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 will carry a complex carbohydrate snack with me when I exercise."
"I should exercise first thing in the morning before eating breakfast."
"I should avoid injecting insulin into my thigh if I am going to go running."
"I will increase the intensity of my exercise routine if my urine is positive for ketones."
The Correct Answer is C
Rationale:
A. Carrying a simple carbohydrate snack (not a complex one) is recommended during exercise to prevent hypoglycemia, but this is not the correct statement.
B. Exercising first thing in the morning before eating can cause hypoglycemia due to low glucose levels after fasting.
C. Injecting insulin into the thigh before running can increase absorption rates, leading to hypoglycemia. Rotating injection sites and avoiding muscle groups that will be heavily exercised is recommended.
D. Exercise should be avoided if ketones are present in the urine, as it can indicate inadequate insulin and the risk of diabetic ketoacidosis.
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Correct Answer is A
Explanation
Rationale:
A. Weight gain is common in hypothyroidism due to a slowed metabolism.
B. Diaphoresis is more associated with hyperthyroidism, not hypothyroidism.
C. Palpitations are a symptom of hyperthyroidism.
D. Protruding eyeballs (exophthalmos) is associated with Graves' disease, a form of hyperthyroidism.
Correct Answer is B
Explanation
Rationale:
A. Weight gain is typically associated with hypothyroidism; clients with hyperthyroidism often experience weight loss due to increased metabolism.
B. Frequent mood changes, including anxiety and irritability, are common in hyperthyroidism as a result of increased thyroid hormone levels affecting mood regulation.
C. Sensitivity to cold is associated with hypothyroidism; hyperthyroid clients usually have an increased sensitivity to heat.
D. Constipation is more characteristic of hypothyroidism; hyperthyroidism often causes increased bowel movements or diarrhea.