Which patient statement indicates to the nurse the need for further teaching regarding the new diagnosis of type 1 diabetes mellitus (DM)?
I will need to take medication by mouth until my blood sugar is within normal limits again
If I get the flu, the dose of my insulin may need to be altered to control my blood glucose
I will monitor my blood glucose to help determine whether my medication is working as anticipated
The things that I eat may impact the dose of my medication used to control my blood glucose
The Correct Answer is A
Choice A reason: I will need to take medication by mouth until my blood sugar is within normal limits again is an incorrect statement that indicates the need for further teaching. Type 1 diabetes mellitus (DM) is a condition where the pancreas does not produce any insulin, a hormone that helps the cells use glucose for energy. Patients with type 1 DM need to take insulin injections or use an insulin pump for life to replace the missing hormone. Oral medications for diabetes are not effective for type 1 DM, as they work by stimulating the pancreas to produce more insulin or by increasing the sensitivity of the cells to insulin.
Choice B reason: If I get the flu, the dose of my insulin may need to be altered to control my blood glucose is a correct statement that shows understanding of the disease process. Illnesses such as the flu can increase the blood glucose level, as the body releases hormones that counteract the effects of insulin. Patients with type 1 DM may need to adjust their insulin dose, monitor their blood glucose more frequently, and check for ketones in their urine or blood when they are sick. Ketones are acidic substances that are produced when the body breaks down fat for energy, and can lead to a serious complication called diabetic ketoacidosis.
Choice C reason: I will monitor my blood glucose to help determine whether my medication is working as anticipated is another correct statement that demonstrates knowledge of the disease management. Blood glucose monitoring is an essential part of diabetes care, as it helps the patients and the health care providers to evaluate the effectiveness of the insulin therapy, the diet, and the exercise plan. Blood glucose monitoring also helps to prevent or detect hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar), and to adjust the insulin dose accordingly.
Choice D reason: The things that I eat may impact the dose of my medication used to control my blood glucose is also a correct statement that reflects awareness of the disease implications. The amount and type of carbohydrates that the patients eat can affect their blood glucose level, as carbohydrates are the main source of glucose in the diet. Patients with type 1 DM need to balance their insulin dose with their carbohydrate intake, and follow a consistent and healthy eating pattern. They may also use carbohydrate counting, a method of estimating the grams of carbohydrates in the foods they eat, to help them plan their meals and snacks.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason: This statement is false. Asking the patient about home insulin doses is not the action that the nurse should take first. Insulin is a hormone that lowers the blood glucose level and can also lower the blood potassium level by driving potassium into the cells. However, this is not the primary cause of hypokalemia, or low blood potassium level, which can be due to other factors such as diuretics, vomiting, diarrhea, or alkalosis.
Choice B reason: This statement is true. Administering IV potassium supplements is the action that the nurse should take first. Potassium is an electrolyte that is essential for the normal function of the heart, muscles, and nerves. Hypokalemia can cause cardiac arrhythmias, muscle weakness, and paralysis. IV potassium supplements can restore the blood potassium level and prevent life-threatening complications.
Choice C reason: This statement is false. Placing the patient on a cardiac monitor is not the action that the nurse should take first. A cardiac monitor is a device that records the electrical activity of the heart and can detect any abnormal rhythms or conduction problems. It is a useful tool for monitoring the patient's cardiac status, but it does not treat the underlying cause of hypokalemia.
Choice D reason: This statement is false. Starting an insulin infusion at 0.1 units/kg/h is not the action that the nurse should take first. Insulin infusion is a method of delivering insulin continuously through a pump or a catheter. It is used for patients with diabetes who need tight glucose control. It can also lower the blood potassium level by driving potassium into the cells. However, this is not t
Correct Answer is D
Explanation
Choice A reason: 1:00 PM is not the correct time to monitor the patient for signs of hypoglycemia related to the insulin's peak action. Humalog is a rapid acting insulin that starts to work within 15 minutes, peaks in about an hour, and lasts for 2 to 4 hours. Therefore, the peak action of Humalog given at 8:00 AM would be around 9:00 AM, not 1:00 PM.
Choice B reason: 8:00 PM is also not the correct time to monitor the patient for signs of hypoglycemia related to the insulin's peak action. As explained in choice A, Humalog peaks in about an hour and lasts for 2 to 4 hours. Therefore, the effect of Humalog given at 8:00 AM would wear off by 12:00 PM, not 8:00 PM.
Choice C reason: There is no peak action for this insulin is an incorrect statement. Humalog does have a peak action, as described in choice A. The peak action of an insulin is the time when the insulin is most effective in lowering the blood glucose level. The peak action of an insulin can vary depending on the type, dose, and individual response of the patient.
Choice D reason: 9:00 AM is the correct time to monitor the patient for signs of hypoglycemia related to the insulin's peak action. Hypoglycemia is a condition of low blood glucose level, which can cause symptoms such as sweating, shaking, hunger, headache, dizziness, confusion, and loss of consciousness. Hypoglycemia can occur when the insulin dose is too high, the food intake is too low, or the physical activity is too high. The nurse should monitor the patient for signs of hypoglycemia around the peak action of the insulin, as this is when the blood glucose level is most likely to drop. The nurse should also teach the patient how to prevent, recognize, and treat hypoglycemia.
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