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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Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: This is incorrect because nausea is not a common or serious adverse effect of estrogen therapy. However, the patient should take the estrogen with food or milk to prevent stomach upset.

Choice B reason: This is incorrect because triglycerides are not affected by estrogen therapy. However, the patient should monitor their cholesterol and blood pressure levels regularly and follow a healthy diet and exercise regimen.

Choice C reason: This is correct because smoking and estrogen therapy are both risk factors for thrombosis, which is the formation of blood clots in the blood vessels. The patient should stop smoking and report any signs of thrombosis, such as leg pain, swelling, redness, or warmth, to the provider.

Choice D reason: This is incorrect because bleeding during menstruation is not increased by estrogen therapy. However, the patient should report any abnormal vaginal bleeding, such as spotting, heavy bleeding, or prolonged bleeding, to the provider.

A. Administer with short-acting insulin. B. Assess for hypoglycemia 4 hr after the insulin injection. C. Inject the insulin 15 min before a meal. D. Monitor for polyuria.

Correct Answer is C

Explanation

Choice A reason: This is incorrect because lispro insulin is a rapid-acting insulin that does not need to be administered with another type of insulin. However, the patient may need a long-acting or intermediate-acting insulin to provide basal coverage throughout the day.

Choice B reason: This is incorrect because lispro insulin has a peak action of 30 to 90 min after the injection, which means that the patient is at the highest risk of hypoglycemia during this time. The nurse should assess for hypoglycemia more frequently than 4 hr after the injection.

Choice C reason: This is correct because lispro insulin has a fast onset of action of 15 to 30 min after the injection, which means that the patient should eat a meal within 15 min of the injection to prevent hypoglycemia.

Choice D reason: This is incorrect because polyuria is a sign of hyperglycemia, not hypoglycemia. The nurse should monitor for polyuria before the insulin injection, as it may indicate that the patient's blood glucose level is high.

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Naxlex Comprehensive Predictor Exams

During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased:

Correct Answer is C

Explanation

A nurse is preparing to administer lispro insulin to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take?

Correct Answer is C

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?

A nurse is teaching a client how to draw up regular insulin and NPH insulin in the same syringe. Which of the following instructions should the nurse include?

After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months?

A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching?

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?

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

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance?

A nurse is providing teaching for a client who has diabetes and a new prescription for insulin glargine. Which of the following instructions should the nurse provide regarding this type of insulin?