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:
Maintaining normal salt and fluid intake is crucial for patients on lithium. Lithium can affect sodium levels in the body, and consistent sodium intake helps to keep lithium levels stable. Patients should be advised to drink adequate fluids to prevent dehydration but avoid excessive fluid intake, which could alter lithium levels and potentially lead to toxicity¹²³⁴.

Choice B Reason:
Drinking twice the usual amount of fluids daily is not recommended for patients on lithium unless directed by a healthcare provider. Excessive fluid intake can lead to changes in lithium levels and increase the risk of lithium toxicity. Patients should aim to consume a sufficient amount of fluids to stay hydrated, especially in situations that may lead to dehydration, such as during hot weather or illness.

Choice C Reason:
Avoiding aged cheese, processed meats, and red wine is generally advised for patients taking monoamine oxidase inhibitors (MAOIs), not lithium. These foods can contain high levels of tyramine, which can interact with MAOIs. However, there are no specific dietary restrictions for lithium regarding these foods. Patients should follow a balanced diet and consult with their healthcare provider for personalized dietary advice.

Choice D Reason:
Doubling the lithium dose if diarrhea or vomiting occurs is incorrect and potentially dangerous. If a patient experiences diarrhea or vomiting, it can affect lithium absorption and increase the risk of toxicity. Instead, patients should contact their healthcare provider for guidance. Adjustments to the medication regimen should only be made under medical supervision.

A. a negative sputum culture. B. decreased hemoptysis. C. an improved chest x-ray. D. a decreased rate of coughing.

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.

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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

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Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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