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: Decreases inflammation is a therapeutic effect of prednisone. Prednisone is a corticosteroid that suppresses the immune system and reduces the production of inflammatory mediators. This helps to relieve the pain, swelling, and stiffness of rheumatoid arthritis.
Choice B reason: Increases bone density is not a therapeutic effect of prednisone. Prednisone can cause bone loss and osteoporosis by decreasing calcium absorption and increasing calcium excretion. This increases the risk of fractures and bone damage.
Choice C reason: Reduces risk of infection is not a therapeutic effect of prednisone. Prednisone can increase the risk of infection by weakening the immune system and making it less able to fight off pathogens. This requires close monitoring and prophylactic antibiotics.
Choice D reason: Improves peripheral blood flow is not a therapeutic effect of prednisone. Prednisone can impair peripheral blood flow by causing vasoconstriction and increasing blood pressure. This can worsen the symptoms of peripheral vascular disease and increase the risk of thrombosis.
Correct Answer is D
Explanation
Choice A reason: This is incorrect because reporting symptoms that last longer than 2 days is not specific to guaifenesin. This is a general instruction for any patient with a sinus infection, regardless of the medication they are taking.
Choice B reason: This is incorrect because reporting clear-colored sputum to the prescriber is not necessary. Clear-colored sputum indicates that the infection is improving and the mucus is thinning. This is a desired effect of guaifenesin, not a problem that needs to be reported.
Choice C reason: This is incorrect because guaifenesin does not have sedating effects. Guaifenesin is an expectorant that helps to break up and expel mucus from the respiratory tract. It does not cause drowsiness or impair the ability to drive or operate machinery.
Choice D reason: This is correct because increasing fluid intake is an important instruction for a patient taking guaifenesin. Fluids help to hydrate the body and thin the mucus, making it easier to cough up and clear the sinuses. Fluids also help to prevent dehydration and dryness of the mucous membranes.
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