A nurse is reinforcing teaching with a client who has osteoarthritis and is taking acetaminophen for pain management. Which of the following statements should the nurse include in the teaching?

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.

Choice A rationale
Regular insulin is correct because it is a short-acting insulin that can be used to treat diabetic ketoacidosis (DKA). The client’s symptoms of confusion, flushed appearance, and acetone odor on the breath suggest DKA, which requires prompt treatment with insulin to lower blood glucose levels and correct metabolic acidosis. Regular insulin has a rapid onset of action and can be administered intravenously to achieve quick results.
Choice B rationale
NPH insulin is incorrect because it is an intermediate-acting insulin that is not suitable for the immediate treatment of DKA. NPH insulin has a slower onset of action and is typically used for

basal insulin coverage rather than for acute management of hyperglycemia. In cases of DKA, rapid-acting or short-acting insulin is preferred to achieve quick glucose control.
Choice C rationale
Glargine insulin is incorrect because it is a long-acting insulin that provides basal insulin coverage over 24 hours. It is not suitable for the immediate treatment of DKA, as it does not have a rapid onset of action. Glargine insulin is typically used for maintaining stable blood glucose levels over a prolonged period rather than for acute management of hyperglycemia.
Choice D rationale
Detemir insulin is incorrect because it is a long-acting insulin similar to glargine. It provides basal insulin coverage and is not suitable for the immediate treatment of DKA. Detemir insulin has a slower onset of action and is used for maintaining stable blood glucose levels rather than for rapid correction of hyperglycemia in acute situations.