A client diagnosed with type 1 diabetes states he is not comfortable with self-injections and asks the nurse if oral an anti- diabetic agent can be prescribed instead. Which of the following responses from the nurse is appropriate?
"Diet, exercise and oral medications can be effective. I will ask the physician to prescribe Metformin"
"Your body does not produce insulin, and the only treatment is injected insulin"
"Glucophage can help your body better utilize the insulin secreted by the pancreas"
"Initially, you will need injections, but after your body adjusts to the insulin, you can switch to Metformin"
The Correct Answer is B
A. "Diet, exercise, and oral medications can be effective. I will ask the physician to prescribe Metformin":
Explanation: This statement is not accurate for type 1 diabetes. Type 1 diabetes results from the inability of the pancreas to produce insulin, so oral medications like Metformin, which work to increase insulin sensitivity or reduce glucose production in the liver, are not effective. Insulin replacement is the mainstay of treatment for type 1 diabetes.
B. "Your body does not produce insulin, and the only treatment is injected insulin":
Explanation: This is the correct statement. In type 1 diabetes, the pancreas does not produce insulin or produces very little, and insulin cannot be taken orally because it would be broken down in the digestive system. Therefore, injections are the primary and necessary mode of insulin delivery.
C. "Glucophage can help your body better utilize the insulin secreted by the pancreas":
Explanation: This statement is more applicable to type 2 diabetes, where the pancreas may still produce insulin, but the body's cells are resistant to its effects. In type 1 diabetes, the issue is a lack of insulin production, so medications to improve insulin utilization are not relevant.
D. "Initially, you will need injections, but after your body adjusts to the insulin, you can switch to Metformin":
Explanation: This is not accurate for type 1 diabetes. The need for insulin in type 1 diabetes is not something the body adjusts to over time. Insulin is a lifelong requirement for individuals with type 1 diabetes, and it cannot be replaced by oral medications like Metformin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. 30 minute onset; 2-hour duration: This does not accurately represent the onset and peak action time of Insulin Lispro.
B. 15 minute onset; 30-60 minutes peak: This is correct. Insulin Lispro has a rapid onset (starts working within 15 minutes) and a peak action time of 30-60 minutes after administration.
C. 2-hour onset; 12-hour duration: This is not accurate for rapid-acting insulin. Rapid-acting insulin has a much quicker onset and shorter duration compared to this option.
D. 15 minute onset; no peak (continuous): While the onset time is correct, stating "no peak" is not entirely accurate. Rapid-acting insulin does have a peak, but it's relatively short, occurring within the first hour after administration.
Correct Answer is A
Explanation
A. Stress has likely caused an increase in the client's blood sugar levels:
This statement is accurate. Stress, especially related to surgery, can lead to increased levels of stress hormones, such as cortisol and catecholamines, which can elevate blood sugar levels. Surgery is a physiological stressor that can impact glucose metabolism.
B. The client's volatile fluid balance surrounding surgery has likely caused unstable blood sugars:
This is the most appropriate choice. Surgery, anesthesia, and changes in fluid balance can affect blood glucose levels. The stress response to surgery can lead to fluctuations in blood sugar, and patients may need insulin during this period.
C. The client has likely overstimulated her ability to control her diabetes using non-pharmacologic measures:
This statement is not accurate. Overstimulation is not a common cause of the need for insulin in the context of surgery. The stress and physiological changes associated with surgery are more likely contributors.
D. Alterations in bile metabolism and release have likely caused hyperglycemia:
While alterations in metabolism can impact glucose regulation, in the context of surgery, the primary factors are the stress response, changes in fluid balance, and potential alterations in the ability to eat or drink normally rather than specific effects on bile metabolism.
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