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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 B

Explanation

Choice A rationale

Obesity is not a direct cause of renal calculi. However, it can be a risk factor due to associated conditions such as metabolic syndrome, diabetes, and hypertension, which can contribute to stone formation. Weight management and a healthy lifestyle can help reduce the risk of kidney stones.

Choice B rationale

Dehydration is a significant risk factor for the formation of renal calculi. When the body is dehydrated, the urine becomes concentrated, leading to the crystallization of minerals and the formation of stones. Adequate hydration is essential in preventing kidney stones by diluting the urine and reducing the concentration of stone-forming substances.

Choice C rationale

Iron deficiency is not associated with the formation of renal calculi. Iron deficiency primarily affects red blood cell production and can lead to anemia. It does not contribute to the crystallization of minerals in the urine or the formation of kidney stones.

Choice D rationale

Protein in the urine, or proteinuria, is not a direct cause of renal calculi. Proteinuria is often a sign of kidney damage or disease but does not lead to stone formation. The presence of protein in the urine should be evaluated to determine the underlying cause and appropriate treatment.

Correct Answer is D

Explanation

Choice A rationale

Sweating is incorrect. While sweating can be a symptom of hypoglycemia, it is not a specific indicator of effective diabetes management.

Choice B rationale

Tachycardia is incorrect. Tachycardia can occur during hypoglycemia due to the body’s release of adrenaline, but it is not a specific indicator of effective diabetes management.

Choice C rationale

Polydipsia is incorrect. Polydipsia, or excessive thirst, is a symptom of hyperglycemia, indicating poor blood sugar control.

Choice D rationale

Polyuria is correct. Polyuria, or frequent urination, is a symptom of hyperglycemia. Effective diabetes management aims to reduce hyperglycemia and its symptoms.

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