The nurse is evaluating the teaching of self-monitoring of blood glucose levels in a newly diagnosed Type 2 diabetic client. The nurse identifies a need for additional teaching when the client:

Warms the hands with water prior to the procedure.

Alternates fingers used in a systematic manner.

Chooses the center of the finger pad as a puncture site.

Verbalizes that a random result of 115 mg/dL indicates good glucose control.

Answer and Explanation

The Correct Answer is D

Choice a reason:
Warming the hands with water before testing is actually a recommended practice. It helps increase blood flow to the fingertips, making it easier to get a sufficient blood sample for testing. Cold hands can restrict blood flow, leading to difficulty in obtaining a blood sample and potentially inaccurate results.

Choice b reason:
Alternating fingers for blood glucose testing is also a recommended practice. It helps prevent soreness and calluses on the fingers from repeated pricks. Using different fingers or different sides of the same finger can help reduce pain and potential damage to the skin.

Choice c reason:
Choosing the center of the finger pad as a puncture site is not recommended. The sides of the fingertips are preferred because they have fewer nerve endings, making the process less painful. The center of the finger pad has a denser nerve supply and can lead to more discomfort during the test.

Choice d reason:
A random blood glucose result of 115 mg/dL is slightly above the normal range for non-diabetics, which is typically between 70 to 99 mg/dL when fasting. For someone with diabetes, this result might be considered within a target range, depending on individual treatment goals set by healthcare providers. However, it's important to note that a single glucose reading does not provide a complete picture of glucose control. An A1C test, which reflects average blood glucose levels over the past 2-3 months, is also necessary to assess overall glucose management.

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Correct Answer is ["A","B","D","E"]

Explanation

Choice a reason:
Assessing capillary refill and the color of the extremity is essential for determining the vascular status of the limb. A normal capillary refill time is less than 2 seconds and indicates good blood flow. The color should be consistent with the rest of the body, without pallor or cyanosis, which could indicate compromised circulation.

Choice b reason:
Checking pedal pulses is another critical aspect of assessing vascular integrity. The presence of strong and equal pulses in both feet suggests that the blood supply to the lower extremities is not compromised.

Choice c reason:
While the ACE wrap and Velcro boot are part of the postoperative management to provide support and protection to the affected limb, and hanging weights might be used for traction, these are not part of the physiological assessment of the extremity.

Choice d reason:
Monitoring pin sites for signs of infection, such as redness, swelling, or discharge, is crucial in a client with ORIF. Infection can lead to complications that may affect the healing process and the integrity of the fixation.

Choice e reason:
Evaluating the temperature, sensation, and movement of toes helps in assessing for potential nerve damage or compartment syndrome. Any changes in these parameters should be reported immediately as they may signify serious complications.

A. A blood glucose level of 80 mg/dL before eating. B. Gaining 5 pounds in the last 7 months. C. Waking up with a fever. D. Insomnia.

Correct Answer is C

Explanation

Choice A Reason:
A blood glucose level of 80 mg/dL before eating falls within the normal fasting blood glucose range, which is between 70 mg/dL to 110 mg/dL. Therefore, this finding is not a priority concern for a client taking prednisone.

Choice B Reason:
Gaining 5 pounds over 7 months is not typically a priority concern unless it is sudden or unexplained. Prednisone can cause fluid retention and weight gain as a common side effect, but this gradual weight change does not indicate an immediate health risk.

Choice C Reason:
Waking up with a fever is a priority finding as it may indicate an infection. Patients on prednisone are at increased risk of infections due to its immunosuppressive effects¹. Fever could also signify an exacerbation of inflammatory bowel disease or other complications.

Choice D Reason:
While insomnia is a common side effect of prednisone and can impact quality of life, it is not typically a priority over signs that could indicate infection or exacerbation of the underlying condition

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The nurse is evaluating the teaching of self-monitoring of blood glucose levels in a newly diagnosed Type 2 diabetic client. The nurse identifies a need for additional teaching when the client:

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