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. Obtain the patient's blood glucose level between 2a.m-4a.m – Correct Answer. The Somogyi effect occurs when nighttime hypoglycemia triggers a rebound hyperglycemia in the morning. Checking the blood glucose level during the early morning hours helps confirm this phenomenon.
B. Check the patient for a change in level of consciousness between 2a.m-4a.m – Incorrect. While severe hypoglycemia can affect consciousness, the best way to confirm the Somogyi effect is through blood glucose monitoring.
C. Withhold the nighttime snack and check the glucose at 6:00 a.m. – Incorrect. A nighttime snack can help prevent the hypoglycemia that leads to the Somogyi effect.
D. Administer an increased dose of NPH insulin in the evening. – Incorrect. Increasing insulin could worsen nighttime hypoglycemia, making the Somogyi effect worse.
Correct Answer is C
Explanation
A. Suggest the visitors stay a bit longer to provide support and distraction. – Noise and stimulation can worsen migraines.
B. Suggest the patient ambulates in the hallway to become fatigued, so they can rest. – Movement may increase pain.
C. Turn the lights and television off except for a night light. – Correct Answer. Migraines are worsened by light and noise, so a dark and quiet environment is best.
D. Turn on the television to be used as a distractor for the patient. – Bright lights and sound can aggravate symptoms.
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