Metformin works by:
Increasing the cells' sensitivity to insulin.
Stimulating the release of insulin from the pancreas.
Stimulating glucose uptake in the skeletal muscles.
Increasing hepatic glucose production.
The Correct Answer is A
Choice A rationale
Metformin primarily increases peripheral insulin sensitivity, particularly in muscle and adipose tissues, facilitating glucose uptake and utilization. It inhibits hepatic glucose production through AMPK activation, reducing gluconeogenesis. Metformin also improves lipid profiles and insulin resistance without promoting insulin secretion, which minimizes the risk of hypoglycemia. Its actions target metabolic pathways, enhancing cellular glucose management for type 2 diabetes control.
Choice B rationale
Metformin does not stimulate pancreatic insulin release. It acts independently of insulin production mechanisms, focusing on improving peripheral sensitivity and reducing hepatic glucose output. Drugs like sulfonylureas target beta cells for insulin release, unlike metformin, which avoids direct engagement with the pancreas, minimizing hypoglycemia risks associated with excessive insulin secretion.
Choice C rationale
Stimulating glucose uptake in skeletal muscles is a partial outcome of improved insulin sensitivity induced by metformin. However, metformin’s mechanism extends beyond this, involving significant hepatic effects. It does not directly stimulate glucose uptake as a sole action; rather, it enhances overall metabolic efficiency and glucose management through multiple pathways.
Choice D rationale
Metformin decreases hepatic glucose production rather than increasing it. It inhibits gluconeogenesis by activating AMPK, suppressing the production of glucose from non-carbohydrate sources. This inhibition aids in reducing fasting glucose levels, which are often elevated in type 2 diabetes. The opposite action described contradicts its therapeutic role in managing hyperglycemia effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Applying a warm pack is inappropriate for controlling active bleeding, as it can exacerbate blood flow to the site, worsening the hemorrhage rather than controlling it effectively.
Choice B rationale
Using a tourniquet above the bleeding site is a last-resort method typically reserved for life-threatening bleeding. It may cause complications such as nerve damage or ischemia, so other measures are prioritized first.
Choice C rationale
Direct pressure or sterile pressure dressing with elevation minimizes blood loss effectively by compressing the damaged vessels, promoting clot formation, and utilizing gravity to reduce the pressure at the wound site. It is the recommended first-line method.
Choice D rationale
Placing an ice pack on the bleeding site may reduce localized blood flow by inducing vasoconstriction but is less effective than direct pressure for stopping active hemorrhage. It is secondary to other control measures.
Correct Answer is B
Explanation
Choice A rationale
Staying with the patient and rechecking blood glucose delays immediate corrective action required for severe hypoglycemia (40 mg/dL). While safety is important, prompt treatment with glucose is the priority to prevent further complications.
Choice B rationale
Following the hypoglycemia protocol ensures immediate glucose administration, either orally, intravenously, or intramuscularly, to stabilize the patient. This is critical as glucose levels below 40 mg/dL require urgent intervention to prevent neuronal damage or coma.
Choice C rationale
Monitoring and rechecking glucose after treating is essential but not sufficient as the first action. Hypoglycemia this severe needs immediate treatment before monitoring, ensuring prompt glucose replacement to prevent worsening symptoms.
Choice D rationale
Notifying the physician without treating the hypoglycemia risks unnecessary delays. Immediate action, such as administering glucose per protocol, is vital in this emergency scenario for patient safety.
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