A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Discard the NPH solution if it appears cloudy.

NPH is an intermediate-acting insulin.

Freeze unopened insulin vials.

Shake the insulin vigorously before loading the syringe.

Answer and Explanation

The Correct Answer is B

Choice A reason: This is incorrect because NPH insulin is normally cloudy and should be gently mixed before use. However, the nurse should discard the solution if it has clumps, flakes, or crystals.

Choice B reason: This is correct because NPH insulin is an intermediate-acting insulin that has a slower onset and longer duration than short-acting or rapid-acting insulins. The nurse should explain to the client that NPH insulin provides basal coverage and may need to be combined with other types of insulin to control blood glucose levels.

Choice C reason: This is incorrect because freezing insulin can damage its potency and effectiveness. The nurse should instruct the client to store unopened insulin vials in the refrigerator and opened vials at room temperature.

Choice D reason: This is incorrect because shaking insulin can cause air bubbles and frothing, which can affect the accuracy of the dose. The nurse should instruct the client to roll the insulin vial between the palms of the hands to mix it gently.

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Correct Answer is D

Explanation

Choice A reason: This is incorrect because sildenafil and nitrates do not affect each other's effectiveness, but rather their side effects. Sildenafil is a phosphodiesterase-5 inhibitor that enhances the effect of nitric oxide, which causes vasodilation and increases blood flow to the penis. Nitrates are vasodilators that also increase nitric oxide levels and reduce the workload of the heart.

Choice B reason: This is incorrect because sildenafil and nitrates do not cause a significant increase in pulse rate, but rather a decrease. This is because the vasodilation caused by both drugs lowers the blood pressure and the cardiac output, which reduces the heart rate.

Choice C reason: This is incorrect because sildenafil and nitrates do not increase the risk of bleeding, unless they are combined with other drugs that affect the blood clotting process, such as anticoagulants or antiplatelets.

Choice D reason: This is correct because sildenafil and nitrates can cause a significant decrease in blood pressure when taken together, as they both cause vasodilation and increase nitric oxide levels. This can lead to hypotension, dizziness, fainting, or even a heart attack or stroke. The patient should avoid taking sildenafil and nitrates within 24 hours of each other.

A. Alcohol B. Milk C. Grapefruit juice D. Coffee

Correct Answer is A

Explanation

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.

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A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

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Naxlex Comprehensive Predictor Exams

A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil. He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?

Correct Answer is D

Explanation

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?

Correct Answer is A

Explanation

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