What is a major factor in the development of type 1 diabetes?

Choice A rationale: Administering half the dose of an oral antidiabetic medication without food can still cause hypoglycemia. The patient is NPO, meaning their body is not receiving any glucose from food intake. Oral antidiabetic drugs lower blood glucose. Even a reduced dose could precipitate a hypoglycemic episode, which is particularly dangerous in a hospitalized patient undergoing a procedure.
Choice B rationale: Withholding all medications as ordered is not always the correct action without a specific order. While withholding the medication is likely the correct course of action for an NPO patient, a nurse should always follow a prescriber's explicit orders. A nurse should not withhold medications independently, especially when the patient is on a scheduled medication regimen, as this could lead to unintended consequences.
Choice C rationale: The nurse should contact the prescriber for orders to clarify the patient's medication regimen. Patients who are NPO should not take oral medications that can cause hypoglycemia without a food source. Therefore, a new order is needed to either withhold the medication or adjust the dose based on the patient's fasting status and blood glucose levels, ensuring patient safety.
Choice D rationale: Giving the medication with a sip of water is dangerous because it provides no nutritional support to counteract the medication's glucose-lowering effects. Since the patient is NPO, they are not consuming food, and the medication could cause a severe hypoglycemic event. Additionally, taking anything by mouth may violate the NPO status required for the endoscopy, compromising the procedure.

Choice A rationale: Taking insulin immediately before exercise can be dangerous for a person with diabetes. Physical activity increases glucose uptake by muscle cells, which, when combined with the effect of exogenous insulin, can lead to a rapid and significant drop in blood glucose levels, resulting in exercise-induced hypoglycemia.
Choice B rationale: Eating a large meal immediately before or during exercise is not the recommended treatment for hypoglycemia. While a large meal will raise blood glucose, it is not the most rapid or efficient method. A concentrated source of simple carbohydrates is required to quickly raise blood sugar to a safe level.
Choice C rationale: Hard candy contains simple carbohydrates, such as sucrose or dextrose, which are rapidly absorbed into the bloodstream. This quick absorption is crucial for reversing the symptoms of hypoglycemia, such as lightheadedness and shakiness, which are caused by insufficient glucose delivery to the brain.
Choice D rationale: For many people with diabetes, adjusting insulin dosage is necessary to prevent hypoglycemia during exercise. However, a blanket recommendation to take no insulin before exercise is not scientifically sound or safe. The appropriate action depends on the type, duration, and intensity of exercise, as well as current blood glucose levels.