The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.
St. John's Wort
Corticosteroids
Ibuprofen
Oral contraceptives
Epinephrine
Correct Answer : A,B,D,E
Choice A rationale: St. John's Wort is an herbal supplement that can interact with various medications, including insulin, and may alter blood glucose levels. It can reduce the effectiveness of insulin, leading to decreased blood glucose control. It is essential for the client to inform the healthcare provider about any use of St. John's Wort to adjust the insulin regimen accordingly.
Choice B rationale: Corticosteroids can increase blood glucose levels by promoting insulin resistance and inhibiting insulin action. Clients with diabetes may require adjustments in their insulin dosage while taking corticosteroids to prevent hyperglycemia.
Choice C rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that does not typically have a direct impact on blood glucose levels in people with diabetes.
Choice D: Oral contraceptives, specifically combination hormonal contraceptives containing estrogen and progestin, can impact blood glucose levels. They may lead to insulin resistance and, in some cases, increase blood glucose levels. The healthcare provider may need to adjust the insulin dosage for better glycemic control.
Choice E rationale: Epinephrine is a hormone that may transiently increase blood glucose levels in response to stress, but it is not a home medication that the client would be taking regularly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A
Providing pamphlets about heart-healthy diet selections should not be implemented. Providing information is important, but it might not be as effective if the client is strongly resistant. Engaging in a conversation first can help tailor the information to the client's needs.
Choice B
Referring the client to a dietitian for nutrition education should not be implemented. A dietitian can provide valuable education, but it might be more beneficial to address the client's concerns and resistance before making the referral.
Choice C
Discussing client's concerns about the change in diet should be implemented. When a client is resistant or unwilling to make changes to their diet and lifestyle, it's important for the nurse to engage in open and empathetic communication. Option C, discussing the client's concerns about the change in diet, is the most appropriate initial response.
By engaging in a conversation with the client, the nurse can better understand the client's perspective, reasons for resistance, and potential barriers to making dietary changes. This approach allows the nurse to address the client's concerns, provide information, and work collaboratively to find solutions that might be more acceptable to the client.
Choice D
Suggesting exercise as an alternative to increase HDL levels should not be implemented. Exercise is important for heart health, but it's important to address the client's resistance to dietary changes first. Additionally, dietary changes and exercise can work together to improve overall heart health.
Correct Answer is B
Explanation
Choice A
Explain the benefits of a high fibre diet is not correct response. While a high fibre diet can indeed be beneficial for individuals with haemorrhoids by promoting regular bowel movements and reducing strain during defecation, the immediate concern here is addressing the client's understanding about avoiding nuts and seeds. This information could be provided as a follow-up after confirming the client's understanding in response to option B.
Choice B
Confirm that these foods should be avoided is the correct response. In this situation, the nurse's first response should be to confirm the client's understanding and provide accurate information about the need to avoid certain foods. Nuts and seeds can be challenging to digest and may lead to irritation and inflammation in individuals with haemorrhoids. Confirming the client's understanding and providing guidance aligns with the nurse's role in patient education and care.
Choice C
Encourage soft foods such as yogurt is not the correct response. Encouraging soft foods like yogurt is a reasonable suggestion for someone with haemorrhoids, as soft foods are generally easier to digest and less likely to cause irritation. However, the client's statement was specifically about avoiding nuts and seeds. While this choice might be relevant, it doesn't directly address the client's statement.
Choice D
Suggest that the client also avoid fruit skins is not the correct response. This option is not directly related to the client's concern about nuts and seeds. Fruit skins generally contain dietary fibre, which can be beneficial for maintaining regular bowel movements. While some individuals might find that certain fruits with tough skins could exacerbate their haemorrhoid symptoms, this advice might be better suited for a separate discussion about dietary choices rather than as a direct response to the client's statement.

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