Which of the following would be the best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes?

Correct Answer: D

Rationale: The best strategy for the nurse to use when teaching insulin injection techniques to a newly diagnosed client with diabetes is option D: Observe a return demonstration. Rationale: - Option D is the correct answer because observing a return demonstration allows the nurse to assess the client's understanding and mastery of the insulin injection technique. This hands-on approach ensures that the client can accurately perform the procedure independently. - Option A, giving written pre and post-tests, may assess theoretical knowledge but does not ensure practical skill acquisition, which is crucial in insulin administration. - Option B, asking questions during practice, is helpful for clarifying doubts but may not guarantee that the client can perform the injection correctly. - Option C, allowing another diabetic to assist, may provide peer support but does not offer direct feedback on the client's technique. Educational Context: In medical-surgical nursing practice, teaching insulin injection techniques is a critical skill for clients with diabetes. Providing hands-on demonstrations and return demonstrations is essential to ensure client safety and independence in managing their condition. Observing a return demonstration allows for immediate feedback and correction, enhancing the client's confidence and competence in performing insulin injections accurately.

Correct Answer: A

Rationale: In the context of a client undergoing hemodialysis, the nurse would anticipate that low hemoglobin (Option A) would not be improved by this procedure. Hemodialysis primarily focuses on removing waste products and excess fluids from the blood, such as urea and creatinine, which are water-soluble substances. Hemoglobin, on the other hand, is a component of red blood cells responsible for oxygen transport and is not directly affected by the process of hemodialysis. Hypernatremia (Option B), high serum creatinine (Option C), and hyperkalemia (Option D) are all conditions that can be effectively managed through hemodialysis. Hypernatremia can be corrected by adjusting the sodium concentration in the dialysate, high serum creatinine levels can be reduced by clearing the blood of waste products, and hyperkalemia can be normalized by removing excess potassium during hemodialysis. From an educational perspective, understanding the rationale behind the impact of hemodialysis on different lab values is crucial for nurses caring for clients undergoing this procedure. It reinforces the importance of monitoring lab values, understanding the principles of hemodialysis, and providing safe and effective care to clients with renal insufficiency.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Helplessness. During the 'tension building' phase of a violent relationship, the battered victim often experiences a sense of helplessness due to the increasing demands and escalating tension from the abuser. This feeling of helplessness is a common emotional response in abusive relationships where the victim may feel trapped and powerless to change the situation. Option A) Anger may be a valid emotional response for the victim, but it is not typically the predominant feeling during the tension building phase. Anger may arise more prominently during the 'explosive' phase of the cycle. Option C) Calm is an unlikely response during the tension building phase of a violent relationship as the victim is likely to experience heightened anxiety and stress during this period. Option D) Explosive is also an incorrect choice as this phase comes after the tension building phase, where the actual violent incident occurs, not during the tension building phase. Educationally, understanding the dynamics of abusive relationships is crucial for healthcare professionals, especially nurses, who may encounter victims seeking care. Recognizing the signs and stages of abuse can help nurses provide appropriate support, resources, and interventions to assist victims in breaking free from abusive situations and accessing the help they need to ensure their safety and well-being.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Crashing. The term "crashing" in the context of drug use refers to the period following the high when the user experiences a range of unpleasant symptoms. This can include fatigue, depression, anxiety, irritability, and intense drug cravings. It is a physiological response to the stimulant effects of cocaine wearing off and the body's attempt to regain balance. Option A) Craving is incorrect because while it is a common experience after drug use, it specifically refers to the intense desire or urge to use the drug again, rather than the overall unpleasant feeling after the high. Option C) Outward bound is unrelated to the physiological effects of cocaine use and does not describe the specific state discussed in the question. Option D) Nodding out is a term more commonly associated with opioid use, describing the drowsy, semi-conscious state that users may experience, which is not typically associated with the effects of cocaine. In an educational context, understanding the physiological and psychological effects of drug use, such as the concept of crashing after a cocaine high, is crucial for healthcare professionals, especially nurses, who may encounter patients with substance use disorders. Recognizing these symptoms and understanding their implications can help in providing appropriate care and support to individuals struggling with substance abuse.

Correct Answer: C

Rationale: The correct answer is C) Palpate for a thrill over the fistula. This action is important because a thrill is a vibrating sensation that can be felt over a functioning fistula, indicating proper blood flow. Assessing for a thrill is a key nursing intervention to ensure the patency of the fistula and the success of hemodialysis treatments. This assessment technique allows the nurse to detect any potential issues with blood flow promptly. Option A) Observe for edema proximal to the site is incorrect because edema may not always be present even if there is an issue with the fistula. Option B) Irrigate with 5 mls of 0.9% Normal Saline is incorrect as it is not a standard practice to irrigate a fistula without a specific medical order. Option D) Check color and warmth in the extremity is also incorrect because while changes in color and warmth can indicate issues, they may not always be reliable indicators of fistula patency. In an educational context, it is crucial for nursing students to understand the importance of proper fistula assessment in clients with end-stage renal disease. By mastering this skill, students can ensure the safety and effectiveness of hemodialysis treatments for their patients, promoting positive outcomes and quality care.