A nurse in a provider's office is preparing to teach a middle adult client who has a new diagnosis of metabolic syndrome and an HbA1c of 6.5%. Which of the following medications should the nurse plan to teach the client about first?
Regular insulin
Exenatide
Insulin glargine
Metformin
The Correct Answer is D
Choice A Reason:
Regular insulin is incorrect. Regular insulin is a short-acting insulin used for managing diabetes, particularly for controlling blood sugar levels during meals. However, it's not typically the initial medication introduced in the management of metabolic syndrome with an HbA1c of 6.5%. Insulin therapy is generally considered when other medications or lifestyle changes aren't effective in controlling blood sugar levels.
Choice B Reason:
Exenatide is incorrect. Exenatide is a GLP-1 receptor agonist, used to manage type 2 diabetes. While it's effective in controlling blood sugar levels, it's often considered after initial treatments like metformin, especially in newly diagnosed cases or those with moderately elevated HbA1c levels.
Choice C Reason:
Insulin glargine is incorrect. Insulin glargine is a long-acting insulin used in diabetes management, providing a steady level of insulin throughout the day. Like regular insulin, insulin glargine is typically considered later in the treatment plan and is not usually the first medication introduced in cases of new metabolic syndrome diagnoses with moderately elevated HbA1c levels.
Choice D Reason:
Considering the client's new diagnosis and moderately elevated HbA1c level, educating about metformin aligns with the typical first-line approach in managing blood sugar levels and metabolic syndrome in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Dark amber urine is incorrect. Dark urine can indicate concentrated urine, often seen in dehydration when the body is trying to conserve water.
Choice B Reason:
Decreased skin turgor is incorrect. Decreased skin turgor is a classic sign of dehydration, indicating that the skin lacks elasticity due to insufficient fluid intake or loss.
Choice C Reason:
Pink, frothy sputum is correct. Normal saline is a common intravenous solution used to treat dehydration. However, in some cases, especially when administered in excessive amounts, it can lead to fluid overload or pulmonary edema. This can manifest as pink, frothy sputum, indicating potential pulmonary congestion or edema, which is a serious adverse effect of fluid overload.
Choice D Reason:
Increased bowel sounds is incorrect. Increased bowel sounds can be seen in various conditions, including gastrointestinal disturbances or hyperactive bowel motility, but it's not typically associated with the adverse effects of normal saline administration.
Correct Answer is C
Explanation
Choice A Reason:
Increase in serum glucose is incorrect. Desmopressin, which is a synthetic form of vasopressin, primarily affects water reabsorption in the kidneys and doesn't directly impact glucose levels. Therefore, an increase in serum glucose wouldn't be an expected therapeutic response to desmopressin for diabetes insipidus.
Choice B Reason:
Decrease in blood pressure is incorrect. Desmopressin is primarily used for its antidiuretic effect, concentrating urine by increasing water reabsorption in the kidneys. It typically doesn't have a significant impact on blood pressure. Therefore, a decrease in blood pressure wouldn't typically be an anticipated therapeutic response to desmopressin in this context.
Choice C Reason:
Decrease in urine output is correct. Desmopressin is a synthetic form of vasopressin (antidiuretic hormone) used to treat diabetes insipidus, a condition characterized by excessive urination and extreme thirst due to the inability to concentrate urine. The primary goal of desmopressin is to reduce urine output by increasing water reabsorption in the kidneys, thereby decreasing excessive urination. Therefore, a decrease in urine output would indicate a therapeutic response to the medication in this context.
Choice D Reason:
Increase in WBC count is incorrect. Desmopressin's action is centered on affecting kidney function by regulating water reabsorption and does not involve changes in white blood cell count. Consequently, an increase in WBC count wouldn't be an expected therapeutic response to desmopressin for diabetes insipidus.
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