After teaching a client with diabetes mellitus to inject insulin, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?

The lower abdomen is the best location because it is closest to the pancreas.

I can reach my thigh the best, so I will use the different areas of my thighs.

By rotating the sites in one area, my chance of having a reaction is decreased.

Changing injection sites from the thigh to the arm will change absorption rates.

Answer and Explanation

The Correct Answer is A

Choice A rationale: This statement is incorrect. While the abdomen is a preferred injection site due to its large subcutaneous fat layer and consistent absorption, the proximity to the pancreas is not the reason. The pancreas's location is irrelevant to where insulin is absorbed and distributed systemically. The statement shows a misunderstanding of anatomy and pharmacology.
Choice B rationale: This is a correct statement. Using different areas within the same site, such as the thigh, is a good practice for rotating injection spots. It helps prevent lipodystrophy (fat hypertrophy or atrophy) and ensures consistent insulin absorption. The thigh is an appropriate injection site.
Choice C rationale: This is a correct statement. Rotating injection sites within one area, such as the abdomen, minimizes the risk of tissue damage and the formation of scar tissue or lumps (lipohypertrophy). These reactions can alter insulin absorption, making blood glucose management unpredictable.
Choice D rationale: This is a correct statement. Insulin absorption rates vary between different injection sites. The abdomen generally has the fastest absorption, followed by the arm, thigh, and buttocks. This is due to differences in blood flow and subcutaneous tissue composition. Changing sites can thus change absorption rates.

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Correct Answer is A

Explanation

Choice A rationale: Polydipsia, polyphagia, polyuria, and glycosuria are hallmark clinical manifestations of uncontrolled diabetes mellitus. Polydipsia is excessive thirst due to hyperosmolarity and dehydration from polyuria. Polyphagia is increased hunger resulting from cellular starvation despite hyperglycemia. Polyuria is frequent urination caused by osmotic diuresis from glucose spilling into the renal tubules, and glycosuria is the presence of glucose in the urine.
Choice B rationale: While obesity and excessive sugar consumption are risk factors for developing type 2 diabetes, they are not direct clinical symptoms of the disease itself. They are associated with the metabolic syndrome that often precedes diabetes. The symptoms are the physiological consequences of insulin resistance or deficiency, leading to hyperglycemia.
Choice C rationale: While weight loss can occur in uncontrolled diabetes (due to osmotic diuresis and catabolism), nervousness and dysuria are not primary, classic symptoms. Dysuria (painful urination) is more indicative of a urinary tract infection, which can be a complication of diabetes, but not a core symptom. Nervousness is a symptom of hypoglycemia, not typically hyperglycemia.
Choice D rationale: A blood glucose level of 90 mg/100 mL is within the normal range (fasting blood glucose is 70–100 mg/dL). Therefore, this finding does not indicate diabetes mellitus. While albumin in the urine (microalbuminuria) is a sign of diabetic nephropathy, a long-term complication, it is not a direct, initial clinical symptom of the disease's onset.

A. Do not walk around barefoot. B. Soak your feet in a tub each evening. C. Trim toenails straight across with a nail clipper. D. Treat any blisters or sores with Epsom salts. E. Wash your feet every other day.

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

Explanation

Choice A rationale: Peripheral neuropathy and decreased circulation make the feet of a person with diabetes susceptible to injury and infection. Walking barefoot increases the risk of stepping on sharp objects or sustaining cuts, which may go unnoticed due to sensory loss. Proper footwear is essential to protect the feet from injury.
Choice B rationale: Soaking the feet, especially in hot water, can lead to maceration of the skin, making it more prone to fungal infections and breakdown. Due to nerve damage, a client with diabetes may not accurately perceive water temperature, risking burns. It is recommended to wash the feet with lukewarm water and pat them dry.
Choice C rationale: Trimming toenails straight across prevents ingrown toenails, a common source of foot infections. Ingrown nails can cause skin breakdown, creating an entry point for bacteria. Diabetic clients should avoid cutting the nails in a curved fashion to prevent this complication and should be cautious to avoid cutting the cuticles.
Choice D rationale: Epsom salts are a magnesium sulfate solution. They can be very drying to the skin, which is already prone to cracking in diabetic individuals, increasing the risk of infection. Furthermore, they are not an effective treatment for blisters or sores and could exacerbate the problem by irritating the skin.
Choice E rationale: Washing the feet every day is crucial for maintaining hygiene and inspecting for any cuts, sores, or changes. Daily washing with mild soap and lukewarm water helps prevent bacterial and fungal infections. Waiting until every other day to wash the feet increases the risk of infection.

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After teaching a client with diabetes mellitus to inject insulin, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?

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Naxlex Comprehensive Predictor Exams

After obtaining a history and assessing a client with diabetes mellitus, the nurse can expect to see or gather information about the following clinical symptoms.

Correct Answer is A

Explanation

A nurse teaches a client with diabetes mellitus about foot care. Which statements should the nurse include in this client's teaching? (Select all that apply).

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

Explanation

When a client's glucose level drops below 70 mg/dL, often before meals or when insulin action is peaking, the client is experiencing what condition?

Which of these complications of insulin therapy is characterized by a rapid decrease in serum glucose, usually at night, causing the release of glucose-elevating hormones and an elevated glucose level in the morning, which may be inadvertently treated with an increased insulin dose?

The nurse is teaching patients about self-injection of insulin. Which statement is true regarding injection sites?

Which type of diabetes is frequently associated with obesity and aging and may or may not require insulin therapy?

A nurse assesses a client who has diabetes mellitus and notes the client is awake and alert, but shaky, diaphoretic, and weak. Five minutes after administering a half-cup of orange juice, the client's clinical manifestations have not changed. Which action should the nurse take next?

The patient has 1000 mL ordered over 10 hours. Using an IV pump, how many milliliters per hour should the IV fluids be infused?

A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?

A client with a diagnosis of diabetic ketoacidosis (DKA) is being treated in the emergency department. Which of the following findings would the nurse expect to note as confirming this diagnosis?