The nurse is evaluating teaching provided to a patient with type 1 diabetes mellitus. Which patient observation indicates that medication teaching has been effective?
Inserts the needle at a 25-degree angle prior to injecting the medication
Provides an injection in the thigh after an abdominal injection in the morning
Uses a 1 mL syringe to measure insulin dose
Places a new injection an inch away from previous injection site
The Correct Answer is B
A. Incorrect → Insulin injections should be administered at a 90-degree angle unless the patient has minimal subcutaneous fat, in which case a 45-degree angle is used. A 25-degree angle is too shallow and may lead to improper absorption.
B. Rotating insulin injection sites helps prevent lipodystrophy and ensures consistent absorption. The patient’s decision to inject in the thigh after using the abdomen in the morning demonstrates proper site rotation.
C. Incorrect → Insulin should be administered with a U-100 insulin syringe (not a 1 mL syringe) to ensure accurate dosing.
D. Incorrect → While injecting an inch away from a previous site is reasonable, the preferred practice is rotating between different anatomical sites to prevent tissue damage and inconsistent absorption.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Check the patient’s blood temperature. – Correct Answer. A headache and stiff neck are classic signs of meningitis. Fever is another key symptom, so checking temperature helps confirm suspicion and guides urgent intervention.
B. Administer an oral analgesic. – Incorrect. Pain management is secondary. The priority is assessing for infection (meningitis).
C. Perform a complete blood count. – Incorrect. While a CBC may show elevated WBCs, immediate assessment is more urgent.
D. Evaluate the patient’s neurological status. – Incorrect. While neurological assessment is important, confirming fever as an infection indicator is the first step.
Correct Answer is B
Explanation
A. Give potassium intravenously. – The potassium level is 3.7 (within normal range 3.5–5.0), so potassium is not needed yet.
B. Administer D5 NS with the insulin drip. – Correct Answer. Once glucose drops to ≤200 mg/dL, dextrose is added to prevent hypoglycemia while continuing insulin to correct ketoacidosis.
C. Administer 3% NS at 200 mL/hr. – Hypertonic saline is used for severe hyponatremia, which is not the case here.
D. Expect the insulin drip to be discontinued. – The insulin drip is not discontinued until ketoacidosis has fully resolved (when HCO3 > 18, pH > 7.3, and anion gap normalizes).
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