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 D

Explanation

A: Ibuprofen does not typically interact with calcium citrate to decrease its effects. Instead, ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal irritation and, with long-term use, may affect kidney function.

B: Hydrochlorothiazide is a diuretic that can lead to increased calcium levels in the blood. It does not decrease the effects of calcium citrate; rather, it could potentially cause hypercalcemia if used concurrently with calcium supplements.

C: Diltiazem is a calcium channel blocker used to treat hypertension and angina. While it affects calcium channels in the heart and blood vessels, it does not typically interact with calcium citrate supplements to decrease their effectiveness.

D: Prednisone is a corticosteroid that can decrease calcium absorption and increase calcium excretion, leading to lower bone density. Long-term use of prednisone can lead to osteoporosis, making it counterproductive when taken with calcium citrate for bone health.

A. Dextroamphetamine B. Dexmethylphenidate C. Dextroamphetamine and amphetamine D. Atomoxetme

Correct Answer is D

Explanation

Atomoxetine is a non-stimulant medication that is used to treat attentiondeficit/hyperactivity disorder (ADHD). Unlike central nervous system (CNS) stimulants such as dextroamphetamine, dexmethylphenidate, and dextroamphetamine/amphetamine, atomoxetine does not have a high risk of abuse or dependence.

CNS stimulants like dextroamphetamine, dexmethylphenidate, and dextroamphetamine/amphetamine can be effective in treating ADHD symptoms, but they can also be abused and lead to dependence. These medications work by increasing levels of dopamine and norepinephrine in the brain, which can improve focus and attention. However, they also have the potential to be misused, particularly by individuals seeking a "high" or increased alertness.

In contrast, atomoxetine works by selectively inhibiting the reuptake of norepinephrine in the brain. This mechanism of action does not produce the same effects on dopamine levels as CNS stimulants, and it is not associated with a high risk of abuse or dependence. However, it may take several weeks for the full therapeutic effects of atomoxetine to be seen, and it may not be as effective as CNS stimulants for some individuals with ADHD.

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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?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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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?