A nurse is providing teaching about self-administration of insulin to the parent of a school-age child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parent indicates a need for further teaching?
"The insulin can be injected anywhere there is adipose tissue."
"I will be sure my child rotates sites after 5 injections in one area."
"I will be sure my child aspirates before injecting the insulin."
"The insulin should be injected at a 90-degree angle."
The Correct Answer is C
Choice A: This statement does not indicate a need for further teaching, as it is correct that insulin can be injected anywhere there is adipose tissue. Adipose tissue is the layer of fat under the skin that can absorb insulin and prevent damage to muscles or organs. The common sites for insulin injection are the abdomen, thighs, buttocks, or upper arms.
Choice B: This statement does not indicate a need for further teaching, as it is correct that the child should rotate sites after 5 injections in one area. Rotating sites can prevent lipodystrophy, which is a condition that causes abnormal changes in fat tissue due to repeated injections. Lipodystrophy can affect the appearance and absorption of insulin in the affected area.
Choice C: This statement indicates a need for further teaching, as it is incorrect that the child should aspirate before injecting the insulin. Aspiration is the process of pulling back on the plunger of the syringe to check for blood before injecting the medication. Aspiration is not recommended for insulin injection, as it can cause pain, bruising, or leakage of insulin from the injection site.
Choice D: This statement does not indicate a need for further teaching, as it is correct that insulin should be injected at a 90-degree angle. Injecting insulin at a 90-degree angle can ensure that the medication reaches the adipose tissue and prevents skin irritation or muscle damage. The only exception is if the child has very thin skin or uses very short needles, in which case they may inject at a 45-degree angle.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A: A video game is not a therapeutic play activity for a 4-year-old child who is distressed after an insulin injection, as it does not address the child's feelings or concerns about the injection. A video game may provide distraction or entertainment, but it does not help the child cope with or understand their condition.
Choice B: A period of play in the playroom is not a therapeutic play activity for a 4-year-old child who is distressed after an insulin injection, as it does not address the child's feelings or concerns about the injection. A period of play in the playroom may provide socialization or stimulation, but it does not help the child cope with or understand their condition.
Choice C: A storybook about a 4-year-old child is not a therapeutic play activity for a 4-year-old child who is distressed after an insulin injection unless the storybook is specifically about diabetes mellitus and insulin injections. A storybook about a 4-year-old child may provide identification or imagination, but it does not help the child cope with or understand their condition.
Choice D: A needleless syringe and a doll is a therapeutic play activity for a 4-year-old child who is distressed after an insulin injection, as it allows the child to express their feelings and concerns about the injection through role-playing and simulation. A needleless syringe and a doll can help the child cope with and understand their condition by providing mastery, control, and education.
Correct Answer is D
Explanation
Choice A reason: This choice is incorrect because the radial artery is not an ideal site to assess the heart rate in an infant. The radial artery is located on the thumb side of the wrist, and it can be palpated by placing two fingers over it. It may be used for adults or older children who have a strong pulse, but it may be difficult to locate or feel in an infant who has a small or weak pulse.
Choice B reason: This choice is incorrect because the carotid artery is not an ideal site to assess the heart rate in an infant. The carotid artery is located on either side of the neck, and it can be palpated by placing two fingers over it. It may be used for adults or older children who have a cardiac arrest or shock, but it may be risky to use in an infant who has a fragile neck or airway.
Choice C reason: This choice is incorrect because the brachial artery is not an ideal site to assess the heart rate in an infant. The brachial artery is located on the inner side of the upper arm, and it can be palpated by placing two fingers over it. It may be used for infants or young children who have a blood pressure measurement, but it may be uncomfortable or inaccurate to use for a heart rate assessment.
Choice D reason: This choice is correct because the apex of the heart is an ideal site to assess the heart rate in an infant. The apex of the heart is located at the fifth intercostal space on the left midclavicular line, and it can be auscultated by placing a stethoscope over it. It may be used for infants or young children who have a regular and strong heartbeat, and it may provide the most accurate measurement of the heart rate.
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