A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication?
Alcohol
Milk
Grapefruit juice
Coffee
The Correct Answer is A
The correct answer is a. Alcohol.
Choice A: Alcohol
Reason: Alcohol can significantly affect blood glucose levels in patients taking glimepiride. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can occur depending on the amount and frequency of alcohol consumption. Alcohol can enhance the blood sugar-lowering effect of glimepiride, leading to a dangerous drop in blood sugar levels, known as hypoglycemia. Symptoms of hypoglycemia include dizziness, confusion, weakness, and in severe cases, loss of consciousness. Therefore, it is advised to avoid alcohol while taking glimepiride.
Choice B: Milk
Reason: There are no known interactions between glimepiride and milk. Milk does not affect the absorption or efficacy of glimepiride. Therefore, it is generally safe to consume milk while taking this medication.
Choice C: Grapefruit juice
Reason: Grapefruit juice might theoretically increase the levels of drugs metabolized by CYP2C9, including glimepiride, due to its potential to inhibit CYP2C9 enzymes. However, this interaction has not been reported in humans and is considered unlikely to have a significant clinical impact. Therefore, grapefruit juice is not a major concern for patients taking glimepiride.
Choice D: Coffee
Reason: Coffee and other caffeinated beverages may increase blood sugar levels, which can counteract the effects of glimepiride. However, this interaction is not as significant as the interaction with alcohol. It is generally advised to monitor blood sugar levels and consume coffee in moderation while taking glimepiride.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E"]
Explanation
Choice A reason: This is incorrect because drowsiness is not a common or serious adverse effect of alendronate. However, the client should avoid driving or operating machinery if they experience drowsiness.
Choice B reason: This is incorrect because tachycardia is not a common or serious adverse effect of alendronate. However, the client should monitor their pulse and blood pressure regularly and report any abnormal changes to the provider.
Choice C reason: This is correct because jaw pain can indicate a rare but serious condition called osteonecrosis of the jaw, which is associated with alendronate use. The client should report any jaw pain, swelling, or infection to the provider immediately and avoid dental procedures while taking alendronate.
Choice D reason: This is incorrect because dizziness is not a common or serious adverse effect of alendronate. However, the client should rise slowly from a lying or sitting position to prevent orthostatic hypotension and falls.
Choice E reason: This is correct because esophageal erosion can occur if alendronate is not taken correctly. The client should take alendronate with a full glass of water, at least 30 minutes before any food or drink, and remain upright for at least 30 minutes after taking it. The client should report any difficulty swallowing, chest pain, or heartburn to the provider.

Correct Answer is A
Explanation
Choice A reason: Taking the bronchodilator inhaler first will help to open up the airways and make it easier for the corticosteroid inhaler to reach the lungs and reduce inflammation. This will improve the effectiveness and safety of the inhalers.
Choice B reason: Taking the corticosteroid inhaler first may not be as effective as taking the bronchodilator inhaler first, because the airways may be constricted and prevent the corticosteroid from reaching the lungs. This may reduce the anti-inflammatory effect of the corticosteroid and increase the risk of side effects.
Choice C reason: Taking these two drugs at least 2 hours apart is not necessary and may not be practical for the patient. The bronchodilator and the corticosteroid can be taken together, as long as the bronchodilator is taken first.
Choice D reason: It does matter which inhaler the patient uses first, because the order of the inhalers can affect their efficacy and safety. The patient should always use the bronchodilator inhaler first, followed by the corticosteroid inhaler.
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