A nurse is reinforcing teaching about self-administration of insulin with a 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?
I will be sure my child aspirates before injecting the insulin
The insulin can be injected anywhere there is adipose tissue
The insulin should be injected at a 90-degree angle
I will be sure my child rotates sites after two injections into one site
The Correct Answer is A
Choice A reason: Aspiration before insulin injection is outdated and unnecessary, as modern subcutaneous injections into adipose tissue pose minimal risk of entering a vessel. This practice delays administration and increases discomfort. The parent’s statement reflects incorrect technique, indicating a need for further teaching to ensure safe insulin delivery in diabetes management.
Choice B reason: Insulin injections into adipose tissue (e.g., abdomen, thigh) ensure proper subcutaneous absorption, minimizing intramuscular injection risk. This statement is correct, as insulin is effectively absorbed in areas with sufficient fat, supporting glycemic control. The parent’s understanding aligns with standard practice, requiring no further teaching on injection site selection.
Choice C reason: A 90-degree angle is appropriate for subcutaneous insulin injections in children with adequate adipose tissue, ensuring proper drug delivery. This statement is correct, reflecting proper technique for insulin administration to achieve consistent absorption and glycemic control, indicating the parent understands this aspect of diabetes management.
Choice D reason: Rotating injection sites after two injections prevents lipodystrophy, ensuring consistent insulin absorption. This statement is correct, as site rotation minimizes tissue damage and maintains efficacy in diabetes management. The parent’s understanding is accurate, requiring no further teaching on this critical aspect of insulin administration technique.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Syrup of ipecac is obsolete for acetaminophen overdose, as it delays definitive treatment like N-acetylcysteine. Acetaminophen causes hepatotoxicity via toxic metabolites, requiring specific antidote administration. Ipecac risks aspiration and is ineffective post-gastric lavage, making it an inappropriate choice for managing this potentially life-threatening overdose.
Choice B reason: Vitamin K treats bleeding from anticoagulant overdose, not acetaminophen toxicity, which causes hepatotoxicity by depleting glutathione, leading to liver damage. Vitamin K does not address acetaminophen’s metabolic effects, making it irrelevant. N-acetylcysteine is needed to restore glutathione and detoxify metabolites, making this choice incorrect.
Choice C reason: N-acetylcysteine is the antidote for acetaminophen overdose, replenishing glutathione to detoxify the toxic metabolite NAPQI, preventing liver damage. Administered post-gastric lavage, it reduces hepatotoxicity risk, especially if given within 8 hours of ingestion, making it the expected treatment to protect the child’s liver function.
Choice D reason: Activated charcoal adsorbs toxins in the gut but is less effective post-gastric lavage, as the stomach is already cleared. Acetaminophen’s rapid absorption requires N-acetylcysteine to prevent hepatotoxicity. Charcoal may be used early but is secondary to the antidote, making it less critical in this scenario.
Correct Answer is A
Explanation
Choice A reason: The Somogyi phenomenon involves rebound hyperglycemia in the morning following nocturnal hypoglycemia, triggering counter-regulatory hormones (e.g., glucagon, cortisol), causing diaphoresis and headaches. Excess insulin at night lowers glucose, prompting a hyperglycemic rebound. This explains the child’s symptoms, requiring insulin dose adjustment to prevent nocturnal hypoglycemia.
Choice B reason: The Honeymoon effect is a temporary period of improved insulin production post-diagnosis in type 1 diabetes, not causing hyperglycemia, diaphoresis, or headaches. It reflects residual beta-cell function, not a morning rebound. The Somogyi phenomenon better explains the symptoms, making this an incorrect diagnosis.
Choice C reason: Ketoacidosis causes hyperglycemia, but with fruity breath, lethargy, and dehydration, not diaphoresis or headaches alone. It results from insulin deficiency, not nocturnal hypoglycemia rebound. The Somogyi phenomenon’s counter-regulatory response better matches the morning symptoms, making ketoacidosis an incorrect suspicion for this presentation.
Choice D reason: The Dawn phenomenon causes morning hyperglycemia due to growth hormone surges, not diaphoresis or headaches, which suggest a hypoglycemic event. It lacks the rebound mechanism of the Somogyi phenomenon, which explains the combination of symptoms, making this an incorrect suspicion for the child’s condition.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.