A client with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U- 100 regular insulin and 35 U of 100-U isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?

Correct Answer: B

Rationale: The nurse should instruct the client to rotate injection sites within the same anatomic region, not among different regions. Proper rotation of injection sites helps prevent lipodystrophy (changes in fat tissue) and ensures consistent absorption of insulin. By rotating sites within the same region, the client can minimize the risk of developing localized skin complications. Additionally, rotating sites helps to ensure that the insulin is absorbed consistently, leading to more predictable blood glucose control. It is important to avoid injecting into areas of scar tissue, hypotrophy, large blood vessels, or nerves, as these can affect the absorption of insulin and may lead to inconsistent blood glucose levels.

Correct Answer: B

Rationale: Aling Iska's hemoglobin level of 11mg/dl and hematocrit level of 32% are both below the normal range for her age group. These low levels indicate anemia, which is a condition characterized by a decrease in the number of red blood cells or hemoglobin in the blood. Anemia can be caused by various factors, such as nutritional deficiencies (iron, vitamin B12, folate), chronic diseases, or bone marrow problems. In this case, given Aling Iska's advanced age of 78 years, it is essential for the nurse to conduct a thorough nutritional assessment to determine if her anemia is related to any deficiencies that can be addressed through dietary changes or supplementation. It is important to identify the underlying cause of anemia to provide appropriate interventions and prevent further complications.

Correct Answer: C

Rationale: The sudden sharp pain in the midepigastric region with a rigid boardlike abdomen in a patient with a bleeding gastric ulcer, especially in the setting of chronic alcohol use, is indicative of a perforation of the ulcer. Perforation occurs when the ulcer penetrates through the wall of the stomach or duodenum, leading to the leakage of gastric contents into the peritoneal cavity. This results in peritonitis, causing severe abdominal pain and rigidity. Perforation of the ulcer is a surgical emergency requiring immediate intervention to repair the perforation, control the infection, and prevent further complications like sepsis. It is a life-threatening condition that necessitates prompt diagnosis and management.

Correct Answer: D

Rationale: Doing the exercise program according to Mang Simon's needs and abilities is the most appropriate intervention to help ensure his compliance and adherence to the program. By tailoring the exercise program to fit his personal limitations and capabilities, Mang Simon will be more likely to engage in physical activities without risking injury or overwhelming his body. Adjusting the intensity, duration, and type of exercises to suit his individual health condition is crucial in promoting his overall well-being and successfully managing his hypertension. This personalized approach will help him feel more confident and motivated to continue with the exercise program in the long term.

Correct Answer: C

Rationale: Clients with cirrhosis, which is a serious liver condition, should avoid or limit their alcohol intake. Alcohol can worsen liver damage and lead to further complications such as liver failure. Nurse Dennis is correct in advising clients with cirrhosis to adhere to this measure in order to promote their health and reduce the progression of the disease. Taking daily multivitamins can be beneficial for some individuals, but limiting alcohol intake is crucial for those with cirrhosis. Taking sleeping pills at home without medical supervision can also be dangerous, as it may interact with other medications and worsen liver function. Limiting contact at all times is not relevant to managing cirrhosis.