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1.The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following? a) “I will need a bedtime snack because I take an evenin... g dose of NPH insulin.” b) “I can choose any foods, as long as I use enough insulin to cover the calories.” c) “I can have an occasional beverage with alcohol if I include it in my meal plan.” d) “I will eat something at meal times to prevent hypoglycemia, even if I am not hungry.” ANS: B Most patients with type 1 diabetes need to plan diet choices very carefully. Patients who are using intensified insulin therapy have considerable flexibility in diet choices but still should restrict dietary intake of items such as fat, protein, and alcohol. The other patient statements are correct and indicate good understanding of the diet instruction. 2.To assist an older patient with diabetes to engage in moderate daily exercise, which action is most important for the nurse to take? a) Determine what types of activities the patient enjoys. b) Remind the patient that exercise improves self-esteem. c) Teach the patient about the effects of exercise on glucose level. d) Give the patient a list of activities that are moderate in intensity. ANS: A Because consistency with exercise is important, assessment for the types of exercise that the patient finds enjoyable is the most important action by the 129 This study source was downloaded by 100000840275362 from on 04-29-2022 08:05:16 GMT -05:00 nurse in ensuring adherence to an exercise program. The other actions may be helpful but are not the most important in improving compliance. 3.Which statement by the patient indicates a need for additional instruction in administering insulin? 1.“I need to rotate injection sites among my arms, legs, and abdomen each day.” 2.“I can buy the 0.5-mL syringes because the line markings will be easier to see.” 3.“I do not need to aspirate the plunger to check for blood before injecting insulin.” 4.“I should draw up the regular insulin first, after injecting air into the NPH bottle.” ANS: A Rotating sites is no longer recommended because there is more consistent insulin absorption when the same site is used consistently. The other patient statements are accurate and indicate that no additional instruction is needed. 11. Which patient action indicates good understanding of the nurse’s teaching about administration of aspart (NovoLog) insulin? a) The patient avoids injecting the insulin into the upper abdominal area. b) The patient cleans the skin with soap and water before insulin administration. c) The patient stores the insulin in the freezer after administering the prescribed dose. d) The patient pushes the plunger down while removing the syringe from the injection site. ANS: B 129 This study source was downloaded by 100000840275362 from on 04-29-2022 08:05:16 GMT -05:00 Cleaning the skin with soap and water is acceptable. Insulin should not be frozen. The patient should leave the syringe in place for about 5 seconds after injection to be sure that all the insulin has been injected. The upper abdominal area is one of the preferred areas for insulin injection. 12. A patient receives aspart (NovoLog) insulin at 8:00 AM. At which time would the nurse anticipate the highest risk for hypoglycemia? a) 10:00 AM b) 12:00 AM c) 2:00 PM d) 4:00 PM [Show More]

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