A nurse is reinforcing teaching with an adolescent who has type 1 diabetes mellitus. Which of the following statements by the adolescent indicates an understanding of the teaching?

"I will discard insulin bottles 60 days after opening.”.

"Before I exercise, I will need to take an extra 10 units of insulin.”.

"If I feel dizzy, I will drink 4 ounces of orange juice.”

"A hemoglobin A1c of 9 percent is a good goal."

Answer and Explanation

The Correct Answer is C

Choice A reason:

The statement "I will discard insulin bottles 60 days after opening”. is incorrect. Insulin bottles typically have a shorter shelf life after opening, usually around 28 days. Discarding them after 60 days could lead to using ineffective insulin, which can be harmful to the individual's blood sugar control.

Choice B reason:

This statement is incorrect. Excessive insulin use can cause hypoglycemia which is aggravated by involvement in streneous exercise.

Choice C reason:

The statement "If I feel dizzy, I will drink 4 ounces of orange juice”. is correct. A feeling of dizziness is an early sign of hypoglycemia. Client should be encouraged to take simple acrbohydrayes when tehy experience any symptoms consistent with hypoglycemia

Choice D reason:

The statement "A hemoglobin A1c of 9 percent is a good goal”. is incorrect. Hemoglobin A1c reflects average blood sugar levels over the past 2-3 months. An A1c of 9 percent is relatively high and suggests poor diabetes management. The target A1c goal for most people with diabetes is typically below 7 percent, as recommended by the American Diabetes Association.

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Correct Answer is A

Explanation

Choice A reason:

The nurse's priority in this situation is the respiratory rate of 10/min. A respiratory rate of 10 breaths per minute is significantly low and could indicate respiratory depression, especially if the patient is receiving morphine, which is known to depress the respiratory system. This could lead to inadequate oxygenation, potential hypoxia, and other life-threatening complications.

Choice B reason:

Bladder distention may be a concern, but it is not the nurse's priority in this situation. Bladder distention can cause discomfort and urinary retention, but it is not an immediate life- threatening condition compared to potential respiratory depression.

Choice C reason:

A blood pressure of 108/64 mm Hg is within the normal range for an adolescent and may not be the nurse's priority at this time. Although it should be monitored, it does not pose an immediate threat to the patient's life.

Choice D reason:

Nausea and vomiting are common side effects of morphine administration, but they are not the nurse's priority in this situation. While they can cause distress and discomfort to the patient, they are not life-threatening conditions.

A. Ask the client to empty their bladder. B. Assist the client into a left-lateral position. C. Apply an external fetal monitor to the clients abdomen. D. Instruct the client to perform nipple stimulation. E. Able to move from back to front.

Correct Answer is ["A","B","C"]

Explanation

Choice A reason: The nurse should plan to ask the client to empty their bladder before performing Leopold maneuvers. The rationale behind this is to ensure that the client's bladder is empty to allow for better palpation of the uterus and fetal position. A full bladder can interfere with accurate assessment and may lead to incorrect findings during the examination.

Choice B reason:

The nurse should assist the client into a left-lateral position. This position is ideal for performing Leopold maneuvers because it helps to displace the uterus away from the vena cava, reducing the risk of supine hypotension syndrome. Moreover, the left-lateral position promotes optimal blood flow to the placenta, which is essential for the well-being of the fetus during the examination.

Choice C reason:

The nurse should apply an external fetal monitor to the client's abdomen after completing the Leopold maneuvers. The purpose of Leopold maneuvers is to determine the fetal position and presentation manually. Once this information is obtained, applying the external fetal monitor allows continuous monitoring of the fetal heart rate and uterine contractions to assess the baby's well-being and the progression of labor.

Choice D reason:

The nurse should not instruct the client to perform nipple stimulation when planning to assist with Leopold maneuvers. Nipple stimulation is a method to induce or augment labor, and it is not related to the process of assessing fetal position and presentation using Leopold maneuvers. It may lead to unnecessary contractions and confusion during the examination.

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