A nurse is reinforcing teaching about exercise with a client who has type 1 diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching?
“I should avoid injecting insulin into my thigh if I am going to go running.”
“I will carry a complex carbohydrate snack with me when I exercise.”
“I should exercise first thing in the morning before eating breakfast.”
“I will increase the intensity of my exercise routine if my urine is positive for ketones.”
The Correct Answer is A
Choice A reason: Injecting insulin into a muscle that is going to be exercised can increase the absorption of insulin and lower the blood glucose level, leading to hypoglycemia. Therefore, it is advisable to avoid injecting insulin into the same body part that will be involved in the exercise.
Choice B reason: Carrying a complex carbohydrate snack with you when you exercise is not a good idea. Complex carbohydrates take longer to digest and raise the blood glucose level slowly. They are not suitable for treating or preventing hypoglycemia during or after exercise. A simple carbohydrate snack, such as glucose tablets, juice or candy, is more appropriate for this purpose.
Choice C reason: Exercising first thing in the morning before eating breakfast is not recommended for people with type 1 diabetes. This can cause a drop in blood glucose level and increase the risk of hypoglycemia. It is beter to have a balanced breakfast that includes some carbohydrates and adjust the insulin dose accordingly before exercising.
Choice D reason: Increasing the intensity of your exercise routine if your urine is positive for ketones is a dangerous practice. Ketones are produced when the body breaks down fat for energy due to lack of insulin or glucose. High levels of ketones can lead to diabetic ketoacidosis, a life-threatening condition that requires urgent medical atention. Intense exercise can raise the blood glucose level further and worsen the situation. If your urine is positive for ketones, you should avoid vigorous activity and check your blood glucose and ketone levels frequently.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Wearing closed-toed shoes daily is a good practice for people with diabetes, as it can protect the feet from injuries and infections. However, it is not the most important action for preventing long-term complications of retinopathy and neuropathy. These complications are mainly caused by high blood glucose levels that damage the blood vessels and nerves in the eyes and feet.
Choice B reason: Maintaining stable blood glucose levels is the most important action for preventing long-term complications of retinopathy and neuropathy. High blood glucose levels can cause oxidative stress, inflammation, and endothelial dysfunction, which impair the blood flow and oxygen delivery to the eyes and feet. This can lead to nerve damage (neuropathy) and vision loss (retinopathy) over time. Keeping blood glucose levels within the target range can reduce the risk of these complications and slow down their progression if they already exist.
Choice C reason: Planning to have an eye examination once per year is a recommended action for people with diabetes, as it can help detect and treat retinopathy before it causes irreversible damage to the retina. However, it is not the most important action for preventing long-term complications of retinopathy and neuropathy. Eye examinations cannot prevent retinopathy from occurring or worsening; they can only monitor its status and provide appropriate interventions.
Choice D reason: Examining your feet carefully every day is another recommended action for people with diabetes, as it can help identify and treat any signs of neuropathy, such as numbness, tingling, pain, or ulcers. However, it is not the most important action for preventing long-term complications of retinopathy and neuropathy. Foot examinations cannot prevent neuropathy from occurring or worsening; they can only monitor its status and provide appropriate care.
Correct Answer is D
Explanation
Choice A: Both illnesses result in malabsorption of nutrients. This is incorrect because malabsorption of nutrients is more common in Crohn’s disease than in ulcerative colitis. Crohn’s disease can affect any part of the gastrointestinal tract, including the small intestine, where most of the nutrient absorption occurs. Ulcerative colitis mainly affects the colon and rectum, which are responsible for water and electrolyte absorption.
Choice B: Both illnesses begin in the rectum. This is incorrect because ulcerative colitis usually begins in the rectum and spreads proximally to the colon, while Crohn’s disease can begin anywhere in the gastrointestinal tract, from the mouth to the anus.
Choice C: Both illnesses manifest fistula formation. This is incorrect because fistula formation is more common in Crohn’s disease than in ulcerative colitis. Fistulas are abnormal connections between different parts of the gastrointestinal tract or other organs, such as the bladder, vagina, or skin. They are caused by inflammation, ulceration, and infection that penetrate through the bowel wall.
Choice D: Both illnesses are inflammatory in nature. This is correct because both ulcerative colitis and Crohn’s disease are types of inflammatory bowel disease (IBD), which are chronic conditions that cause inflammation and damage to the gastrointestinal tract. The exact cause of IBD is unknown, but it may involve genetic, immune, environmental, and microbial factors.
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