A nurse in a clinic is teaching a client who has diabetes mellitus about self-administration of insulin using a prefilled, multidose pen. Which of the following instructions should the nurse include?

Avoid pinching the skin when injecting the needle.

Use pen needles that have a safe-needle protection device attached.

Use the dominant hand to recap the needle before removing it from the pen device.

Remove the needle from the pen device before placing the needle in a sharps container.

Answer and Explanation

The Correct Answer is B

A. Avoid pinching the skin when injecting the needle:

This instruction is not specific to the use of a prefilled, multidose pen for insulin administration. Pinching the skin may be necessary for some injection techniques but is not directly related to the use of a prefilled pen.

B. Use pen needles that have a safe-needle protection device attached.

Using pen needles with a safe-needle protection device attached ensures safe handling and disposal of the needle after use, reducing the risk of accidental needlestick injuries. These devices help prevent accidental needlesticks by covering the needle after use, reducing the risk of transmission of bloodborne pathogens.

C. Use the dominant hand to recap the needle before removing it from the pen device:

Recapping needles is not recommended as it increases the risk of needlestick injuries. Additionally, the use of the dominant hand for recapping is not essential and may not be safe practice.

D. Remove the needle from the pen device before placing the needle in a sharps container:

It's crucial to dispose of needles safely in a sharps container immediately after use without removing the needle from the pen device. Removing the needle before disposal increases the risk of needlestick injuries. The entire pen needle unit, including the needle, should be disposed of intact into an appropriate sharps container to minimize the risk of injury to healthcare workers and others handling the waste.

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Correct Answer is A

Explanation

A. Metabolic syndrome: Metabolic syndrome is a cluster of conditions that occur together, increasing the risk of cardiovascular disease, stroke, and type 2 diabetes. The conditions include increased blood pressure, high blood sugar levels, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. Metabolic syndrome significantly increases the risk of developing cardiovascular disease by promoting atherosclerosis (hardening and narrowing of the arteries) and increasing the likelihood of developing other risk factors such as hypertension and diabetes.

B. Family history of alcohol use disorder: While excessive alcohol consumption can contribute to cardiovascular disease by raising blood pressure, increasing triglyceride levels, and promoting obesity, a family history of alcohol use disorder alone is not considered a direct risk factor for cardiovascular disease.

C. Participation in competitive sports: Regular physical activity, including participation in competitive sports, is typically associated with a reduced risk of cardiovascular disease. However, extreme levels of physical activity or certain types of competitive sports may pose risks, such as sudden cardiac events in individuals with underlying heart conditions. Overall, regular exercise is beneficial for cardiovascular health when performed in moderation and according to individual fitness levels.

D. Hypotension: Hypotension, or low blood pressure, is generally not considered a significant risk factor for cardiovascular disease. In fact, low blood pressure is often associated with a reduced risk of conditions such as heart attack and stroke. However, severe hypotension can indicate underlying health issues and may require medical evaluation and management.

A. Urinary catheter care B. Wound irrigation C. Enteral feeding D. Endotracheal suctioning

Correct Answer is D

Explanation

A. Urinary catheter care:

While urinary catheter care is important for maintaining urinary hygiene and preventing urinary tract infections, it is not as urgent as addressing respiratory needs. If the client is stable and not experiencing acute urinary retention or other urinary complications requiring immediate intervention, urinary catheter care can be performed after addressing respiratory concerns.

B. Wound irrigation:

Wound irrigation is typically performed to clean and debride wounds, promoting healing and preventing infection. While wound care is essential for preventing complications, it is not as urgent as ensuring adequate respiratory function, particularly in a client with an artificial airway requiring suctioning.

C. Enteral feeding:

Enteral feeding is crucial for providing nutrition to clients who cannot consume adequate nutrients orally. However, initiating enteral feeding can wait until the client's respiratory needs are addressed, as the immediate priority is to ensure effective breathing and oxygenation.

D. Endotracheal suctioning

Endotracheal suctioning is a critical procedure performed to clear secretions from the airway, ensuring adequate oxygenation and ventilation in patients with artificial airways such as endotracheal tubes. Maintaining a patent airway is a fundamental aspect of patient care, and suctioning helps prevent airway obstruction, hypoxia, and respiratory distress. Therefore, it takes precedence over other procedures in ensuring the client's respiratory stability and preventing potential complications.

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