Correct Answer: A

Rationale: The correct answer is A because the patient with type 1 diabetes should check glucose levels before, during, and after swimming to monitor for fluctuations and adjust insulin or food intake accordingly. This allows for better glycemic control and prevents hypoglycemia or hyperglycemia during and after swimming.


Choice B is incorrect because delaying eating can lead to hypoglycemia during swimming due to increased insulin action without adequate glucose intake.
Choice C is incorrect as increasing NPH insulin dose without monitoring glucose levels can result in hypoglycemia during exercise.
Choice D is incorrect because timing the insulin injection for peak action while swimming can also lead to hypoglycemia if glucose levels are not monitored.

Correct Answer: D

Rationale: The correct answer is D. It is essential to maintain the patient's blood glucose levels to prevent hypoglycemia. Since the patient missed lunch, returning them to the unit to eat ensures timely access to food for glycemic control. This action addresses the immediate need for nutrition and glucose intake.

A: Saving the lunch tray is not immediate and does not address the patient's current hypoglycemia risk.
B: Starting a dextrose IV is an option for severe hypoglycemia, not for preventing it in this scenario.
C: Sending milk or orange juice may help raise blood sugar but does not address the need for a complete meal to prevent hypoglycemia.

Correct Answer: C

Rationale: The correct answer is C because metformin is typically held before a coronary angiogram due to the risk of lactic acidosis. This information is crucial for the health care provider to know to prevent potential complications during the procedure. Option A is not as urgent as the patient's current medication status. Option B is less relevant as it does not impact the procedure directly. Option D is important but not as critical as knowing the status of metformin intake. Reporting the patient's current medication, especially metformin, is vital for ensuring patient safety during the coronary angiogram.

Correct Answer: B

Rationale: The correct answer is B (as soon as possible) because individuals with type 2 diabetes are at risk for diabetic retinopathy, a complication that can lead to vision loss. Early detection through a dilated eye exam allows for timely intervention to prevent or slow down progression.
Choice A (every 2 years) may not be frequent enough for early detection.
Choice C (when the patient is 39 years old) is not specific to the individual's diabetes diagnosis.
Choice D (within the first year after diagnosis) is too delayed for optimal monitoring. Thus, scheduling a dilated eye exam as soon as possible is crucial for early detection and management of diabetic retinopathy.

Correct Answer: B

Rationale: The correct answer is B: Potassium 5.8 mEq/L. In hypovolemia, there is a decrease in blood volume leading to electrolyte imbalances. Potassium levels outside the normal range can be life-threatening, causing cardiac arrhythmias.
Therefore, a potassium level of 5.8 mEq/L is a priority to report to the provider for prompt intervention.

Rationale for why the other choices are incorrect:
A: BUN within the normal range. It may indicate dehydration but not immediately life-threatening.
C: Creatinine slightly elevated, indicating kidney function impairment but not as critical as potassium imbalance.
D: Sodium within acceptable range, not an immediate concern in hypovolemia.