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    Mental Health Northern Kentucky University Proctored Exam 5

    A 49-year-old female patient with type 2 diabetes (T2DM) and a BMI of 31 presents to the nurse practitioner with a swollen, thick, rubbery area of the skin on her abdomen. She recently went to the ED for a hypoglycemic episode, but today her fasting blood glucose level is 197. Which of the following most closely aligns with this clinical scenario?

    Explanation & Rationale

    Choice A reason: Antiplatelet therapy does not cause localized swelling or lipodystrophy, making this unlikely. Choice B reason: Repeated insulin injections in the same area can lead to lipodystrophy, characterized by thickened, rubbery skin. Injecting into these areas alters insulin absorption, causing unpredictable glycemic fluctuations, including hyperglycemia. Choice C reason: There is no evidence of insulin “rejection” by autoimmune disorders; this is an inaccurate explanation for the physical findings and glycemic instability. Choice D reason: Nonadherence may affect blood glucose, but the localized abdominal swelling is clinically consistent with lipodystrophy rather than deception.

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