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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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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Abduction is the correct position for the client’s right leg following a right total hip arthroplasty. This position helps prevent dislocation of the hip joint by keeping the leg away from the midline.

Choice B rationale

Internal rotation should be avoided as it can increase the risk of hip dislocation. This position places stress on the new hip joint.

Choice C rationale

External rotation is also not recommended as it can lead to dislocation of the hip joint. Proper alignment is crucial for healing.

Choice D rationale

Adduction, or moving the leg towards the midline, should be avoided as it significantly increases the risk of hip dislocation. Keeping the leg in abduction helps maintain joint stability.

Correct Answer is B

Explanation

Choice A rationale

Respiratory alkalosis is incorrect. Respiratory alkalosis is characterized by a high pH and low PaCO₂, which is not consistent with the given ABG values. The client’s pH is low (7.22), indicating acidosis, and the PaCO₂ is high (68 mm Hg), indicating a respiratory cause.

Choice B rationale

Respiratory acidosis is correct. Respiratory acidosis occurs when there is an accumulation of carbon dioxide (CO₂) in the blood, leading to a decrease in pH. The given ABG values show a low pH (7.22) and a high PaCO₂ (68 mm Hg), which are indicative of respiratory acidosis. The elevated bicarbonate (28 mEq/L) suggests partial compensation by the kidneys.

Choice C rationale


Metabolic acidosis is incorrect. Metabolic acidosis is characterized by a low pH and low bicarbonate (HCO₃⁻) levels. In this case, the bicarbonate level is elevated (28 mEq/L), which isnot consistent with metabolic acidosis. The primary issue is respiratory, as indicated by the high PaCO₂.

Choice D rationale

Metabolic alkalosis is incorrect. Metabolic alkalosis is characterized by a high pH and high bicarbonate levels. The given ABG values show a low pH (7.22), which indicates acidosis, not alkalosis. Additionally, the primary issue is respiratory, as indicated by the high PaCO₂.

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