A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
“I should avoid injecting insulin into my thigh if I am going to go running.”
“I will carry a complex carbohydrate snack with me when I exercise.”
“I should exercise first thing in the morning before eating breakfast.”
“I will increase the intensity of my exercise routine if my urine is positive for ketones.”
The Correct Answer is A
Choice A reason: Injecting insulin into a muscle that is going to be exercised can increase the absorption of insulin and lower the blood glucose level, leading to hypoglycemia. Therefore, it is advisable to avoid injecting insulin into the same body part that will be involved in the exercise.
Choice B reason: Carrying a complex carbohydrate snack with you when you exercise is not a good idea. Complex carbohydrates take longer to digest and raise the blood glucose level slowly. They are not suitable for treating or preventing hypoglycemia during or after exercise. A simple carbohydrate snack, such as glucose tablets, juice or candy, is more appropriate for this purpose.
Choice C reason: Exercising first thing in the morning before eating breakfast is not recommended for people with type 1 diabetes. This can cause a drop in blood glucose level and increase the risk of hypoglycemia. It is beter to have a balanced breakfast that includes some carbohydrates and adjust the insulin dose accordingly before exercising.
Choice D reason: Increasing the intensity of your exercise routine if your urine is positive for ketones is a dangerous practice. Ketones are produced when the body breaks down fat for energy due to lack of insulin or glucose. High levels of ketones can lead to diabetic ketoacidosis, a life-threatening condition that requires urgent medical atention. Intense exercise can raise the blood glucose level further and worsen the situation. If your urine is positive for ketones, you should avoid vigorous activity and check your blood glucose and ketone levels frequently.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A fruity odor in the breath is a symptom of hyperglycemia, especially when it is severe and causes ketoacidosis. Ketoacidosis is a condition where the body produces ketones, which are acidic substances that result from the breakdown of fat for energy when there is not enough insulin or glucose available. Ketones can make the breath smell fruity or like nail polish remover.
Choice B reason: A decreased appetite is not a symptom of hyperglycemia. On the contrary, an increased appetite or hunger is a symptom of hyperglycemia, as the body tries to compensate for the lack of glucose in the cells by stimulating the hunger center in the brain.
Choice C reason: An increased thirst is a symptom of hyperglycemia, as the body tries to flush out the excess glucose and ketones in the blood through urine. This leads to dehydration and thirst signals in the brain.
Choice D reason: A blurry vision at times is a symptom of hyperglycemia, as high blood glucose levels can cause swelling and damage to the lens of the eye, affecting its ability to focus light properly. This can lead to temporary or permanent vision problems.
Correct Answer is C
Explanation
Choice A reason: Weight loss is not a symptom of Cushing’s syndrome. On the contrary, weight gain and obesity are common signs of this condition, especially in the trunk, face and upper back1.
Choice B reason: Diaphoresis, or excessive sweating, is not a symptom of Cushing’s syndrome. It can be caused by other conditions, such as hyperthyroidism, menopause or anxiety.
Choice C reason: Hyperpigmentation, or darkening of the skin, is a symptom of Cushing’s syndrome. It occurs due to increased production of melanin, the pigment that gives color to the skin. Hyperpigmentation can affect any part of the body, but it is more noticeable in areas exposed to friction or pressure, such as the elbows, knees, knuckles and armpits.
Choice D reason: Hypotension, or low blood pressure, is not a symptom of Cushing’s syndrome. In fact, high blood pressure (hypertension) is one of the common symptoms of this condition, due to the effects of cortisol on the cardiovascular system.
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