A nurse is caring for four clients for whom she has to administer oral medications in the morning. The nurse should administer which of the following medications before breakfast?

A) "I can store unopened bottles of insulin in the freezer."

This statement is incorrect. Insulin should not be stored in the freezer. Insulin should be stored in the refrigerator, and the currently used vial can be kept at room temperature for up to 28 days to avoid the discomfort of injecting cold insulin.

B) "I should not take my regular insulin when I am sick."

This statement is incorrect. When a person with type 1 diabetes is sick, it's important to continue taking insulin. In fact, during illness, blood sugar levels can become more difficult to manage, and insulin may be needed in adjusted doses. Skipping insulin during sickness can lead to uncontrolled blood sugar levels and potentially worsen the illness.

C) "My morning blood glucose should be between 90 and 130."

This statement is a good range to aim for in terms of fasting blood glucose levels, but it's not an indication of understanding the teaching about diabetes management as a whole. While this knowledge is important, the statement about eating a snack before playing soccer directly reflects understanding of how to manage blood sugar during physical activity.

"D) I should eat a snack half an hour before playing soccer."

Explanation:

Managing blood sugar levels is crucial for individuals with type 1 diabetes, especially when engaging in physical activities like playing soccer. Eating a snack before playing helps prevent hypoglycemia (low blood sugar) during exercise. Physical activity can cause the body to use up glucose faster, potentially leading to low blood sugar levels, and having a snack before exercise can help maintain stable blood sugar levels.

A. Allow for adjustment of rules to correlate with the child's behavior.Rules should be consistent and predictable for children with ASD. Frequently changing or “adjusting” rules to match variable behavior increases confusion and anxiety and reduces opportunities to learn expected behaviors.

B. Allow for imaginative play with peers without supervision.
Many children with ASD need structured, supervised social interactions and support to learn play skills, take turns, and interpret social cues. Unsupervised imaginative play may lead to misunderstanding, frustration, or safety issues.

C. Provide a flexible schedule that adjusts to the child's interests.
While incorporating a child’s interests into activities is useful, children with ASD generally do best with a structured, predictable schedule. Sudden flexibility or frequent schedule changes can be disorienting. Best practice: keep a consistent routine but incorporate preferred interests within that structure.

D. Establish a reward system for positive behavior.A reward system (token economy, sticker charts, immediate specific praise) provides clear, consistent, and concrete reinforcement for targeted behaviors. This increases motivation, helps teach expected behaviors, and can be faded gradually as behaviors become routine.