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?
“I will freeze unopened insulin vials.”.
“I should increase my insulin when I exercise.”.
“I should inject the insulin into my abdominal area.”.
“I will shake the insulin vial vigorously to mix.”.
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 A
Explanation
Choice A rationale
Rifampin can cause discoloration of body fluids, including tears, which can stain contact lenses. Therefore, it is recommended to wear glasses instead of contacts while taking this medication.
Choice B rationale
A yellow tint to the skin is not an expected reaction to rifampin. This could indicate jaundice, a sign of liver dysfunction, which requires immediate medical attention.
Choice C rationale
Lifelong treatment with rifampin is not necessary. The typical duration of treatment for active tuberculosis is 6 to 9 months.
Choice D rationale
Rifampin does not cause amenorrhea when taken with oral contraceptives. However, it can reduce the effectiveness of oral contraceptives, so additional contraceptive methods should be used.
Correct Answer is B
Explanation
Choice A rationale
Urine specific gravity of 1.020 is within the normal range (1.005 to 1.030). This indicates that the urine concentration is normal and does not suggest any abnormality that needs to be reported.
Choice B rationale
Microscopic hematuria refers to the presence of red blood cells in the urine, which is not visible to the naked eye. This finding can indicate a urinary tract infection, kidney stones, or other renal pathology and should be reported to the provider for further evaluation.
Choice C rationale
Amber yellow urine color is considered normal and does not indicate any pathology. The color of urine can vary depending on hydration status and does not necessarily indicate a problem.
Choice D rationale
The absence of glucose in the urine is a normal finding. The presence of glucose in the urine would indicate glycosuria, which is often associated with diabetes mellitus.