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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Venous thromboembolism is a contraindication for taking SERMs. SERMs are drugs that act like estrogen in some tissues and block estrogen in others. They can help prevent bone loss and fractures in postmenopausal women, but they can also increase the risk of blood clots in the veins, such as deep vein thrombosis and pulmonary embolism. Therefore, women who have a history of or are at high risk for venous thromboembolism should not take SERMs.
Choice B reason: Breast cancer is not a contraindication for taking SERMs. In fact, some SERMs, such as tamoxifen and raloxifene, are used to treat or prevent breast cancer in women who have estrogen receptor-positive tumors. These SERMs block the effects of estrogen in the breast tissue and reduce the growth of cancer cells.
Choice C reason: Hypocalcemia is not a contraindication for taking SERMs. Hypocalcemia is a low level of calcium in the blood. SERMs do not affect calcium levels directly, but they can help prevent calcium loss from the bones by mimicking the effects of estrogen in the bone tissue. However, women who take SERMs should also take adequate calcium and vitamin D supplements to maintain bone health.
Choice D reason: Stress fractures are not a contraindication for taking SERMs. Stress fractures are small cracks in the bones that result from repeated stress or overuse. SERMs can help prevent stress fractures by strengthening the bones and reducing the risk of osteoporosis. However, women who take SERMs should also avoid excessive or inappropriate physical activity that can cause stress fractures.
Correct Answer is B
Explanation
Choice A reason: This is incorrect because insulin can be given intravenously in certain situations, such as diabetic ketoacidosis, hyperglycemic hyperosmolar state, or perioperative care.
Choice B reason: This is correct because regular insulin is the only type of insulin that can be administered intravenously, as it is a short-acting insulin that has a rapid onset and peak. Other types of insulin, such as intermediate-acting or long-acting, are not suitable for intravenous use, as they have a delayed onset and peak and may cause hypoglycemia.
Choice C reason: This is incorrect because insulin aspart and insulin lispro are rapid-acting insulins that have a faster onset and peak than regular insulin. They are not recommended for intravenous use, as they may cause severe hypoglycemia. They are usually given subcutaneously before meals to control postprandial blood glucose levels.
Choice D reason: This is incorrect because not all forms of insulin can be administered intravenously, as explained above. Only regular insulin can be given intravenously, and the dose may differ from the subcutaneous dose depending on the patient's blood glucose level and insulin sensitivity.
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