A medical nurse is caring for a patient with type 1 diabetes. The patient's medication administration record includes the administration of regular insulin three times daily. Knowing that the patient's dinner tray will arrive at 1645, when should the nurse administer the patient's insulin to ensure the onset of the insulin coincides with the start of the meal?

1645

1615

1545

1600

Answer and Explanation

The Correct Answer is B

A. Regular insulin typically begins to take effect 30 minutes after administration. Administering insulin at the time of the meal (1645) would not allow enough time for the insulin to reach its onset of action, potentially resulting in the blood glucose level being high during the meal.

B. Regular insulin has an onset of action of 30 minutes. By administering the insulin at 1615, it will start to take effect by 1645, when the meal arrives, and help ensure the insulin action aligns with the meal, preventing postprandial hyperglycemia.

C. Administering insulin at 1545 would be too early and could lead to the insulin peaking before the meal, which could result in hypoglycemia if the insulin peak occurs before the patient has food to absorb the glucose.

D. Administering insulin at 1600 would result in the insulin starting to work too soon, with the onset happening before the meal and possibly leading to hypoglycemia if the insulin peaks before the meal is consumed.

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Correct Answer is D

Explanation

A. The need to monitor urine for the presence of albumin:
Explanation: Monitoring urine for albumin is more associated with microvascular complications, particularly diabetic nephropathy. When the kidneys are affected, albumin may leak into the urine. This is not a macrovascular complication.

B. The relationship between kidney function and blood glucose levels:
Explanation: The relationship between kidney function and blood glucose levels is important, but it is more directly related to microvascular complications, particularly diabetic nephropathy. High blood glucose levels over time can damage the small blood vessels in the kidneys.

C. The need for frequent eye examinations for clients with diabetes:
Explanation: This is related to microvascular complications, specifically diabetic retinopathy. Changes in the small blood vessels of the retina can lead to vision problems. While important, it's not directly addressing macrovascular complications.

D. The fact that clients with diabetes have an elevated risk of myocardial infarction:
Explanation: This is the correct answer. Macrovascular complications involve large blood vessels and are associated with conditions such as coronary artery disease, which increases the risk of myocardial infarction in individuals with diabetes.

A. Avoid the use of moisturizing lotions. B. Examine feet weekly for redness, blisters, and abrasions. C. Dry feet vigorously after each bath. D. Avoid hot-water bottles and heating pads.

Correct Answer is D

Explanation

A. Avoid the use of moisturizing lotions.
This statement is not a priority instruction. Moisturizing lotions, especially those designed for diabetic foot care, can help prevent dry skin and complications. However, it's crucial to choose appropriate, diabetes-friendly moisturizers.

B. Examine feet weekly for redness, blisters, and abrasions.
This is an important and relevant instruction. Regular foot inspections help detect any signs of injury or infection early, preventing complications, especially for individuals with peripheral neuropathy.

C. Dry feet vigorously after each bath.
This statement is not advisable. Vigorous drying can potentially harm the skin, especially for individuals with diabetes. A gentle and thorough drying is recommended to prevent skin damage.

D. Avoid hot-water bottles and heating pads.
This is a priority instruction. Patients with peripheral neuropathy may have reduced sensation in their feet, making them more susceptible to burns. Avoiding sources of excessive heat helps prevent injuries.

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Naxlex Comprehensive Predictor Exams

The nurse is discussing macrovascular complications of diabetes with a client. The nurse would address what topic during this dialogue?

Correct Answer is D

Explanation

A client with type 1 diabetes mellitus and peripheral neuropathy is seeing the nurse to review foot care. What would be a priority instruction for the nurse to give the client?

Correct Answer is D

Explanation

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A nurse is assessing a client who has diabetes for the presence of peripheral neuropathy. The nurse should question the client about what sign or symptom that would suggest the possible development of peripheral neuropathy?