A client tells the nurse that sometimes he gets lightheaded and shaky when he exercises. The nurse advised him to always:

Choice A rationale: Carrying a piece of hard candy is a proactive and safe strategy for managing hypoglycemia during exercise. A hard candy provides a rapid source of glucose, which can quickly elevate blood sugar levels if they begin to drop. This demonstrates an understanding of how to prevent and treat exercise-induced hypoglycemia, a common concern for individuals with diabetes.
Choice B rationale: Having emergency money is a prudent measure to manage unexpected situations related to diabetes, such as needing to purchase food or glucose tablets if an episode of hypoglycemia occurs. This action indicates a level of preparedness and understanding of the potential risks associated with physical activity when managing diabetes, showcasing good self-management skills.
Choice C rationale: Skipping breakfast before morning exercise, such as a soccer game, is dangerous and indicates a significant knowledge deficit. This behavior dramatically increases the risk of exercise-induced hypoglycemia because the body's glucose stores are already low from an overnight fast, and the added energy expenditure from exercise can deplete them further, leading to a hypoglycemic episode.
Choice D rationale: Playing in a soccer game after dinner is a safe practice. It demonstrates an understanding of timing exercise relative to meals. The meal provides a source of carbohydrates, which helps to maintain stable blood glucose levels during the physical activity, reducing the risk of hypoglycemia. This is a well-managed approach to combining physical activity with diabetes care.

Choice A rationale: Basal dosing involves a continuous, low-level release of insulin throughout the day and night to mimic the pancreas's natural basal insulin secretion. This helps to maintain stable blood glucose levels between meals and overnight, preventing hyperglycemia. Long-acting insulins like glargine or detemir are used for this purpose.
Choice B rationale: This statement describes bolus or prandial insulin dosing, not basal dosing. Bolus insulin is administered before meals to manage the anticipated rise in blood glucose from food intake. Basal insulin provides a constant background level and does not correlate with specific meals.
Choice C rationale: Glargine is a long-acting basal insulin. It is designed to be given once or twice a day to provide a steady, continuous insulin level. Bolus insulin, such as lispro or aspart, is given with meals to cover the carbohydrate intake. Glargine should never be used as a bolus with meals due to its delayed onset and peakless profile.
Choice D rationale: Basal-bolus dosing is the modern, intensive method of managing blood glucose, not the traditional one. The traditional approach often involved fixed-dose insulin regimens. Basal-bolus therapy, which combines long-acting basal insulin with short-acting bolus insulin, is a more flexible and effective approach that more closely mimics normal pancreatic function.