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 A

Explanation

Disulfiram is a medication used to treat alcohol use disorder (AUD). It works by inhibiting the enzyme acetaldehyde dehydrogenase, which is responsible for breaking down acetaldehyde, a toxic metabolite of alcohol. When alcohol is consumed while taking disulfiram, the accumulation of acetaldehyde in the body leads to unpleasant symptoms such as flushing, sweating, nausea, and vomiting. This creates an aversive reaction to alcohol consumption, which can help the client refrain from drinking.

The aversive effects of disulfiram can last for several hours to several days after alcohol consumption, depending on the dose of disulfiram and the amount of alcohol consumed. Therefore, it is important for clients taking disulfiram to avoid all sources of alcohol, including alcoholic beverages, mouthwash, and other products containing alcohol.

It is important to note that disulfiram is not a cure for AUD, and it works best when used as part of a comprehensive treatment plan that includes counseling and support. Disulfiram should only be used under the close supervision of a healthcare provider, as it can have serious side effects if used improperly.

A. Oral B. Intravenous C. Intranasal D. Topical

Correct Answer is C

Explanation

Calcitonin is a medication used to treat postmenopausal osteoporosis in older adults. It works by inhibiting bone resorption and decreasing the breakdown of bone tissue. Calcitonin is available in several forms, including intranasal spray, subcutaneous injection, and intravenous infusion. However, for the treatment of postmenopausal osteoporosis, calcitonin is most commonly administered via intranasal spray.

Intranasal calcitonin is easy to use and well-tolerated by most clients. It is absorbed through the nasal mucosa and reaches peak blood levels within 30-60 minutes after administration. The medication is usually administered once daily, alternating nostrils with each dose.

Other routes of administration, such as subcutaneous injection and intravenous infusion, may be used in certain situations, such as for the treatment of Paget's disease of bone or hypercalcemia. However, these routes of administration are less commonly used for the treatment of postmenopausal osteoporosis in older adults. The healthcare provider will determine the appropriate route of administration based on the individual client's needs and medical history.

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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

Naxlex Comprehensive Predictor Exams

A client is prescribed disulfiram. How does this medication assist the client in refraining from ingestion of alcohol?

Correct Answer is A

Explanation

An older adult client has been diagnosed with postmenopausal osteoporosis and has been prescribed calcitonin. The nurse should anticipate administration by what route’

Correct Answer is C

Explanation

A client will soon begin long-term treatment with hydrocortisone after being diagnosed with Addison's disease. In order to mitigate the potential adverse effect of this treatment regimen, the nurse should encourage the client to increase the intake of what nutrient?

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