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 B

Explanation

Choice A reason: This choice is incorrect because taking glyburide with breakfast is not recommended for an adolescent who has type 1 diabetes mellitus. Glyburide is an oral hypoglycemic medication that lowers blood glucose levels by stimulating insulin secretion from the pancreas. It may be used for clients who have type 2 diabetes mellitus, but it does not work for clients who have type 1 diabetes mellitus or DKA.

Choice B reason: This choice is correct because obtaining an inﬂuenza vaccine annually is recommended for an adolescent who has type 1 diabetes mellitus. The inﬂuenza vaccine is a vaccine that protects against inﬂuenza, a viral infection that aﬀects the respiratory system. It may prevent or reduce the severity of inﬂuenza and its complications, such as pneumonia or sepsis. It is recommended for everyone who is 6 months or older, especially those who have chronic conditions such as diabetes mellitus that increase their risk of inﬂuenza-related complications.

Choice C reason: This choice is incorrect because administering glucagon for hyperglycemia is not indicated for an adolescent who has type 1 diabetes mellitus. Glucagon is a hormone that raises blood glucose levels by stimulating glycogen breakdown in the liver. It may be used for clients who have hypoglycemia, which is a condition in which blood glucose levels are lower than normal (less than 70 mg/dL). It may cause symptoms such as sweating, trembling, confusion, or loss of consciousness. However, in type 1 diabetes mellitus, hyperglycemia (high blood glucose levels) rather than hypoglycemia is more likely to occur due to insulin deficiency or resistance.

Choice D reason: This choice is incorrect because injecting insulin in the deltoid muscle is not an optimal method for an adolescent who has type 1 diabetes mellitus. Insulin is a hormone that lowers blood glucose levels by facilitating glucose uptake into the cells. It may be administered by injection or infusion, and it may vary in onset, peak, and duration of action. The preferred sites for insulin injection are the abdomen, the thighs, the buttocks, or the upper arms, as they have more subcutaneous fat and less muscle tissue. Injecting insulin into the deltoid muscle may cause faster absorption and shorter duration of action, which can affect blood glucose control and increase the risk of hypoglycemia.

A. "This test will indicate if your child has rheumatic fever." B. "This test will confirm if your child had a recent streptococcal infection." C. "This test will indicate if your child has a therapeutic blood level of an aminoglycoside." D. "This test will confirm if your child has immunity to streptococcal bacteria."

Correct Answer is B

Explanation

Choice A: This test will not indicate if the child has rheumatic fever, as rheumatic fever is a complication of an untreated or inadequately treated streptococcal infection that aﬀects the heart, joints, skin, and brain. Rheumatic fever is diagnosed based on clinical criteria, such as carditis, polyarthritis, chorea, erythema marginatum, and subcutaneous nodules.

Choice B: This test will confirm if the child had a recent streptococcal infection, as antistreptolysin O (ASO) is an antibody that the body produces in response to streptococcal bacteria. A high ASO titer indicates that the child was exposed to streptococcal bacteria within the past few weeks. A streptococcal infection can cause pharyngitis, tonsillitis, scarlet fever, or impetigo.

Choice C: This test will not indicate if the child has a therapeutic blood level of an aminoglycoside, as an aminoglycoside is a type of antibiotic that is used to treat serious bacterial infections. A therapeutic blood level of an aminoglycoside means that the drug is eﬀective and safe in the body. A therapeutic blood level of an aminoglycoside is measured by a peak and trough level.

Choice D: This test will not confirm if the child has immunity to streptococcal bacteria, as immunity to streptococcal bacteria means that the body can resist or fight the infection. Immunity to streptococcal bacteria can be acquired by natural exposure or vaccination. Immunity to streptococcal bacteria is measured by an antibody titer or a skin test.

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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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Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to an adolescent who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching?

Correct Answer is B

Explanation

A nurse is caring for a child who was admitted with suspected rheumatic fever. The provider prescribes an antistreptolysin O (ASO) titer. The parent asks the nurse about the purpose of the test. Which of the following responses should the nurse make?

Correct Answer is B

Explanation

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