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 A
Explanation
Choice A Reason:
Identify the client using two identifiers is correct. Prior to administering any medication, especially controlled substances, it's crucial to confirm the client's identity using two unique identifiers, such as their name and date of birth or an identification band and verbal confirmation. Ensuring accurate identification helps prevent medication errors and ensures the right medication is given to the right patient.
Choice B Reason:
Compare the amount of medication available to the inventory record is incorrect. This is part of maintaining accurate documentation and inventory control, ensuring that the amount of medication matches the recorded inventory. However, it typically occurs after confirming the client's identity.
Choice C Reason:
Document the administration of the medication is incorrect. Documentation of medication administration is crucial for legal and medical purposes but should occur after the medication has been safely administered to the correct patient.
Choice D Reason:
Remove the medication from the medication dispensing cabinet is incorrect. Retrieving the medication from the dispensing cabinet is an essential step in the administration process, but it should occur after confirming the client's identity to ensure the right medication is administered to the right individual.
Correct Answer is D
Explanation
Choice A Reason:
Bilateral muscle weakness is not typically associated specifically with fluid volume excess. Muscle weakness can result from various causes, such as electrolyte imbalances or certain medical conditions, but it's not a primary manifestation of fluid volume excess.
Choice B Reason:
Thready pulse is not correct. A thready pulse refers to a weak and barely palpable pulse. This is more commonly associated with conditions like shock or reduced cardiac output rather than fluid volume excess.
Choice C Reason:
Decreased bowel sounds is not correct. Reduced or absent bowel sounds may indicate gastrointestinal issues, but they are not a direct manifestation of fluid volume excess. Increased bowel sounds might be more associated with certain types of gastrointestinal disturbances or fluid imbalances, but decreased sounds are not a typical sign of fluid volume excess.
Choice D Reason:
Distended neck veins is correct. In a client experiencing fluid volume excess, distended neck veins can often be observed due to increased venous pressure. This occurs as a result of the body retaining more fluid than it can handle, leading to an increase in blood volume and pressure within the vascular system. This can cause the jugular veins in the neck to appear distended or prominent.
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