The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?

Correct Answer: C

Rationale: The correct answer is C because stating "I can choose any foods, as long as I use enough insulin to cover the calories" shows a lack of understanding of diabetes management. In type 1 diabetes, it's crucial to follow a balanced diet to regulate blood sugar levels. Choosing any foods without considering their impact on blood sugar control can lead to unstable glucose levels. Explanation for why the other choices are incorrect: A: Choosing to have an occasional alcoholic drink if included in the meal plan is acceptable as long as it's done in moderation and accounted for in the overall diabetes management plan. B: Needing a bedtime snack with NPH insulin is appropriate to prevent hypoglycemia overnight. D: Eating something at meal times to prevent hypoglycemia, even if not hungry, is a good practice to maintain stable blood sugar levels.

Correct Answer: D

Rationale: Step 1: Glargine and regular insulin should not be mixed in the same syringe as they have different onset and duration of action. Step 2: Administering glargine 30 minutes before each meal is incorrect as it is a long-acting insulin. Step 3: Pre-filling syringes weekly with the mix of insulins can lead to incorrect dosing or contamination. Step 4: Disposing of open vials after 4 weeks is the correct action to ensure potency and safety of the insulin. Summary: Choice D is correct because it demonstrates proper insulin storage and disposal practices. Choices A, B, and C are incorrect as they involve incorrect administration techniques or storage practices.

Correct Answer: C

Rationale: The correct answer is C. This statement indicates effective teaching because taking aspirin at least an hour before exenatide (Byetta) helps prevent any potential interactions between the two medications. By understanding the importance of timing, the patient shows comprehension of medication management and potential risks. Incorrect choices: A: This choice is incorrect because exenatide is known to reduce appetite, not increase hunger. B: This choice is incorrect because hypoglycemia is still a risk with exenatide, especially if used with other medications that lower blood sugar. D: This choice is incorrect because exenatide is injected, not taken as a pill, and should be taken before meals, not with breakfast.

Correct Answer: C

Rationale: The correct answer is C: Maintain a consistent time to wake up each day. This recommendation helps regulate the body's internal clock, promoting a consistent sleep-wake cycle. By waking up at the same time every day, the client's body will naturally adjust and improve their ability to fall asleep at night. Watching TV in bed (A) can disrupt sleep due to the blue light emitted. Drinking hot cocoa (B) may not be ideal close to bedtime due to the caffeine content. Exercising before bed (D) can stimulate the body and make it harder to fall asleep.

Correct Answer: D

Rationale: The correct answer is D: Abdominal cramping. A sodium level of 125 mEq/L indicates hyponatremia, which can lead to abdominal cramping due to electrolyte imbalance affecting muscle function. Chvostek's sign (choice A) is associated with hypocalcemia, not hyponatremia. Bradycardia (choice B) is more commonly seen in hyperkalemia. Numbness of the extremities (choice C) is a symptom of hypocalcemia or peripheral neuropathy, not specifically related to hyponatremia. In summary, the healthcare professional should expect abdominal cramping as a result of the low sodium level in this client.