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. Vitamin D levels may be normal or low in hypoparathyroidism, but this value is within the expected range.
B. Calcium levels are expected to be low in hypoparathyroidism. A calcium level of 9.8 mg/dL is within the normal range (8.5 to 10.5 mg/dL), which is not consistent with hypoparathyroidism.
C. Magnesium levels are often normal or low in hypoparathyroidism, but this value is within the normal range.
D. Hypoparathyroidism results in hypocalcemia and hyperphosphatemia due to insufficient parathyroid hormone (PTH) secretion. A phosphate level of 5.7 mg/dL is elevated, which is consistent with this condition.
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.