The nurse is caring for a client who reports periods of exacerbations and remissions of bloody diarrhea and abdominal pain. A recent X-ray indicated a continuous pattern of lesions in the large bowel. What underlying condition does the nurse suspect?

Choice A reason: Antidepressants, like SSRIs or tricyclics, require 3-6 weeks to achieve full therapeutic effect due to gradual neuroplastic changes, including upregulation of serotonin or norepinephrine receptors. Initial synaptic monoamine increases take time to translate into mood improvement, making this statement accurate and reassuring for the patient.

Choice B reason: Expecting symptom improvement within 7 days is unrealistic, as antidepressants require weeks to alter brain chemistry effectively. Suggesting immediate follow-up implies treatment failure prematurely, which is inaccurate. Monitoring is needed, but this statement misrepresents the typical timeline for antidepressant efficacy.

Choice C reason: Lack of symptom relief in 5-7 days does not necessitate switching medications, as antidepressants typically take 3-6 weeks for effect. Early non-response does not indicate failure, as synaptic and receptor adaptations are gradual. This statement is inaccurate and may lead to unnecessary medication changes.

Choice D reason: Incomplete symptom relief at 7 days is normal, but stating remaining symptoms are permanent is inaccurate. Antidepressants often achieve partial or full response by 6-8 weeks, and adjustments can optimize outcomes. This statement is misleading, as it falsely suggests persistent symptoms are unchangeable.

Choice A reason: Sweating, trembling, and confusion indicate hypoglycemia in type 1 diabetes, likely from excess insulin. Administering fast-acting carbohydrates (e.g., glucose tablets, juice) rapidly raises blood glucose by providing readily absorbable sugars, reversing neuroglycopenic symptoms. This is the first action to prevent seizures or coma, ensuring immediate stabilization.

Choice B reason: Administering insulin during hypoglycemia would further lower blood glucose, exacerbating symptoms and risking severe outcomes like unconsciousness. Insulin drives glucose into cells, worsening the deficit. This action is contraindicated and dangerous, as it directly opposes the need to raise blood sugar immediately.

Choice C reason: Complex carbohydrates and proteins digest slowly, providing delayed glucose release, unsuitable for acute hypoglycemia requiring rapid correction. While appropriate for long-term glucose stability, this is not the first action, as it fails to address the urgent need for fast-acting sugars to reverse symptoms.

Choice D reason: Calling the healthcare provider delays treatment of hypoglycemia, which requires immediate carbohydrate administration to prevent neurological damage. While provider consultation may follow for insulin adjustment, it is not the first action. This choice is inappropriate, as it postpones critical intervention needed for symptom resolution.