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 D
Explanation
Rationale:
A. Hypertension does not contraindicate the use of sulfonylureas.
B. A blood glucose level of 140 mg/dL is a common finding in type 2 diabetes, and sulfonylureas are used to control such levels.
C. Shingles (herpes zoster) does not directly contraindicate the use of sulfonylureas.
D. Sulfonylureas should not be given to patients with a sulfa allergy because these medications contain sulfa compounds, which could cause an allergic reaction.
Correct Answer is C
Explanation
Rationale:
A. A butterfly rash is associated with systemic lupus erythematosus (SLE), not Cushing's syndrome.
B. Muscle hypertrophy is not typically seen in Cushing's syndrome; instead, muscle wasting may occur due to excess cortisol.
C. Moon face is a classic sign of Cushing's syndrome, resulting from fat redistribution caused by elevated cortisol levels.
D. A positive Chvostek's sign indicates hypocalcemia, which is not a finding associated with Cushing's syndrome.