When teaching the patient with type 1 diabetes, what should the nurse emphasize as the major advantage of using an insulin pump?

Correct Answer: A

Rationale: In teaching a patient with type 1 diabetes about the major advantage of using an insulin pump, emphasizing the option A) Tight glycemic control can be maintained is crucial. Insulin pumps deliver insulin continuously, mimicking the body's natural insulin release more closely than manual injections. This continuous delivery helps in maintaining stable blood glucose levels throughout the day, leading to better glycemic control. Option B) Errors in insulin dosing are less likely to occur is incorrect because while insulin pumps can reduce dosing errors related to manual injections, they can still occur due to factors like incorrect programming or pump malfunctions. Option C) Complications of insulin therapy are prevented is incorrect because while insulin pumps can help in better managing blood sugar levels, they do not prevent all complications associated with insulin therapy, such as hypoglycemia or skin irritation at the infusion site. Option D) Frequent blood glucose monitoring is unnecessary is incorrect because even with an insulin pump, regular blood glucose monitoring is still necessary to ensure the pump is delivering the right amount of insulin and to make any necessary adjustments in insulin doses based on blood sugar levels. In an educational context, it is important to emphasize to students or patients that while insulin pumps offer advantages in glycemic control, they are not a cure for diabetes and require proper education, monitoring, and management to be effective in diabetes care. Understanding the benefits and limitations of insulin pump therapy is essential for individuals with type 1 diabetes to make informed decisions about their treatment options.

Correct Answer: C

Rationale: In caring for a patient with nephrogenic diabetes insipidus, the treatment typically includes thiazide diuretics (Option C) because they can paradoxically decrease urine output by enhancing water reabsorption in the kidneys. Thiazides reduce the amount of urine produced, helping to manage the excessive urination characteristic of diabetes insipidus. Option A, fluid restriction, is not the primary treatment for nephrogenic diabetes insipidus because it can lead to dehydration without addressing the underlying issue of impaired kidney response to antidiuretic hormone. Option B, a high-sodium diet, would exacerbate the symptoms of diabetes insipidus by increasing urine output due to sodium's osmotic effect. Option D, chlorpropamide (Diabinese), is a sulfonylurea used to treat diabetes mellitus, not diabetes insipidus. In an educational context, understanding the appropriate treatment for nephrogenic diabetes insipidus is crucial for nursing students as it demonstrates the importance of differentiating between various types of diabetes and the tailored interventions required for each condition to ensure optimal patient outcomes. By grasping the rationale behind using thiazide diuretics in this scenario, students can apply this knowledge to clinical practice when caring for patients with similar conditions.

Correct Answer: B

Rationale: In the context of hyperparathyroidism, the correct nursing intervention of increasing fluid intake to 3000 to 4000 mL daily is crucial for several reasons. Hyperparathyroidism leads to increased levels of parathyroid hormone, which can result in hypercalcemia. Increasing fluid intake helps to prevent kidney stone formation, a common complication of hypercalcemia, by promoting urinary calcium excretion. Option A, padding side rails as a seizure precaution, is unrelated to the management of hyperparathyroidism. Seizures are not a typical manifestation of this condition. Option C, maintaining bed rest to prevent pathologic fractures, is not the best intervention for hyperparathyroidism. While bone resorption can lead to weakened bones and an increased risk of fractures in this condition, promoting bed rest can lead to further bone loss. Option D, monitoring the patient for Trousseau's and Chvostek's signs, is more indicative of hypocalcemia, not hypercalcemia associated with hyperparathyroidism. These signs are related to low calcium levels, not high levels seen in hyperparathyroidism. In an educational context, understanding the rationale behind the correct intervention emphasizes the importance of managing fluid intake to prevent complications associated with hypercalcemia in patients with hyperparathyroidism. It also highlights the need for nurses to have a strong foundation in pathophysiology to provide effective and evidence-based care for patients with endocrine disorders.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) she has an infection that is increasing her insulin needs. When a person with diabetes like Mary experiences an infection, such as a fever, the body's stress response releases stress hormones like cortisol and adrenaline, which can counteract the effects of insulin. This leads to an increase in blood sugar levels and subsequently an increased need for insulin to maintain control. Option A) she has not been taking her insulin is incorrect because the symptoms described are more indicative of increased insulin requirements due to an infection rather than non-compliance. Option B) her urine-testing supplies are outdated is incorrect as the symptoms described are not related to faulty testing supplies but rather reflect physiological changes in response to an infection. Option D) she is resistant to insulin is incorrect because the symptoms described are more consistent with increased insulin requirements due to the stress response to an infection rather than insulin resistance. Educationally, understanding how infections can impact blood sugar levels in individuals with diabetes is crucial for healthcare providers to effectively manage their patients' conditions. It highlights the importance of monitoring blood sugar levels closely during times of illness and adjusting insulin doses accordingly to prevent complications. This case also emphasizes the need for patients with diabetes to be vigilant in managing their condition during times of illness.

Correct Answer: C

Rationale: In the scenario of Mr. Conrad recovering from diabetic ketoacidosis (DKA), an expected outcome to evaluate the effectiveness of treatment is increasing responsiveness. This is because improving responsiveness indicates a positive response to treatment, with Mr. Conrad becoming more alert and responsive as his condition stabilizes. Option A, thirst, is not the expected outcome as excessive thirst is a common symptom of DKA due to dehydration and high blood sugar levels. Decreased urine output (Option B) is also not the expected outcome as increased urine output is a common symptom of DKA. An elevated hematocrit level (Option D) is not the expected outcome as DKA typically leads to hemoconcentration and elevated hematocrit due to dehydration. Educationally, understanding the expected outcomes of treating DKA is crucial for healthcare professionals to monitor and assess the effectiveness of interventions. Increasing responsiveness indicates neurological improvement and overall better physiological functioning, providing valuable insights into the patient's progress and response to treatment. This knowledge helps in optimizing patient care and making informed decisions in managing DKA and similar conditions.