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 ["C","E"]
Explanation
Choice A reason: This is incorrect because drowsiness is not a common or serious adverse effect of alendronate. However, the client should avoid driving or operating machinery if they experience drowsiness.
Choice B reason: This is incorrect because tachycardia is not a common or serious adverse effect of alendronate. However, the client should monitor their pulse and blood pressure regularly and report any abnormal changes to the provider.
Choice C reason: This is correct because jaw pain can indicate a rare but serious condition called osteonecrosis of the jaw, which is associated with alendronate use. The client should report any jaw pain, swelling, or infection to the provider immediately and avoid dental procedures while taking alendronate.
Choice D reason: This is incorrect because dizziness is not a common or serious adverse effect of alendronate. However, the client should rise slowly from a lying or sitting position to prevent orthostatic hypotension and falls.
Choice E reason: This is correct because esophageal erosion can occur if alendronate is not taken correctly. The client should take alendronate with a full glass of water, at least 30 minutes before any food or drink, and remain upright for at least 30 minutes after taking it. The client should report any difficulty swallowing, chest pain, or heartburn to the provider.
Correct Answer is B
Explanation
Choice A reason: Dextromethorphan is a cough suppressant that does not affect blood glucose levels. It is safe to use for clients with diabetes.
Choice B reason: Prednisone is a corticosteroid that can cause glucose intolerance by increasing glucose production and decreasing insulin sensitivity. It can worsen hyperglycemia and increase the risk of diabetic complications.
Choice C reason: Atorvastatin is a statin that lowers cholesterol levels and reduces the risk of cardiovascular disease. It does not cause glucose intolerance and may have a beneficial effect on glycemic control.
Choice D reason: Cimetidine is a histamine-2 receptor antagonist that reduces stomach acid production and treats ulcers and gastroesophageal reflux disease. It does not cause glucose intolerance and has no significant interaction with diabetes medications.
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