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 B

Explanation

Choice A: Muscular dystrophy is not an example of a neural tube defect, but rather a group of genetic disorders that cause progressive weakness and loss of muscle mass. Muscular dystrophy affects the skeletal muscles that control movement and may also affect the heart, lungs, or other organs. Muscular dystrophy is caused by mutations in genes that encode proteins that protect muscle fibers from damage.

Choice B: Spina bifida is an example of a neural tube defect, which is a birth defect that occurs when the neural tube, which is the structure that develops into the brain and spinal cord, does not close completely during the first month of pregnancy. Spina bifida causes an opening in the spine that exposes the spinal cord and nerves and may result in physical and mental disabilities. Spina bifida can be prevented by taking folic acid before and during pregnancy.

Choice C: Hydrocephalus is not an example of a neural tube defect, but rather a condition that causes accumulation of cerebrospinal ﬂuid (CSF) in the brain. Hydrocephalus can increase the pressure inside the skull and damage the brain tissue and function. Hydrocephalus can be caused by congenital defects, infections, injuries, tumors, or bleeding in the brain.

Choice D: Cerebral palsy is not an example of a neural tube defect, but rather a group of disorders that affect movement, balance, and posture. Cerebral palsy is caused by damage to the developing brain before, during, or after birth. Cerebral palsy can affect muscle tone, coordination, reﬂexes, or speech. Cerebral palsy can be caused by infections, injuries, lack of oxygen, or genetic mutations.

A. Improve the client's school attendance skills. B. Provide teaching on self-care activities. C. Modify the environment for optimal safety and mobility. D. Provide counseling services for the parents.

Correct Answer is C

Explanation

Choice A: Improving the client's school attendance skills is not the priority goal for a child who has hemiplegic cerebral palsy, which is a condition that affects one side of the body and causes muscle weakness, spasticity, and impaired coordination. Improving the client's school attendance skills is a long-term goal that requires collaboration with the school staff, the child, and the parents. The priority goal for a child who has hemiplegic cerebral palsy is to ensure their safety and mobility at home.

Choice B: Providing teaching on self-care activities is not the priority goal for a child who has hemiplegic cerebral palsy, which is a condition that affects one side of the body and causes muscle weakness, spasticity, and impaired coordination. Providing teaching on self-care activities is an important goal that requires assessment of the child's abilities, needs, and preferences. The priority goal for a child who has hemiplegic cerebral palsy is to ensure their safety and mobility at home.

Choice C: Modifying the environment for optimal safety and mobility is the priority goal for a child who has hemiplegic cerebral palsy, which is a condition that affects one side of the body and causes muscle weakness, spasticity, and impaired coordination. Modifying the environment for optimal safety and mobility can prevent falls, injuries, or complications and promote independence and function. The nurse should include interventions such as removing clutter, securing rugs, installing grab bars, providing adaptive equipment, and arranging furniture.

Choice D: Providing counseling services for the parents is not the priority goal for a child who has hemiplegic cerebral palsy, which is a condition that affects one side of the body and causes muscle weakness, spasticity, and impaired coordination. Providing counseling services for the parents is a supportive goal that requires referral to appropriate resources, such as social workers, psychologists, or support groups. The priority goal for a child who has hemiplegic cerebral palsy is to ensure their safety and mobility at home.

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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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