The nurse is performing discharge teaching for a Type 2 diabetic client on insulin glargine. The nurse is aware that the teaching has been effective when the client states:

"I need to eat within 5-10 minutes of injecting this insulin."

"I will mix this in the same syringe with my insulin lispro at bedtime."

"I will rotate the injection site."

"I will administer this insulin in the upper anterior aspect of my arms."

Answer and Explanation

Correct Answer : A,B

Choice A reason:
This statement is incorrect. Insulin glargine is a long-acting insulin with a relatively steady effect and does not require eating within a specific timeframe after injection. It is designed to be injected once daily at any time of the day but at the same time every day.

Choice B reason:
This statement is incorrect. Insulin glargine should not be mixed with any other insulins in the same syringe. It is formulated to be clear and colorless, and mixing it with other insulins, especially rapid-acting insulins like lispro, can affect its action profile.

Choice C reason:
This statement is correct. Rotating the injection site is important to prevent lipodystrophy, which is the breakdown or buildup of fat beneath the skin that can occur with repeated injections at the same site. Rotating sites helps to ensure consistent insulin absorption.

Choice D reason:
This statement is correct. Insulin glargine should be administered in areas of subcutaneous fat, such as the upper arms, thighs, buttocks, or abdomen. The upper anterior aspect of the arm is an appropriate site for insulin injection.

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Correct Answer is A

Explanation

Choice A Reason
A negative sputum culture is the most definitive indicator of the effectiveness of tuberculosis (TB) treatment. When a patient with active TB starts on medication, the goal is to eliminate the Mycobacterium tuberculosis bacteria from the body. A sputum culture that turns from positive to negative signifies that the bacteria have been eradicated from the respiratory secretions, indicating successful treatment.

Choice B Reason
While decreased hemoptysis (coughing up blood) is a positive sign and indicates an improvement in the patient's condition, it is not the most reliable parameter for determining the effectiveness of TB therapy. Hemoptysis may decrease as the patient's overall condition improves, but it does not confirm the eradication of the TB bacteria.

Choice C Reason
An improved chest x-ray can show a reduction in the lesions caused by TB, which is a good sign of recovery. However, chest x-rays cannot confirm whether the TB bacteria have been completely eliminated. They are more of a supportive indicator rather than a definitive one.

Choice D Reason
A decreased rate of coughing is another sign that the patient is responding to treatment, as coughing is a primary symptom of TB. However, similar to hemoptysis and chest x-ray improvements, a decrease in coughing does not necessarily mean that the TB bacteria have been fully cleared from the body.

A. This problem may be related to the medications that are prescribed. B. An ophthalmic examination should be scheduled to evaluate the symptoms. C. Blurred vision is a common problem associated with hypertension. D. Clients who have hypertension are at risk for brain tumors.

Correct Answer is B

Explanation

Choice A Reason
While some medications for hypertension can cause visual side effects, it is not the most immediate concern when a patient reports blurred vision. Medication-related side effects are important to consider, but they typically present consistently rather than intermittently.

Choice B Reason
An ophthalmic examination is crucial for evaluating intermittent blurred vision in a client with hypertension. Hypertension can lead to hypertensive retinopathy, where high blood pressure causes damage to the blood vessels in the retina, potentially resulting in blurred vision or vision loss. An eye exam can help diagnose this condition and prevent further complications.

Choice C Reason
Blurred vision can indeed be associated with hypertension, particularly in severe cases or hypertensive crises. However, it is not considered a 'common' problem but rather a sign of potential end-organ damage, such as hypertensive retinopathy, which requires prompt medical evaluation.

Choice D Reason
The risk of brain tumors is not directly associated with hypertension. While hypertension is a risk factor for certain conditions like stroke, it is not typically linked with an increased risk of brain tumors. This choice might cause unnecessary alarm without a clinical basis.

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The nurse is performing discharge teaching for a Type 2 diabetic client on insulin glargine. The nurse is aware that the teaching has been effective when the client states:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is diagnosed with active tuberculosis and is started on medications. The nurse is aware that which parameter best indicates that the prescribed therapy has been effective? The client has:

Correct Answer is A

Explanation

A client with hypertension reports experiencing blurred vision intermittently over the last few weeks. What should the nurse explain to the client?

Correct Answer is B

Explanation

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