A client with type 2 diabetes normally achieves adequate glycemic control through diet and exercise. Upon being admitted to the hospital for a cholecystectomy, however, the client has required insulin injections on two occasions. The nurse would identify what likely cause for this short-term change in treatment?

Alterations in bile metabolism and release have likely caused hyperglycemia.

The client has likely overestimated her ability to control her diabetes using nonpharmacologic measures.

The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars.

Stress has likely caused an increase in the client's blood sugar levels.