A nurse is obtaining a medical history from a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should report which of the following conditions is a contraindication for the use of metformin?

Seizure disorder

Renal insufficiency

Polycystic ovary syndrome

Gluten intolerance

Answer and Explanation

The Correct Answer is B

A. Seizure disorder: A seizure disorder does not directly affect the use of metformin. While some medications used to manage seizures may have interactions, metformin itself is not contraindicated in clients with a history of seizures, and it can generally be used safely with proper monitoring.

B. Renal insufficiency: Metformin is contraindicated in clients with renal insufficiency because impaired kidney function can lead to accumulation of the drug, increasing the risk of lactic acidosis, a rare but potentially life-threatening complication. Baseline and ongoing assessment of renal function, such as serum creatinine and estimated glomerular filtration rate (eGFR), is essential before starting therapy.

C. Polycystic ovary syndrome: Metformin is actually commonly used in clients with polycystic ovary syndrome to improve insulin sensitivity and support ovulation. This condition is not a contraindication, and metformin may provide therapeutic benefits beyond glucose control.

D. Gluten intolerance: Gluten intolerance has no impact on metformin use. Metformin does not contain gluten and does not interfere with gluten-related conditions, so it can be safely prescribed in clients with gluten intolerance.

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Correct Answer is C

Explanation

A. Avoid oral sucrose: Oral sucrose is actually an effective nonpharmacologic pain management strategy for infants. It should not be avoided; small amounts can help reduce procedural pain during circumcision.

B. Provide IV morphine: IV morphine is not routinely indicated for circumcision in healthy term infants due to the risk of respiratory depression and because less invasive pain control methods are effective.

C. Swaddle the infant: Swaddling provides comfort and a sense of security, reducing pain and distress after circumcision. It is a safe, nonpharmacologic intervention that helps calm the infant during recovery.

D. Apply petroleum daily: Petroleum jelly is typically applied to the circumcision site to prevent the diaper from sticking and protect the healing tissue. However, it is usually applied with each diaper change, not just once daily, to ensure proper care and healing.

A. Position the newborn on their abdomen after feeding. B. Place the newborn on a rigid feeding schedule. C. Offer the newborn a pacifier after feedings D. Burp the newborn several times during the feeding

Correct Answer is D

Explanation

A. Position the newborn on their abdomen after feeding: Placing a newborn on their abdomen after feeding increases the risk of aspiration and sudden infant death syndrome (SIDS). The recommended position after feeding is upright or on their back when sleeping.

B. Place the newborn on a rigid feeding schedule: Strict feeding schedules can lead to overfeeding or underfeeding, both of which can increase spit-up. Feeding on demand or according to the newborn’s hunger cues is safer and helps minimize gastrointestinal discomfort.

C. Offer the newborn a pacifier after feedings: Using a pacifier may soothe the newborn but does not reduce the incidence of spit-up. It is unrelated to gastric emptying or swallowing air during feeding.

D. Burp the newborn several times during the feeding: Frequent burping helps release swallowed air, which can decrease gastric distention and reduce spit-up. This technique is an effective intervention to minimize discomfort and regurgitation in formula-fed newborns.

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A nurse is obtaining a medical history from a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should report which of the following conditions is a contraindication for the use of metformin?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an infant who just had a circumcision. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is providing teaching to a client who is formula feeding their newborn. Which of the following information should the nurse include in the teaching to minimize their newborn's spit-up?

Correct Answer is D

Explanation

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