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

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A

Beef broth should not be omitted. Generally, clear broths like beef broth are lower in fat and may be a better choice for someone with cholelithiasis compared to creamy or fatty foods.

Choice B

Ketchup should not be omitted. Ketchup is not typically high in fat and may not be a significant concern for someone with cholelithiasis.

Choice C

Ice cream should be omitted. Cholelithiasis refers to the presence of gallstones in the gallbladder. Gallstones can form from substances in the bile, and certain foods can trigger symptoms in individuals with gallbladder issues. One of the common triggers is high-fat foods, which can cause the gallbladder to contract and potentially lead to pain or discomfort.

Choice D

Bread should not be omitted. While bread contains some fat, it's not as high in fat as ice cream. The focus for individuals with cholelithiasis is often on high-fat foods rather than moderate-fat foods like bread.

A. Describe the value of eating smaller portion sizes. B. Encourage a well-balanced diet and moderate exercise. C. Explore the reasons the client wants to lose weight. D. Determine if the client has a history of anorexia.

Correct Answer is B

Explanation

Choice A

Describing the value of eating smaller portion sizes is not appropriate. While portion control is important, this advice alone might not address the overall dietary quality and exercise component necessary for effective weight loss.

Choice B

Encouraging a well-balanced diet and moderate exercise is appropriate. This intervention focuses on promoting healthy and sustainable weight loss. A well-balanced diet helps ensure that the client is getting all the necessary nutrients while aiming for a calorie deficit for weight loss. Moderate exercise complements dietary changes and contributes to overall health and weight management.

Choice C

Exploring the reasons, the client wants to lose weight is inappropriate. While understanding the client's motivations is valuable, this doesn't directly provide guidance on how to achieve the goal of losing 10 pounds.

Choice D

Determining if the client has a history of anorexia is inappropriate. While assessing for eating disorders is important in general, assuming there's no indication of anorexia, the focus should be on providing guidance for safe and effective weight loss.

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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.

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Naxlex Comprehensive Predictor Exams

A middle-aged client newly diagnosed with cholelithiasis is choosing the evening meal. What food choice should the nurse encourage the client to omit?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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