A nurse is providing teaching about self-administration of insulin to the parent of a school-age child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parent indicates a need for further teaching?

"The insulin can be injected anywhere there is adipose tissue."

"I will be sure my child rotates sites after 5 injections in one area."

"I will be sure my child aspirates before injecting the insulin."

"The insulin should be injected at a 90-degree angle."

Answer and Explanation

The Correct Answer is C

Choice A: This statement does not indicate a need for further teaching, as it is correct that insulin can be injected anywhere there is adipose tissue. Adipose tissue is the layer of fat under the skin that can absorb insulin and prevent damage to muscles or organs. The common sites for insulin injection are the abdomen, thighs, buttocks, or upper arms.

Choice B: This statement does not indicate a need for further teaching, as it is correct that the child should rotate sites after 5 injections in one area. Rotating sites can prevent lipodystrophy, which is a condition that causes abnormal changes in fat tissue due to repeated injections. Lipodystrophy can affect the appearance and absorption of insulin in the aﬀected area.

Choice C: This statement indicates a need for further teaching, as it is incorrect that the child should aspirate before injecting the insulin. Aspiration is the process of pulling back on the plunger of the syringe to check for blood before injecting the medication. Aspiration is not recommended for insulin injection, as it can cause pain, bruising, or leakage of insulin from the injection site.

Choice D: This statement does not indicate a need for further teaching, as it is correct that insulin should be injected at a 90-degree angle. Injecting insulin at a 90-degree angle can ensure that the medication reaches the adipose tissue and prevents skin irritation or muscle damage. The only exception is if the child has very thin skin or uses very short needles, in which case they may inject at a 45-degree angle.

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Correct Answer is A

Explanation

Choice A: This response is appropriate, as it informs the parent that reporting suspected child abuse is a legal and ethical obligation for nurses, regardless of their personal opinions or feelings. This response also shows respect and honesty by acknowledging the parent's concern and explaining the reason for the nurse's action.

Choice B: This response is not appropriate, as it deﬂects responsibility and avoids answering the parent's question. This response also shows disrespect and dishonesty by implying that the provider is more qualified or authorized to explain the situation than the nurse.

Choice C: This response is not appropriate, as it denies information and creates confusion for the parent. This response also shows indiﬀerence and avoidance by suggesting that the nurse does not want to deal with the issue or communicate with the parent.

Choice D: This response is not appropriate, as it shifts blame and undermines trust between the nurse and the parent. This response also shows defensiveness and insecurity by implying that the nurse did not make the decision or take accountability for their action.

A. "We will give our child pancreatic enzymes with snacks and meals." B. "We will prepare low-fat meals with limited protein for our child." C. "We will limit our child's ﬂuid intake." D. "We will restrict the amount of salt in our child's food."

Correct Answer is A

Explanation

Choice A: This response indicates an understanding of the teaching, as pancreatic enzymes are essential for a child who has cystic fibrosis (CF), which is a condition that causes thick mucus to block the pancreatic ducts and impair digestion and absorption of nutrients. Pancreatic enzymes help break down fats, proteins, and carbohydrates in food and prevent malnutrition, steatorrhea, or vitamin deficiencies. Pancreatic enzymes should be given with snacks and meals to ensure adequate digestion.

Choice B: This response indicates a lack of understanding of the teaching, as low-fat meals with limited protein are not recommended for a child who has cystic fibrosis (CF), which is a condition that causes thick mucus to block the pancreatic ducts and impair digestion and absorption of nutrients. Low-fat meals with limited protein can cause malnutrition, weight loss, or growth failure in a child who has CF. A high-calorie, high-protein diet is recommended for a child who has CF to meet their increased energy needs and promote growth and development.

Choice C: This response indicates a lack of understanding of the teaching, as limiting ﬂuid intake is not recommended for a child who has cystic fibrosis (CF), which is a condition that causes thick mucus to block the airways and lungs and cause respiratory infections and complications. Limiting ﬂuid intake can cause dehydration, thickening of mucus, or difficulty in expectoration in a child who has CF. Adequate ﬂuid intake is recommended for a child who has CF to hydrate the body, thin out mucus, and facilitate clearance.

Choice D: This response indicates a lack of understanding of the teaching, as restricting salt intake is not recommended for a child who has cystic fibrosis (CF), which is a condition that causes excessive loss of salt through sweat due to abnormal chloride transport in cells. Restricting salt intake can cause hyponatremia, dehydration, or electrolyte imbalance in a child who has CF. Adequate salt intake is recommended for a child who has CF to replace the lost salt and maintain ﬂuid and electrolyte balance.

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A nurse is providing teaching about self-administration of insulin to the parent of a school-age child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parent indicates a need for further teaching?

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Correct Answer is A

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