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","B","C","E"]
Explanation
Rationale:
A. Assessing blood glucose levels is important because Cushing's syndrome can cause insulin resistance, leading to hyperglycemia.
B. Assessing for neck vein distention is necessary as it can indicate fluid overload, a common issue in Cushing's syndrome due to increased cortisol levels.
C. Weighing the client daily helps monitor for weight gain, which is a characteristic of Cushing's syndrome due to fat redistribution and fluid retention.
D. Monitoring for postural hypotension is less relevant in Cushing's syndrome; clients often experience hypertension rather than hypotension.
E. Monitoring for an irregular heart rate is important as electrolyte imbalances (like hypokalemia) associated with Cushing's can lead to cardiac arrhythmias.
Correct Answer is D
Explanation
Rationale:
A. Glucose levels are not directly affected by hyperthyroidism and are typically within the normal range unless the client has diabetes or another condition.
B. Triiodothyronine (T3) levels are elevated in hyperthyroidism due to excessive thyroid hormone production.
C. Thyroxine (T4) levels are also elevated in hyperthyroidism.
D. Thyroid stimulating hormone (TSH) is suppressed in hyperthyroidism because the thyroid gland produces excessive hormones, causing a negative feedback loop that reduces TSH levels.