A nurse is reinforcing teaching about foot care for a client with type 1 diabetes. Which statement indicates an understanding of the instructions?

Choice A reason: The Dawn phenomenon involves morning hyperglycemia due to nocturnal growth hormone and cortisol surges, increasing hepatic glucose production. It is not triggered by hypoglycemia, unlike the Somogyi effect, making it an incorrect explanation for rebound glucose elevation following low blood sugar.

Choice B reason: The Somogyi effect is rebound hyperglycemia following hypoglycemia, caused by counter-regulatory hormones (glucagon, cortisol, epinephrine) increasing glucose production and release. This occurs as the body overcorrects low blood sugar, often overnight, leading to elevated morning glucose, making this the correct term.

Choice C reason: Systemic alkalosis, an acid-base imbalance, is unrelated to glucose regulation. It may occur in conditions like vomiting but does not cause rebound hyperglycemia. Glucose fluctuations in diabetes are driven by hormonal and metabolic responses, not pH changes, making this incorrect.

Choice D reason: Systemic acidosis, such as in diabetic ketoacidosis, results from ketone accumulation, not rebound hyperglycemia. It is a complication of uncontrolled hyperglycemia, not a response to hypoglycemia, making it unrelated to the Somogyi effect or glucose rebound mechanisms.

Choice A reason: Cereal and orange juice are high in simple carbohydrates, causing rapid blood glucose spikes in diabetes. These foods have a high glycemic index, leading to poor glycemic control, making this meal inappropriate for a diabetic diet requiring balanced, low-glycemic foods.

Choice B reason: Salmon, brown rice, and steamed broccoli are ideal for diabetes. Salmon provides omega-3 fatty acids, brown rice offers complex carbohydrates for stable glucose release, and broccoli adds fiber and nutrients, promoting glycemic control and cardiovascular health, making this the best choice.

Choice C reason: Fried chicken, mashed potatoes, and gravy are high in saturated fats and simple carbohydrates. Fried foods and gravy increase insulin resistance and cardiovascular risk, while mashed potatoes can spike blood sugar, making this unsuitable for diabetes management requiring low-fat, low-glycemic meals.

Choice D reason: Pepperoni pizza and soda are high in refined carbohydrates, saturated fats, and sugars. Pizza’s dough and soda’s high sugar content cause rapid glucose spikes, while pepperoni adds unhealthy fats, making this inappropriate for diabetes control, which prioritizes balanced, nutrient-dense foods.