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."

Answer and Explanation

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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Correct Answer is D

Explanation

Choice A: Urinary incontinence is a condition of involuntary loss of urine control, which can be caused by various factors, such as nerve damage, bladder dysfunction, or medication side effects. It is not always caused by neuroblastoma, which is a type of cancer that arises from immature nerve cells.

Choice B: Blood-fed is not a term that describes a neuroblastoma. Neuroblastoma is a type of cancer that arises from immature nerve cells, which can form tumors in various parts of the body, such as the adrenal glands, abdomen, chest, or spine.

Choice C: Tiny is not a term that describes a neuroblastoma. Neuroblastoma can vary in size and shape depending on the location and stage of the tumor. Some neuroblastomas can be very large and cause compression of nearby organs or structures.

Choice D: Unfortunately, much of the time, by the time a diagnosis has been made, metastasis has already occurred. This statement describes a neuroblastoma accurately. Neuroblastoma is a type of cancer that arises from immature nerve cells, which can spread rapidly to other parts of the body, such as the bones, liver, lymph nodes, or skin.
Metastasis is the process of cancer cells breaking away from the original tumor and forming new tumors elsewhere. Neuroblastoma often has no specific symptoms until it has metastasized, making it difficult to diagnose early and treat effectively.

A. Take glyburide with breakfast. B. Obtain an inﬂuenza vaccine annually. C. Administer glucagon for hyperglycemia. D. Inject insulin in the deltoid muscle.

Correct Answer is B

Explanation

Choice A reason: This choice is incorrect because taking glyburide with breakfast is not recommended for an adolescent who has type 1 diabetes mellitus. Glyburide is an oral hypoglycemic medication that lowers blood glucose levels by stimulating insulin secretion from the pancreas. It may be used for clients who have type 2 diabetes mellitus, but it does not work for clients who have type 1 diabetes mellitus or DKA.

Choice B reason: This choice is correct because obtaining an inﬂuenza vaccine annually is recommended for an adolescent who has type 1 diabetes mellitus. The inﬂuenza vaccine is a vaccine that protects against inﬂuenza, a viral infection that aﬀects the respiratory system. It may prevent or reduce the severity of inﬂuenza and its complications, such as pneumonia or sepsis. It is recommended for everyone who is 6 months or older, especially those who have chronic conditions such as diabetes mellitus that increase their risk of inﬂuenza-related complications.

Choice C reason: This choice is incorrect because administering glucagon for hyperglycemia is not indicated for an adolescent who has type 1 diabetes mellitus. Glucagon is a hormone that raises blood glucose levels by stimulating glycogen breakdown in the liver. It may be used for clients who have hypoglycemia, which is a condition in which blood glucose levels are lower than normal (less than 70 mg/dL). It may cause symptoms such as sweating, trembling, confusion, or loss of consciousness. However, in type 1 diabetes mellitus, hyperglycemia (high blood glucose levels) rather than hypoglycemia is more likely to occur due to insulin deficiency or resistance.

Choice D reason: This choice is incorrect because injecting insulin in the deltoid muscle is not an optimal method for an adolescent who has type 1 diabetes mellitus. Insulin is a hormone that lowers blood glucose levels by facilitating glucose uptake into the cells. It may be administered by injection or infusion, and it may vary in onset, peak, and duration of action. The preferred sites for insulin injection are the abdomen, the thighs, the buttocks, or the upper arms, as they have more subcutaneous fat and less muscle tissue. Injecting insulin into the deltoid muscle may cause faster absorption and shorter duration of action, which can affect blood glucose control and increase the risk of hypoglycemia.

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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?

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Naxlex Comprehensive Predictor Exams

Which of the following best describes a neuroblastoma?

Correct Answer is D

Explanation

A nurse is providing teaching to an adolescent who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching?

Correct Answer is B

Explanation

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