The nurse is screening clients for an increased risk of thyroid cancer. Which of the following client's would have the highest risk?

A. Gestational diabetes occurs during pregnancy and typically resolves after delivery. It does not typically lead to diabetic ketoacidosis (DKA), though women with gestational diabetes are at higher risk for developing type 2 diabetes later in life.
B. Secondary diabetes results from another condition (such as a hormonal disorder or medication use) and is less commonly associated with DKA.
C. While DKA can occur in type 2 diabetes, it is much more common in type 1 diabetes, especially in cases of severe insulin deficiency or missed insulin doses.
D. Diabetic ketoacidosis (DKA) is most commonly associated with type 1 diabetes mellitus. It occurs due to a severe lack of insulin, which leads to hyperglycemia, dehydration, and the production of ketones. DKA is a life-threatening complication often seen in newly diagnosed individuals or those with poor diabetes management.

A. Milk contains calcium, which can interfere with the absorption of levothyroxine and decrease its effectiveness. It is not recommended to take it with milk.
B. Levothyroxine should be taken on an empty stomach for optimal absorption. Taking it with food, especially on a full stomach, may reduce its effectiveness.
C. While vitamin C in orange juice may enhance the absorption of some medications, it is not recommended for levothyroxine. It is best absorbed when taken with water, not juice.
D. Two hours before a meal Levothyroxine should be taken on an empty stomach, ideally 30 to 60 minutes before breakfast, but taking it at least two hours before a meal ensures the best absorption and avoids food interactions.