A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. The patient has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, the pneumonia has resolved, but when monitoring the blood glucose levels, the nurse notices that the level is still elevated. What is the best explanation for this elevation?

The hypoxia caused by the COPD causes an increased need for insulin.

The corticosteroids may cause an increase in glucose levels.

The antibiotics may cause an increase in glucose levels.

His type 2 diabetes has converted to type 1.

Answer and Explanation

The Correct Answer is B

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.

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Correct Answer is D

Explanation

Choice A reason: 0.2 tablets is not the correct answer. To convert mg to mcg, multiply by 1000. Therefore, 0.175 mg is equal to 175 mcg. To find the number of tablets, divide the dose by the amount available. Therefore, 175 mcg / 8 mcg = 21.875 tablets. Round this to the nearest whole number, which is 22 tablets.

Choice B reason: 2 tablets is not the correct answer. This is the result of dividing the dose by 100 instead of 1000, which is incorrect.

Choice C reason: 20 tablets is not the correct answer. This is the result of rounding down instead of up, which is incorrect.

Choice D reason: 22 tablets is the correct answer. This is the result of converting the dose to mcg, dividing by the amount available, and rounding to the nearest whole number.

A. Hyperkalemia B. Hypokalemia C. Hypermagnesemia D. Hypomagnesemia

Correct Answer is B

Explanation

Choice A reason: Hyperkalemia is not the correct answer. Hyperkalemia is a high level of potassium in the blood. Corticosteroids do not cause hyperkalemia, but rather hypokalemia. Hyperkalemia may be caused by other factors such as renal failure, acidosis, or potassium-sparing diuretics.

Choice B reason: Hypokalemia is the correct answer. Hypokalemia is a low level of potassium in the blood. Corticosteroids can cause hypokalemia by increasing the excretion of potassium and sodium in the urine. Hypokalemia can cause muscle weakness, cramps, arrhythmias, and digoxin toxicity.

Choice C reason: Hypermagnesemia is not the correct answer. Hypermagnesemia is a high level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypermagnesemia may be caused by other factors such as renal failure, excessive antacid use, or magnesium-containing laxatives.

Choice D reason: Hypomagnesemia is not the correct answer. Hypomagnesemia is a low level of magnesium in the blood. Corticosteroids do not affect magnesium levels. Hypomagnesemia may be caused by other factors such as malnutrition, alcoholism, or diuretic use.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer levothyroxine 0.175 mg PO once a day. The amount available is levothyroxine 8 mcg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is D

Explanation

A nurse is caring for a client who has nephrotic syndrome and is receiving high-dose corticosteroid therapy. For which of the following electrolyte imbalances should the nurse monitor?

Correct Answer is B

Explanation

When a patient is taking an adrenergic agonist drug, the nurse expects to observe which effect?

A nurse is teaching a client who has a new prescription for codeine. Which of the following instructions should the nurse include in the teaching?

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?

A nurse is receiving a telephone prescription for a client and documents it as metformin 500 mg PO BID. Which of the following elements should the nurse identify is missing from the prescription?

The nurse is preparing to administer insulin intravenously. Which statement about the administration of intravenous insulin is true?

During a routine checkup, a patient states that she is unable to take the prescribed antihistamine because of one of its most common adverse effects. The nurse suspects that which adverse effect has been bothering this patient?

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?