A nurse is teaching a client who is to begin taking tamoxifen to treat breast cancer. The nurse should instruct the client to expect which of the following findings as an adverse effect of the medication?

Choice A reason: This is incorrect because hypoxia does not cause an increased need for insulin, but rather a decreased utilization of glucose by the cells. Hypoxia can also impair the secretion of insulin by the pancreas.

Choice B reason: This is correct because corticosteroids are known to cause hyperglycemia by stimulating gluconeogenesis, inhibiting glucose uptake, and increasing insulin resistance. The patient may need to adjust his insulin dose or switch to oral antidiabetic agents while on corticosteroid therapy.

Choice C reason: This is incorrect because antibiotics do not cause an increase in glucose levels, unless they are combined with other drugs that affect glucose metabolism, such as sulfonamides or fluoroquinolones.

Choice D reason: This is incorrect because type 2 diabetes does not convert to type 1 diabetes, as they are different types of diabetes with different causes and mechanisms. Type 1 diabetes is caused by autoimmune destruction of the beta cells of the pancreas, resulting in absolute insulin deficiency. Type 2 diabetes is caused by insulin resistance and relative insulin deficiency.

Choice A reason: You should avoid alcohol intake while taking codeine, not limit it to 12 ounces daily. Alcohol can increase the risk of side effects such as drowsiness, dizziness, and respiratory depression.

Choice B reason: You should not expect to experience diarrhea while taking codeine. Codeine can cause constipation, not diarrhea. You should increase your fluid and fiber intake and use laxatives as prescribed to prevent constipation.

Choice C reason: You should not take the medication on an empty stomach to prevent nausea. Codeine can cause nausea and vomiting, especially on an empty stomach. You should take the medication with food or milk to reduce nausea.

Choice D reason: You should change positions slowly while taking codeine. Codeine can cause orthostatic hypotension, which is a sudden drop in blood pressure when you stand up. This can cause dizziness, fainting, and falls. You should change positions slowly and use caution when walking or climbing stairs.