A client diagnosed with type 1 diabetes mellitus has experienced the Somogyi effect. Which explanation best describes this phenomenon?

The client has hypoglycemia during the night and hyperglycemia in the morning.

The client has not taken the prescribed insulin dose prior to the evening meal.

The client will have an abnormal glycosylated hemoglobin (HbA1c) for the next two months.

The client will experience complications earlier than other clients with type 1 diabetes mellitus do.

Answer and Explanation

The Correct Answer is A

Choice A reason: The client has hypoglycemia during the night and hyperglycemia in the morning is the best explanation because it is the definition of the Somogyi effect, which is a rebound phenomenon that occurs in some people with type 1 diabetes mellitus. Type 1 diabetes mellitus is a condition where the pancreas does not produce enough insulin, which is a hormone that helps the cells use glucose, which is a sugar that provides energy for the body. The Somogyi effect happens when the blood glucose level drops too low during the night, usually due to taking too much insulin or not eating enough carbohydrates before bedtime. This triggers the release of hormones, such as glucagon, epinephrine, and cortisol, that raise the blood glucose level by stimulating the liver to produce more glucose and by preventing the cells from using glucose. This results in a high blood glucose level in the morning, which is called hyperglycemia.

Choice B reason: The client has not taken the prescribed insulin dose prior to the evening meal is not the best explanation because it is a factor that can cause the opposite of the Somogyi effect, which is the dawn phenomenon. The dawn phenomenon is a condition where the blood glucose level rises in the early morning, usually due to the natural increase of hormones, such as growth hormone and cortisol, that occur during the night. These hormones reduce the effectiveness of insulin and increase the blood glucose level. The dawn phenomenon can be worsened by not taking enough insulin or by eating too many carbohydrates in the evening.

Choice C reason: The client will have an abnormal glycosylated hemoglobin (HbA1c) for the next two months is not the best explanation because it is a consequence, not a cause, of the Somogyi effect. Glycosylated hemoglobin (HbA1c) is a test that measures the average blood glucose level over the past two to three months, by showing how much glucose is attached to the hemoglobin, which is the protein that carries oxygen in the red blood cells. The Somogyi effect can cause the HbA1c level to be higher than expected, because it reflects the high blood glucose level in the morning, not the low blood glucose level during the night.

Choice D reason: The client will experience complications earlier than other clients with type 1 diabetes mellitus do is not the best explanation because it is a general statement, not a specific explanation, of the Somogyi effect. The Somogyi effect can increase the risk of complications, such as eye, kidney, nerve, and heart problems, because it causes fluctuations in the blood glucose level, which can damage the blood vessels and the organs. However, the Somogyi effect is not the only factor that can affect the development and progression of complications. Other factors, such as genetics, lifestyle, and comorbidities, can also play a role.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: The thyroid gland is cancerous is not a correct description of a goiter. A goiter is a non-specific term that refers to any enlargement of the thyroid gland, which may have various causes and may or may not be associated with thyroid cancer.

Choice B reason: The client has a low serum calcium level is not a correct description of a goiter. A low serum calcium level is a sign of hypoparathyroidism, which is a condition that affects the parathyroid glands, not the thyroid gland. The parathyroid glands are located behind the thyroid gland and regulate the calcium and phosphorus levels in the blood.

Choice C reason: The thyroid gland has been surgically removed is not a correct description of a goiter. A goiter is a condition that involves the presence of an enlarged thyroid gland, not the absence of it. A surgical removal of the thyroid gland is called a thyroidectomy, which may be done for various reasons such as thyroid cancer, hyperthyroidism, or large goiters.

Choice D reason: The thyroid gland is enlarged is the best description of a goiter. A goiter is a condition that involves the enlargement of the thyroid gland, which may be due to iodine deficiency, autoimmune disease, inflammation, infection, benign nodules, or thyroid hormone imbalance. A goiter may cause symptoms such as difficulty swallowing, breathing, or speaking, hoarseness, cough, or neck discomfort.

A. Initiates the fibrinolytic process in the arteries B. Decreases highly sensitive C-reactive protein (hsCRP) levels C. Damages the endothelium of the arteries D. Causes diffuse arterial vasoconstriction

Correct Answer is C

Explanation

Choice A reason: Initiates the fibrinolytic process in the arteries is not a role of inflammation in the development of atherosclerosis, but a protective mechanism against it. Fibrinolysis is the breakdown of blood clots by enzymes such as plasmin. It prevents the formation of thrombi that can occlude the arteries and cause ischemia.

Choice B reason: Decreases highly sensitive C-reactive protein (hsCRP) levels is not a role of inflammation in the development of atherosclerosis, but an indicator of it. hsCRP is a marker of systemic inflammation that is produced by the liver in response to cytokines. It is elevated in patients with atherosclerosis and correlates with the risk of cardiovascular events.

Choice C reason: Damages the endothelium of the arteries is the main role of inflammation in the development of atherosclerosis. Endothelial injury exposes the subendothelial layer to the blood, which triggers the adhesion of monocytes and platelets. Monocytes differentiate into macrophages and engulf oxidized low-density lipoproteins (LDL), forming foam cells. Foam cells accumulate in the intima and form fatty streaks, which are the earliest lesions of atherosclerosis.

Choice D reason: Causes diffuse arterial vasoconstriction is not a role of inflammation in the development of atherosclerosis, but a consequence of it. Atherosclerosis narrows the lumen of the arteries and reduces the blood flow to the tissues. This causes ischemia, which stimulates the release of vasoconstrictors such as angiotensin II and endothelin. Vasoconstriction further worsens the ischemia and increases the blood pressure.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client diagnosed with type 1 diabetes mellitus has experienced the Somogyi effect. Which explanation best describes this phenomenon?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During review of a client's history, the nurse notes that a goiter is present. Which statement best describes a goiter?

Correct Answer is D

Explanation

Which explanation does the nurse know best describes the role of inflammation in the development of atherosclerosis?

Correct Answer is C

Explanation

The nurse cares for the client with a history of pulmonary tuberculosis (TB). Two granulomas were present in the chest x-ray. Which explanation does the nurse understand best describes the primary immune response to tuberculosis infection?

Which explanation best describes the most common cause of duodenal ulcers?

The nurse provides care for a client with a 10-year history of Crohn's disease. Which finding best describes a common complication of Crohn's disease?

The nurse provides care for a client immediately after a motor vehicle accident. The nurse notes BP 90/52 mmHg, absent breath sounds over the right lung, shallow RR 28 breaths/minute, and displacement of the trachea to the left side. Which explanation is correct for these findings?

The nurse cares for a client who has had a left-sided intracerebral hemorrhage. The client is unable to detect light and pain touch on the right arm. Which explanation best describes these observations?

Which term describes the inflammatory mediator released during the early phase of type 1 hypersensitivity response causing immediate bronchoconstriction and vasodilation?

The nurse expects to observe which finding during the assessment of a client diagnosed with myxedema?

The nurse cares for a client with severe ascites due to alcoholic cirrhosis. Which description best explains the mechanism for ascites development in this client?