The nurse is planning discharge instructions for a client with type 2 diabetes who will be starting exenatide.

Which information should be included in the discharge instructions?

Choice A rationale:

"Phobias are characterized by persistent and irrational fear" (Choice A) is an accurate statement. Phobias are defined by the presence of an intense and irrational fear of a specific object or situation. This fear is persistent and often leads to avoidance behaviors, which can significantly impact the individual's daily life.

Choice B rationale:

"Phobias can be caused by biological factors only" (Choice B) is an inaccurate statement. Phobias can have various causes, including both biological and psychological factors. While there may be genetic predispositions to certain phobias, psychological factors, such as traumatic experiences or learned behaviors, can also contribute to the development of phobias.

Choice C rationale:

"Phobias can be diagnosed based on physical symptoms" (Choice C) is an inaccurate statement. Phobias are typically diagnosed based on the individual's reported symptoms, such as intense fear and avoidance behaviors. There are no specific physical symptoms that directly indicate the presence of a phobia.

Choice D rationale:

"Phobias can be managed with medication alone" (Choice D) is an inaccurate statement. Medication alone is not considered the primary treatment for phobias. While medications like selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines may be prescribed to alleviate anxiety symptoms, the most effective treatment for phobias is psychotherapy, particularly exposure therapy or cognitive-behavioral therapy. These therapies address the root causes of the phobia and help individuals learn to manage their fear.

Choice A rationale:

Systemic autoimmune vasculopathy is not a typical underlying disease pathology associated with a waddling gait and frequent falls in a 5-year-old child. This choice is not relevant to the symptoms described.

Choice B rationale:

Autonomic neuropathy may manifest with a variety of symptoms, including autonomic dysregulation, but it is not a common underlying pathology leading to a waddling gait and frequent falls in a child. This choice is not relevant to the symptoms described.

Choice C rationale:

Impaired neuron function can result in various neurological symptoms, but it does not specifically explain the waddling gait and frequent falls in a 5-year-old child. This choice is not relevant to the symptoms described.

Choice D rationale:

Muscle fiber degeneration is the most appropriate explanation for the symptoms of a waddling gait and frequent falls in a 5-year-old child. These symptoms are indicative of a neuromuscular disorder known as Duchenne muscular dystrophy (DMD), which involves progressive muscle weakness and degeneration. DMD is characterized by the loss of muscle fibers and is a common cause of a waddling gait and falls in affected children. Therefore, choice D is the correct answer based on the understanding of the underlying disease pathology.