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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 A

Explanation

Choice A rationale

Regular insulin is correct because it is a short-acting insulin that can be used to treat diabetic ketoacidosis (DKA). The client’s symptoms of confusion, flushed appearance, and acetone odor on the breath suggest DKA, which requires prompt treatment with insulin to lower blood glucose levels and correct metabolic acidosis. Regular insulin has a rapid onset of action and can be administered intravenously to achieve quick results.

Choice B rationale

NPH insulin is incorrect because it is an intermediate-acting insulin that is not suitable for the immediate treatment of DKA. NPH insulin has a slower onset of action and is typically used for basal insulin coverage rather than for acute management of hyperglycemia. In cases of DKA, rapid-acting or short-acting insulin is preferred to achieve quick glucose control.

Choice C rationale

Glargine insulin is incorrect because it is a long-acting insulin that provides basal insulin coverage over 24 hours. It is not suitable for the immediate treatment of DKA, as it does not have a rapid onset of action. Glargine insulin is typically used for maintaining stable blood glucose levels over a prolonged period rather than for acute management of hyperglycemia.

Choice D rationale

Detemir insulin is incorrect because it is a long-acting insulin similar to glargine. It provides basal insulin coverage and is not suitable for the immediate treatment of DKA. Detemir insulin has a slower onset of action and is used for maintaining stable blood glucose levels rather than for rapid correction of hyperglycemia in acute situations.

Correct Answer is C

Explanation

Choice A rationale

Avoiding bubble baths is a correct measure for preventing UTIs. Bubble baths can irritate the urethra and increase the risk of infection by allowing bacteria to enter the urinary tract. The warm, soapy water can disrupt the natural balance of bacteria in the genital area, making it easier for harmful bacteria to thrive and cause infections.

Choice B rationale

Voiding after sexual intercourse is a correct measure for preventing UTIs. During sexual activity, bacteria can be introduced into the urethra. By urinating after intercourse, the client can help flush out any bacteria that may have entered the urinary tract, reducing the risk of infection.

Choice C rationale

Wiping the perineal area from back to front after urination is incorrect and indicates the need for further teaching. This practice can transfer bacteria from the anal area to the urethra, increasing the risk of UTIs. The correct method is to wipe from front to back to prevent the spread of bacteria.

Choice D rationale

Drinking at least 8 full glasses of liquid each day is a correct measure for preventing UTIs. Adequate hydration helps flush bacteria from the urinary tract, reducing the risk of infection. Drinking plenty of fluids ensures that the bladder is emptied regularly, which helps prevent the buildup of bacteria.t

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