A nurse in a clinic is assessing a client who has type 1 diabetes mellitus. The client is diaphoretic, has a heart rate of 92/min, and reports palpitations. The client states, "I went for my morning run and feel exhausted." Which of the following responses should the nurse make?

"Were you careful to not have carbohydrates after the run?"

"It is normal to feel this way after a morning run."

"It becomes easier when exercise is a routine."

"Did you decrease your insulin intake before you exercised?"

Answer and Explanation

The Correct Answer is D

Choice A reason: Advising the client to avoid carbohydrates after exercise is not appropriate. Carbohydrates are necessary to replenish glycogen stores after exercise, and individuals with diabetes need to monitor their blood sugar levels to manage carbohydrate intake accordingly.

Choice B reason: Saying it is normal to feel exhausted after a morning run does not address the client's symptoms of diaphoresis, increased heart rate, and palpitations, which could be signs of hypoglycemia, a common risk for individuals with type 1 diabetes after exercise.

Choice C reason: While it's true that exercise can become easier with routine, this statement does not address the client's immediate concerns about their symptoms following exercise.

Choice D reason: Asking if the client decreased their insulin intake before exercising is an appropriate response. Individuals with type 1 diabetes need to adjust their insulin dosage to account for physical activity, which can significantly lower blood glucose levels.

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Correct Answer is D

Explanation

Choice A reason: Gurgling bowel sounds every 10 seconds are considered normal, as normoactive bowel sounds range from 5 to 30 sounds per minute. This finding indicates regular gastrointestinal activity and is not typically a cause for concern.

Choice B reason: A centrally located umbilical protrusion can be a normal finding, especially if it has been present since birth and is not associated with any other symptoms. However, if new or associated with pain or other symptoms, it could indicate a hernia or other pathology.

Choice C reason: Abdominal distention during breathing can be a normal finding, as the abdomen may distend slightly during deep breathing due to the movement of the diaphragm. However, if the distention is pronounced or associated with other symptoms, it may warrant further investigation.

Choice D reason: Rebound tenderness with palpation is a sign of peritoneal irritation and can be an indication of conditions such as appendicitis, which is a surgical emergency. This finding should be considered a priority as it may require immediate intervention.

A. Clear items from the client's surrounding area. B. Loosen the client's restrictive clothing. C. Lower the client to the floor. D. Obtain the client's vital signs.

Correct Answer is C

Explanation

Choice A reason: Clearing items from the client's surrounding area is important, but it is not the first action a nurse should take. The priority is to prevent injury to the client, and while removing potential hazards is part of this, it comes after ensuring the client's immediate safety.

Choice B reason: Loosening restrictive clothing can help the client breathe more easily and prevent further injury. However, this is not the first step in seizure first aid. The initial focus should be on preventing injury by controlling the client's fall.

Choice C reason: Lowering the client to the floor is the first and most critical action to take. This prevents a fall that could result in serious injury. Once on the floor, the client should be turned gently onto one side to help maintain an open airway and allow any fluids to drain, which can help prevent aspiration.

Choice D reason: Obtaining the client's vital signs is a secondary action after the seizure has ended. During a seizure, the primary concern is the client's immediate safety, which includes preventing injury and maintaining an open airway.

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A nurse in a clinic is assessing a client who has type 1 diabetes mellitus. The client is diaphoretic, has a heart rate of 92/min, and reports palpitations. The client states, "I went for my morning run and feel exhausted." Which of the following responses should the nurse make?

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