A client with type 2 diabetes has been treated for severe bronchitis and has been on intravenous corticosteroids and antibiotics for the past week.
The bronchitis symptoms have resolved, but the nurse notes that the client’s blood glucose level is elevated. What is the most likely reason for this increase?
The corticosteroids may have caused an increase in glucose levels.
The type 2 diabetes has now converted to type 1.
The bronchitis has made the tissues less sensitive to insulin.
The antibiotics may have caused an increase in glucose levels.
The Correct Answer is A
Choice A rationale
Corticosteroids, like the ones the client has been receiving for severe bronchitis, can cause an increase in glucose levels. This is because corticosteroids can stimulate the liver to release extra glucose and can also make body tissues less sensitive to insulin.
Choice B rationale
Type 2 diabetes does not convert to type 1 diabetes. These are two distinct conditions with different causes.
Choice C rationale
While illness and stress can make the body’s tissues less sensitive to insulin, leading to higher blood glucose levels, the client’s bronchitis symptoms have resolved. Therefore, this is not the most likely reason for the increase in glucose levels.
Choice D rationale
Antibiotics do not typically cause an increase in glucose levels. Therefore, this is not the most likely reason for the increase in glucose levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Tuberculous meningitis is a serious condition, but it is not a contraindication for the use of prednisone.
Choice B rationale
Chronic obstructive pulmonary disease (COPD) is not a contraindication for prednisone. In fact, prednisone is often used to treat exacerbations of COPD56.
Choice C rationale
Cerebral edema is not a contraindication for prednisone. Prednisone is sometimes used to reduce inflammation and swelling in the brain.
Choice D rationale
Peptic ulcer disease is a contraindication for the use of prednisone. Prednisone can increase the risk of peptic ulcers by increasing stomach acid secretion and decreasing the production of protective mucus in the stomach.
Correct Answer is A
Explanation
Choice A rationale
When a patient is administering both regular insulin and NPH insulin, it’s important to draw up the regular insulin first. This is because regular insulin is clear and NPH insulin is cloudy. If the NPH (cloudy) insulin were drawn up into the syringe first, it could contaminate the regular (clear) insulin when drawing it up second. This could affect the action of the regular insulin, which is meant to be fast-acting.
Choice B rationale
Mixing insulins in a vial before drawing them up is not recommended. This could lead to inaccurate dosing and potential contamination of one or both vials. It’s safer and more accurate to draw up each type of insulin separately into the syringe.
Choice C rationale
While it’s possible to administer insulin using separate syringes, it’s usually not necessary and can be more cumbersome for the patient. As long as the patient is careful to avoid contaminating the insulins and to draw them up in the correct order (regular before NPH), they can be administered together in the same syringe.
Choice D rationale
Drawing up the NPH insulin last is not correct. As mentioned earlier, the regular insulin should be drawn up first to avoid contaminating it with the NPH insulin.
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