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 C
Explanation
Choice A rationale
Kernig’s sign is associated with meningitis, not hypocalcemia. It involves pain and resistance when attempting to extend the leg at the knee while the hip is flexed.
Choice B rationale
Brudzinski’s sign is also associated with meningitis, not hypocalcemia. It involves involuntary lifting of the legs when lifting a patient’s head.
Choice C rationale
Chvostek’s sign is a clinical sign of hypocalcemia. It involves twitching of the facial muscles in response to tapping over the facial nerve.
Choice D rationale
Cullen’s sign is associated with acute pancreatitis and involves bruising around the umbilicus. It is not related to hypocalcemia. .
Correct Answer is C
Explanation
Choice A rationale
Diaphoresis is incorrect. Diaphoresis, or excessive sweating, is not a typical symptom of end- stage kidney disease.
Choice B rationale
Hypotension is incorrect. While hypotension can occur in end-stage kidney disease, it is not as common as other symptoms like edema.
Choice C rationale
Peripheral edema is correct. Peripheral edema is a common symptom of end-stage kidney disease due to the kidneys’ inability to remove excess fluid from the body.
Choice D rationale
Facial flushing is incorrect. Facial flushing is not a typical symptom of end-stage kidney disease. .