Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise?

I carry a piece of hard candy with me in case I start to feel shaky.

I make sure I have emergency money when I have soccer practice or a game.

Sometimes I skip my breakfast when I have a game in the morning.

I play in soccer games that are scheduled after dinner.

Answer and Explanation

The Correct Answer is C

Choice A rationale: Carrying a piece of hard candy is a proactive and safe strategy for managing hypoglycemia during exercise. A hard candy provides a rapid source of glucose, which can quickly elevate blood sugar levels if they begin to drop. This demonstrates an understanding of how to prevent and treat exercise-induced hypoglycemia, a common concern for individuals with diabetes.
Choice B rationale: Having emergency money is a prudent measure to manage unexpected situations related to diabetes, such as needing to purchase food or glucose tablets if an episode of hypoglycemia occurs. This action indicates a level of preparedness and understanding of the potential risks associated with physical activity when managing diabetes, showcasing good self-management skills.
Choice C rationale: Skipping breakfast before morning exercise, such as a soccer game, is dangerous and indicates a significant knowledge deficit. This behavior dramatically increases the risk of exercise-induced hypoglycemia because the body's glucose stores are already low from an overnight fast, and the added energy expenditure from exercise can deplete them further, leading to a hypoglycemic episode.
Choice D rationale: Playing in a soccer game after dinner is a safe practice. It demonstrates an understanding of timing exercise relative to meals. The meal provides a source of carbohydrates, which helps to maintain stable blood glucose levels during the physical activity, reducing the risk of hypoglycemia. This is a well-managed approach to combining physical activity with diabetes care.

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Correct Answer is C

Explanation

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.

A. Hypothyroidism. B. Hyperthyroidism. C. Type 2 diabetes mellitus. D. Tay-Sachs disease.

Correct Answer is A

Explanation

Choice A rationale: Hypothyroidism, or an underactive thyroid gland, in infants is often congenital and characterized by insufficient thyroid hormone production. Thyroid hormones are crucial for metabolic rate regulation and neurologic development. Insufficient levels lead to a slowed metabolism, causing symptoms like lethargy and excessive sleep. Snoring can be a sign of macroglossia, or an enlarged tongue, which is also associated with congenital hypothyroidism.
Choice B rationale: Hyperthyroidism, or an overactive thyroid gland, is characterized by the overproduction of thyroid hormones, leading to an increased metabolic rate. This condition would manifest in an infant with symptoms that are the opposite of those described, such as irritability, sleeplessness, and an increased appetite, not lethargy or excessive sleep. These symptoms reflect a hypermetabolic state.
Choice C rationale: Type 2 diabetes mellitus is a metabolic disorder characterized by insulin resistance and hyperglycemia. While it can cause lethargy and excessive sleepiness, it is extremely rare in infants and is not associated with snoring or an enlarged tongue. The primary symptoms in this age group are more likely to be related to fluid balance and glucose control.
Choice D rationale: Tay-Sachs disease is a rare, fatal, neurodegenerative genetic disorder. It results from the absence of a vital enzyme, hexosaminidase A, which leads to the buildup of gangliosides in the brain. Symptoms typically appear around 6 months of age and include a startle response, loss of motor skills, and an exaggerated response to noise, not lethargy or snoring.

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Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise?

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Naxlex Comprehensive Predictor Exams

A client tells the nurse that sometimes he gets lightheaded and shaky when he exercises. The nurse advised him to always:

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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