A nurse is teaching a child who has type 1 diabetes mellitus about self-care. Which of the following statements by the child indicates understanding of the teaching?
"I should drink a glass of milk when I am feeling irritable."
"I should skip breakfast when I am not hungry."
"I should draw up the NPH insulin into the syringe before the regular insulin."
"I should increase my insulin with exercise."
The Correct Answer is A
Rationale:
A. Feeling irritable can be a sign of hypoglycemia, and drinking a glass of milk (which contains carbohydrates) can help raise blood sugar levels safely.
B. Skipping meals can cause blood sugar levels to drop dangerously low; consistent meal intake is important in diabetes management.
C. When mixing insulins, regular insulin should be drawn up before NPH insulin to prevent contamination.
D. Exercise generally lowers blood glucose, so insulin doses are often adjusted downward or snacks are increased, not insulin increased, before or after activity.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Physical activity increases glucose utilization by muscles, which can lower blood glucose levels. To prevent hypoglycemia, children with diabetes often need additional carbohydrate intake before or after exercise.
B. Decreasing food intake during activity may worsen the risk of hypoglycemia.
C. Physical activity actually increases the risk of insulin shock (hypoglycemia) unless managed appropriately.
D. Exercise generally lowers blood glucose levels, reducing the risk of hyperglycemia, not increasing it.
Correct Answer is C
Explanation
Rationale:
A. Hemoglobin A1c of 5.5% is within the normal range and does not indicate chronic hyperglycemia or diabetic ketoacidosis (DKA).
B. A fasting blood glucose of 124 mg/dL is elevated but not high enough to indicate DKA, which usually involves glucose levels >250 mg/dL.
C. A serum pH of 7.24 indicates metabolic acidosis, a hallmark of diabetic ketoacidosis. This acidic state results from the buildup of ketones due to insulin deficiency.
D. Potassium may initially be elevated in DKA due to acidosis, but a value of 3.9 mEq/L is within normal limits and not specific to DKA.
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