The nurse is performing discharge planning for a client newly diagnosed with type 1 diabetes mellitus. It would be most important for the plan to include:

using a 23 gauge 1/2 inch needle for subcutaneous insulin.

monitoring the skin for dryness at injection site.

reporting multiple consecutive blood glucose levels over 200 mg/dL.

emphasizing the need to get eyes checked every 3 months.

Answer and Explanation

The Correct Answer is C

A. While using the correct needle size is important for insulin administration, it is not the most critical aspect of discharge planning. The focus should be on managing blood glucose levels and recognizing when medical intervention is needed.
B. Monitoring the skin for dryness at the injection site is a good practice, but it is not the most urgent issue to address in discharge planning for a newly diagnosed diabetic client.
C. Consistently elevated blood glucose levels above 200 mg/dL may indicate poor control of diabetes and require prompt adjustments in treatment. Teaching the client to recognize and report hyperglycemia is essential to prevent complications such as diabetic ketoacidosis (DKA).
D. Eye exams are important for long-term diabetes management to monitor for diabetic retinopathy, but every 3 months is excessive. Annual eye exams are typically sufficient unless otherwise indicated by the healthcare provider.

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Free Nursing Study Resources

Correct Answer is ["62.5"]

Explanation

To determine the IV pump rate, we need to calculate the flow rate in milliliters per hour (mL/h).

Given:

Total volume: 500 mL
Infusion time: 8 hours

Calculation:

Flow rate = Total volume / Infusion time
Flow rate = 500 mL / 8 hours
Flow rate = 62.5 mL/h

A. Insert an oral airway and suction as necessary. B. Withhold oral fluids or foods. C. Speak clearly while facing the client. D. Apply artificial tears to protect the cornea.

Correct Answer is B

Explanation

A. Inserting an oral airway and suctioning may be indicated for airway management, but the primary concern is the impaired function of the glossopharyngeal and vagus nerves, which affects swallowing and the risk of aspiration.
B. Withholding oral fluids or foods is crucial because impaired function of these cranial nerves increases the risk of aspiration and can lead to choking or pneumonia, making this the priority action.
C. Speaking clearly while facing the client is a good communication practice but does not address the immediate concern of impaired swallowing and risk of aspiration.
D. Applying artificial tears is important for protecting the cornea, but it is not directly related to the functions of CN IX and CN X or the immediate management of swallowing difficulties.

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The nurse is performing discharge planning for a client newly diagnosed with type 1 diabetes mellitus. It would be most important for the plan to include:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is to receive 500 mL of IV fluid over 8 hours. At what rate should the nurse set the IV pump?

Correct Answer is ["62.5"]

Explanation

The neurologic assessment of a patient indicates impaired function of the glossopharyngeal (CN IX) and the vagus nerve (CN X). Based on these findings the nurse plans to:

Correct Answer is B

Explanation

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