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. Monitoring the patient's breathing and reviewing the patient's arterial blood gases:
Rationale: While respiratory status is crucial in any patient assessment, arterial blood gases primarily evaluate respiratory function. Neutropenia directly affects the immune system, not respiratory function.
Appropriateness: Not directly related to assessing neutropenia.
B. Monitoring the patient's temperature and reviewing the patient's complete blood count with differential:
Rationale: Neutropenia can cause fever due to the increased risk of infection. Monitoring temperature and reviewing the complete blood count (CBC) with differential, specifically the neutrophil count, is essential in evaluating neutropenia and identifying potential infections.
Appropriateness: Correct. Monitoring temperature and reviewing CBC with differential are crucial in assessing neutropenia.
C. Monitoring the patient's blood pressure and reviewing the patient's hematocrit:
Rationale: Blood pressure assessment and hematocrit evaluation are essential aspects of general patient care but are not specific to neutropenia.
Appropriateness: Not directly related to assessing neutropenia.
D. Monitoring the patient's heart rate and reviewing the patient's hemoglobin:
Rationale: Heart rate monitoring and hemoglobin assessment are crucial in various clinical situations but are not specific indicators of neutropenia.
Appropriateness: Not directly related to assessing neutropenia.
Correct Answer is B
Explanation
A. Leukemia:
Explanation: Leukemia is a cancer of the blood-forming tissues, including the bone marrow and lymphatic system. It typically presents with an abnormal increase in white blood cells. While fatigue can be a symptom, increased bilirubin concentration and an increased reticulocyte count are not typical findings in leukemia.
B. Hemolytic Anemia:
Explanation: Hemolytic anemia is characterized by the premature destruction of red blood cells, leading to an increased release of bilirubin (from the breakdown of hemoglobin) and an increased reticulocyte count (as the body attempts to compensate by producing more red blood cells). This is a likely possibility given the presented symptoms.
C. Hypoproliferative Anemia:
Explanation: Hypoproliferative anemia is characterized by a decreased production of red blood cells. It is unlikely in this scenario, as an increased reticulocyte count suggests an attempt by the bone marrow to increase red blood cell production.
D. Thrombocytopenia:
Explanation: Thrombocytopenia is a condition characterized by a low platelet count. It does not typically present with an increased bilirubin concentration or an increased reticulocyte count.
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