An adult client newly diagnosed with type 2 diabetes mellitus asks a nurse to explain how he developed the condition. Which of the following responses should the nurse make?

Choice A rationale
While feeling depressed is a significant concern, it is not the highest priority in the context of systemic lupus erythematosus (SLE). Depression should be addressed, but it does not pose an immediate threat to the client’s physical health.
Choice B rationale
Joint pain in hands and knees is a common symptom of SLE but is not the highest priority. It indicates inflammation but does not pose an immediate risk to the client’s overall health.
Choice C rationale
A dry, raised rash on the face, often referred to as a “butterfly rash,” is a characteristic symptom of SLE. However, it is not the highest priority to report as it does not pose an immediate threat.
Choice D rationale
Presence of peripheral edema is the highest priority to report because it can indicate kidney involvement, which is a serious complication of SLE. Kidney damage can lead to significant health issues and requires immediate attention.

Choice A rationale
A high-purine diet can lead to the formation of uric acid stones, which are a type of kidney stone. However, it is not the most common risk factor for urolithiasis. Urolithiasis is more commonly associated with factors such as dehydration, which leads to concentrated urine and promotes stone formation.
Choice B rationale
Female gender is not a significant risk factor for urolithiasis. In fact, men are more likely to develop kidney stones than women. The higher incidence in men is thought to be related to differences in diet, fluid intake, and urinary tract anatomy.

Choice C rationale
Dehydration is a major risk factor for urolithiasis. When the body is dehydrated, urine becomes more concentrated, which increases the likelihood of stone formation. Adequate hydration helps to dilute the urine and reduce the risk of stone formation.
Choice D rationale
Family history is a known risk factor for urolithiasis. Individuals with a family history of kidney stones are more likely to develop them due to genetic predispositions that affect factors such as urine composition and kidney function.