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","E"]

Explanation

Choice A reason: This is incorrect because alendronate is not safe during pregnancy, as it may harm the fetus or cause birth defects. The client should inform the provider if they are pregnant or planning to become pregnant before taking this medication.

Choice B reason: This is incorrect because the client should not lie down for at least 30 minutes after taking alendronate, as this may cause esophageal irritation, ulceration, or bleeding. The client should take alendronate with a full glass of water and swallow it whole, without chewing or crushing.

Choice C reason: This is incorrect because the client should not continue smoking while on alendronate, as smoking can worsen the bone loss and increase the risk of fractures. The client should quit smoking or reduce the amount of cigarettes they smoke.

Choice D reason: This is correct because the client should avoid alcohol with alendronate, as alcohol can also worsen the bone loss and increase the risk of fractures. Alcohol can also interact with alendronate and cause side effects, such as stomach upset, drowsiness, or liver damage.

Choice E reason: This is correct because the client should sit up for at least 30 minutes after taking alendronate, as this can prevent the medication from refluxing back into the esophagus and causing irritation, ulceration, or bleeding. The client should also avoid eating or drinking anything other than water for at least 30 minutes after taking alendronate, as this can reduce its absorption and effectiveness.

A. Vaginal cultures B. Complete blood count C. Serum potassium level D. Pregnancy test

Correct Answer is C

Explanation

Choice A reason: Vaginal cultures are not necessary for oral contraceptive therapy. They are used to diagnose infections such as bacterial vaginosis, yeast infection, or sexually transmitted diseases.

Choice B reason: Complete blood count is not essential for oral contraceptive therapy. It is used to measure the number and types of blood cells, such as red blood cells, white blood cells, and platelets.

Choice C reason: Serum potassium level is the most important laboratory test for oral contraceptive therapy. This is because some oral contraceptives can increase the risk of hyperkalemia, which is a high level of potassium in the blood. Hyperkalemia can cause serious complications such as cardiac arrhythmias, muscle weakness, and paralysis.

Choice D reason: Pregnancy test is not a laboratory test, but a urine test. It is important to rule out pregnancy before starting oral contraceptive therapy, but it is not the most important test for the nurse to assess.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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)

Correct Answer is ["D","E"]

Explanation

A woman visits a health center requesting oral contraceptives. Which laboratory test is most important for the nurse to assess before the patient begins oral contraceptive therapy?

Correct Answer is C

Explanation

A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects?

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 preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes mellitus. When mixing the two types of insulin, which of the following actions should the nurse take first?

A nurse is receiving a telephone prescription for a client and documents it as metformin 500 mg PO BID. Which of the following elements should the nurse identify is missing from the prescription?

A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply)

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

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?