A nurse is caring for a client who has chronic kidney disease. The nurse should expect the client to have which of the following clinical manifestations?

Choice A rationale:
Fruity-smelling breath is associated with diabetic ketoacidosis (DKA), which is not the expected manifestation of chronic kidney disease (CKD). DKA occurs in uncontrolled diabetes and is not the priority for this client.
Choice B rationale:
Painful urination is not a typical clinical manifestation of chronic kidney disease. It is more commonly associated with urinary tract infections or other urological issues.
Choice C rationale:
Hypotension may occur in end-stage kidney disease, but it is not specific to chronic kidney disease and is not a priority in this scenario.
Choice D rationale:
Lethargy is a common clinical manifestation of chronic kidney disease due to the accumulation of waste products in the blood, leading to uremia. It is a priority as it indicates the progression of the disease and the need for close monitoring and intervention.

Choice A rationale:

The statement "If I can keep my hemoglobin A1C less than 6.5%, I will be cured of diabetes.”. is incorrect. While maintaining an A1C level below 6.5% is a recommended target for some individuals with diabetes, achieving this level does not cure diabetes. Diabetes is a chronic condition that requires ongoing management and lifestyle modifications.

Choice B rationale:

Checking blood sugar levels before exercising is an important aspect of managing type 1 diabetes. Exercise can affect blood glucose levels, and knowing the current level helps the client determine whether it is safe to engage in physical activity or if adjustments to insulin or carbohydrate intake are needed.

Choice C rationale:

Having regular eye checks every 2 years is essential for clients with diabetes, but it is not the best statement that indicates an understanding of health promotion activities for a new diagnosis of type 1 diabetes mellitus.

Choice D rationale:

Soaking feet daily in warm, soapy water is not a recommended practice for clients with diabetes. It can lead to skin dryness and increase the risk of infection. Instead, clients with diabetes should practice daily foot inspections and keep their feet moisturized to prevent complications related to peripheral neuropathy.