An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication?

An increase in serum lactate

A decrease in hemoglobin and hematocrit

An increase in white blood cells

A decrease in potassium accompanied by an increase in sodium

Answer and Explanation

The Correct Answer is A

A. An increase in serum lactate – This is a critical laboratory value that can indicate lactic acidosis, a serious side effect associated with metformin, especially in older adults or those with renal impairment. An increase in serum lactate necessitates discontinuation of the medication.

B. A decrease in hemoglobin and hematocrit – While this change may indicate anemia, it is not directly associated with the need to discontinue metformin. Further evaluation of the cause of anemia would be necessary.

C. An increase in white blood cells – This could indicate an infection or inflammatory process but does not specifically necessitate the discontinuation of metformin.

D. A decrease in potassium accompanied by an increase in sodium – While electrolyte imbalances should be monitored, this change does not directly indicate that metformin should be discontinued.

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Correct Answer is C

Explanation

Menotropins, also known as human menopausal gonadotropin (hMG), are a hormone treatment commonly used in infertility treatment. They contain both follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which stimulate the growth and maturation of follicles in the ovaries and the release of eggs during ovulation. This treatment is often used in women who are not ovulating regularly or who have other fertility problems. Somatotropin is used to treat growth hormone deficiency, thyrotropin alfa is used to treat thyroid cancer, and pegvisomant is used to treat acromegaly.

A. Disulfiram C B. Methadone C. Flumazenil C D. Naloxone

Correct Answer is C

Explanation

Flumazenil is a medication that is used as an antidote for benzodiazepine overdose, including diazepam. Benzodiazepines are a class of drugs that are used to treat anxiety, insomnia, seizures, and other conditions. However, they can also be abused or taken in excessive doses, leading to overdose.

Flumazenil works by binding to the same receptors in the brain that benzodiazepines bind to, but it has the opposite effect. Flumazenil blocks the activity of benzodiazepines and can rapidly reverse the effects of an overdose, including respiratory depression, sedation, and coma.

It is important to note that flumazenil should only be used in cases of benzodiazepine overdose and should be administered under close medical supervision. Flumazenil may cause seizures in clients who are physically dependent on benzodiazepines, and it should not be used as a substitute for appropriate medical care and monitoring.

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An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication?

Nursing Test Bank

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