A client with type 2 diabetes normally achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment?

Stress has likely caused an increase in the client's blood sugar levels.

The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.

The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures.

Alterations in bile metabolism and release have likely caused hyperglycemia.

Answer and Explanation

The Correct Answer is A

A. Stress has likely caused an increase in the client's blood sugar levels:
This statement is accurate. Stress, especially related to surgery, can lead to increased levels of stress hormones, such as cortisol and catecholamines, which can elevate blood sugar levels. Surgery is a physiological stressor that can impact glucose metabolism.

B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars:
This is the most appropriate choice. Surgery, anesthesia, and changes in fluid balance can affect blood glucose levels. The stress response to surgery can lead to fluctuations in blood sugar, and patients may need insulin during this period.

C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures:
This statement is not accurate. Overstimulation is not a common cause of the need for insulin in the context of surgery. The stress and physiological changes associated with surgery are more likely contributors.

D. Alterations in bile metabolism and release have likely caused hyperglycemia:
While alterations in metabolism can impact glucose regulation, in the context of surgery, the primary factors are the stress response, changes in fluid balance, and potential alterations in the ability to eat or drink normally rather than specific effects on bile metabolism.

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Free Nursing Study Resources

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

Explanation

A. I will inject my insulin by pinching up a large area of skin, and then inserting the needle.
The correct technique for subcutaneous insulin injection involves pinching a small area of skin (creating a skinfold) and inserting the needle at a 90-degree angle. Injecting into a large area might result in inadequate subcutaneous administration.

B. I can mix my regular acting insulin and my Lantus in the same syringe.
Lantus (insulin glargine) is a long-acting insulin that should not be mixed with other insulins. It should be administered separately to maintain its long-acting profile.

C. I can inject my insulin in the same location each time.
This statement is correct. Injecting insulin into the same general area consistently can help with consistent absorption.

D. I can use a needle/syringe more than once since I am the only one using it.
It is not safe to reuse needles or syringes. Single-use needles and syringes should be disposed of properly after each use to prevent infection and other complications.

E. I will discard my used syringes in a hard container, like an empty plastic milk jug.
This statement is correct. Used syringes should be discarded in a puncture-resistant container, and an empty plastic milk jug can serve as a suitable container for disposal.

A. "If a vial of insulin will be used up within 21 days, it may be kept at room temperature." B. "If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature." C. "If you are going to use up the vial within 1 month, it can be kept at room temperature." D. "If a vial of insulin will be used up within 1 week, it may be kept at room temperature."

Correct Answer is A

Explanation

A. "If a vial of insulin will be used up within 21 days, it may be kept at room temperature."
This statement suggests a duration of up to 21 days for room temperature storage after the vial is in use. However, most insulins can typically be stored at room temperature for up to 28 days after initial use. This recommendation might be more conservative than necessary for many types of insulin.

B. "If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature."
This choice suggests a timeframe of 14 days for room temperature storage after opening the vial. However, for many insulins, the recommended duration for room temperature storage after opening is up to 28 days.

C. "If you are going to use up the vial within 1 month, it can be kept at room temperature."
This option extends the timeframe to 1 month for room temperature storage after the vial is in use. However, the generally recommended duration for many insulins is up to 28 days after opening.

D. "If a vial of insulin will be used up within 1 week, it may be kept at room temperature."
This choice suggests a very short duration of 7 days for room temperature storage after opening the vial. Most insulins can typically be stored at room temperature for a longer duration after initial use.

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Naxlex Comprehensive Predictor Exams

The nurse instructs the client about the self-administration of insulin. Which statement or statements by the patient indicate a need for further teaching? (SELECT ALL THAT APPLY)

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

Explanation

A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it "goes bad." What would be the nurse's best answer?

Correct Answer is A

Explanation

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