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 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.

A. Hemoglobin A1C level B. Serum insulin level C. Fingerstick fasting blood glucose level D. Hemoglobin level

Correct Answer is A

Explanation

Choice A reason: This is correct because hemoglobin A1C level reflects the average blood glucose level over the past 2 to 3 months. It is a reliable indicator of the patient's glycemic control and adherence to the antidiabetic therapy. The goal for most patients with type 2 diabetes is to keep the hemoglobin A1C level below 7%.

Choice B reason: This is incorrect because serum insulin level is not a good measure of the patient's adherence to the antidiabetic therapy, as it may vary depending on the type, dose, and timing of the insulin or oral antidiabetic agents. Serum insulin level may also be affected by other factors, such as stress, infection, or exercise.

Choice C reason: This is incorrect because fingerstick fasting blood glucose level only reflects the blood glucose level at a single point in time. It does not provide information about the patient's long-term glycemic control or adherence to the antidiabetic therapy. Fingerstick fasting blood glucose level may also be influenced by the patient's diet, activity, or medication intake before the test.

Choice D reason: This is incorrect because hemoglobin level is not related to the patient's adherence to the antidiabetic therapy, as it measures the amount of oxygen-carrying protein in the red blood cells. Hemoglobin level may be affected by conditions such as anemia, dehydration, or blood loss.

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Naxlex Comprehensive Predictor Exams

A patient is taking guaifenesin as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching?

Correct Answer is D

Explanation

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?

Correct Answer is A

Explanation

The nurse is planning an educational program on sildenafil to a group of older male clients. Which of the following information should the nurse include in the educational program?

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:

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?

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.)

A nurse is teaching a client who has type 1 diabetes about insulin administration. Which of the following statements by the client indicates an understanding of the teaching?

The client with hyperparathyroidism is taking alendronate. Which statements by the client indicate an understanding of the proper way to take this medication? (Select all that apply)

A nurse is providing teaching to a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse instruct the client to report to the provider? (Select all that apply.)