A Type 1 diabetic client with a morning (fasting) glucose of 260 mg/dL has been diagnosed with the Somogyi effect from insulin administration.
What intervention should the nurse anticipate including in the plan of care?
Increase the nighttime insulin glargine dose.
Ensure a snack is consumed at bedtime.
Check the morning cortisol level.
Check the glucose level at 2 a.m. and 8 a.m.
The Correct Answer is B
Choice A rationale
Increasing the nighttime insulin glargine dose may exacerbate the Somogyi effect, a phenomenon where the blood sugar level drops too low overnight, causing a rebound high blood sugar level in the morning.
Choice B rationale
Consuming a snack at bedtime can help prevent the blood sugar level from dropping too low overnight, thus preventing the Somogyi effect.
Choice C rationale
Checking the morning cortisol level is not directly related to managing the Somogyi effect.
Choice D rationale
Checking the glucose level at 2 a.m. and 8 a.m. can help identify the Somogyi effect, but it does not prevent it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Soaking feet once daily in warm water is not recommended for diabetic patients. This is because prolonged soaking can lead to skin breakdown and increase the risk of foot ulcers and infections.
Choice B rationale
Utilizing a mirror to examine the soles of the feet is a recommended practice for diabetic patients. This allows them to check for any cuts, sores, blisters, or changes in the skin that they may not be able to see otherwise. Early detection of these issues can prevent serious complications such as infections and ulcers.
Choice C rationale
Cutting nails in a curved direction is not advised for diabetic patients. This can lead to ingrown toenails, which can cause sores and infections. It’s recommended to cut the nails straight across to avoid this.
Choice D rationale
Using a commercial medicine to remove a corn is not recommended for diabetic patients. These products can damage the skin and increase the risk of ulcers and infections. Any issues with corns or calluses should be addressed by a healthcare professional.
Correct Answer is C
Explanation
Choice A rationale
Complaints of muscle cramps with exercise. While muscle cramps with exercise can be a symptom of peripheral arterial disease (PAD), they are more commonly associated with the earlier stages of the disease, known as intermittent claudication.
Choice B rationale
Pedal pulses are +1 bilaterally. Reduced or absent pedal pulses can be a sign of PAD, but a finding of +1 pedal pulses does not necessarily correlate with stage III of the disease.
Choice C rationale
Complaints of burning pain during the night. Stage III PAD, also known as critical limb ischemia, is characterized by more severe symptoms, including discomfort or pain in the feet or toes, even while at rest. Symptoms tend to worsen at night.
Choice D rationale
Tissue that is blackened on the great toe. This is a sign of gangrene, which is a severe and potentially life-threatening complication of PAD2. However, it is not a typical finding in stage III PAD, and would more likely be seen in the most advanced stage of the disease.
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