A home health care nurse is assessing a patient with type 1 diabetes who has been controlled for 6 months. The nurse is surprised and concerned about a blood glucose reading of 52 mg/dL. What action by this patient most likely caused this episode of hypoglycemia?
Administering an insufficient dose of insulin this morning
Using large amounts of sugar substitute in her tea this morning
Taking a new form of birth control pill this morning
A 2-hour long exercise class at the spa this morning
The Correct Answer is D
Rationale:
A. An insufficient dose of insulin would likely cause hyperglycemia, not hypoglycemia.
B. Sugar substitutes do not affect blood glucose levels significantly and would not lead to hypoglycemia.
C. Birth control pills generally do not cause hypoglycemia.
D. Prolonged exercise increases insulin sensitivity and glucose uptake, which can lead to hypoglycemia if insulin or food intake is not adjusted accordingly. The 2-hour exercise session is the most likely cause of the hypoglycemic episode.
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View Related questions
Correct Answer is D
Explanation
Rationale:
A. Taking a laxative yesterday is not directly relevant to the IVP procedure and does not typically pose a significant risk.
B. Not eating or drinking since the night before is expected for clients scheduled for an IVP due to the need for fasting prior to the procedure.
C. Reporting painful voiding may indicate a urinary tract issue, but it is not directly related to the IVP itself.
D. Taking metformin before breakfast is concerning because metformin should generally be withheld prior to IV contrast studies due to the risk of lactic acidosis, especially if renal function is compromised.
Correct Answer is C
Explanation
Rationale:
A. Clammy skin is associated with hypoglycemia, not diabetic ketoacidosis (DKA).
B. A rapid pulse can be present in DKA, but it is not a definitive indicator of the condition.
C. Polydipsia (excessive thirst) is a hallmark symptom of DKA, as the body tries to compensate for the severe dehydration caused by hyperglycemia and osmotic diuresis.
D. Confusion can occur in DKA, but it is usually a later sign when the condition becomes severe and metabolic acidosis worsens.