract anatomy.

Choice C rationale

Dehydration is a major risk factor for urolithiasis. When the body is dehydrated, urine becomes more concentrated, which increases the likelihood of stone formation. Adequate hydration helps to dilute the urine and reduce the risk of stone formation.

Choice D rationale

Family history is a known risk factor for urolithiasis. Individuals with a family history of kidney stones are more likely to develop them due to genetic predispositions that affect factors such as urine composition and kidney function.

Correct Answer is D

Explanation

Choice A rationale

Providing a low protein diet is incorrect. Clients with COPD often require a high-protein diet to maintain muscle mass and support respiratory function. Protein is essential for the repair and maintenance of body tissues, including respiratory muscles. A low-protein diet could lead to muscle wasting and decreased respiratory function.

Choice B rationale

Instructing the client to cough every 4 hours is incorrect. Clients with COPD should be encouraged to perform controlled coughing techniques more frequently to clear secretions and prevent respiratory infections. Coughing every 4 hours may not be sufficient to maintain airway patency and prevent complications.

Choice C rationale

Advising the client to lie down after eating is incorrect. Clients with COPD should avoid lying down immediately after eating to prevent gastroesophageal reflux, which can exacerbate respiratory symptoms. Instead, they should remain upright for at least 30 minutes after meals to aid digestion and reduce the risk of aspiration.

Choice D rationale

Encouraging the client to drink 8 glasses of water a day is correct. Adequate hydration helps to thin mucus secretions, making them easier to expectorate. This can improve airway clearance and reduce the risk of respiratory infections. Additionally, staying hydrated supports overall health and well-being.

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