The nurse is caring for a client with renal dysfunction who requires an oral antidiabetic agent.
What drug will the nurse expect to see ordered?

Tolbutamide.

Tolazamide.

Chlorpropamide.

Chlorpromazine.

Answer and Explanation

The Correct Answer is A

Tolbutamide is preferred for clients with renal dysfunction, who may not be able to excrete chlorpropamide, because it is more easily cleared from the body.

Choice B. Tolazamide is wrong because it is a first-generation sulfonylurea that is used less frequently and is usually tried after tolbutamide and chlorpropamide have been shown to be ineffective.

Choice C. Chlorpropamide is wrong because it is a first-generation sulfonylurea that may accumulate in clients with renal dysfunction and cause hypoglycemia.

Choice D. Chlorpromazine is wrong because it is an antipsychotic agent, not an oral antidiabetic agent.

First-generation sulfonylureas are oral antidiabetic agents that stimulate insulin secretion from the pancreas.

They are used to treat type 2 diabetes mellitus.

The normal range of blood glucose level is 70 to 110 mg/dL.

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Correct Answer is A

Explanation

Phenothiazines are contraindicated in patients with suspected or established subcortical brain damage. Phenothiazines are a class of drugs that have antipsychotic, antiemetic, and sedative effects. They act by blocking dopamine receptors in the brain and can cause extrapyramidal symptoms, hypotension, and anticholinergic effects.

Choice B is wrong because phenothiazines are not contraindicated in patients with ischemic heart disease.

However, they can cause orthostatic hypotension and cardiac arrhythmias, so they should be used with caution and monitored closely in these patients.

Choice C is wrong because phenothiazines are not contraindicated in pediatric patients.

However, they can cause sedation, hypotension, and extrapyramidal symptoms, so they should be used with caution and at lower doses in these patients.

Choice D is wrong because phenothiazines are not contraindicated in patients with type 2 diabetes.

However, they can cause hyperglycemia and weight gain, so they should be used with caution and monitored closely in these patients.

A. Liver failure. B. Radiation injury. C. Malignancy. D. Hypothyroidism.

Correct Answer is C

Explanation

Hypercalcemia is a condition caused by having too much calcium in the blood, which can affect the function of nerves, muscles, kidneys and heart. Hypercalcemia can occur in children due to various causes, both acquired and genetic. One of the most common causes of hypercalcemia in children is cancer, especially cancers that affect the bones or produce substances that mimic parathyroid hormone (PTH), which regulates calcium levels.

Choice A is wrong because liver failure does not directly cause hypercalcemia, although it can affect vitamin D metabolism and calcium absorption.

Choice B is wrong because radiation injury does not cause hypercalcemia, unless it damages the parathyroid glands or causes bone destruction.

Choice D is wrong because hypothyroidism does not cause hypercalcemia, although it can affect bone turnover and calcium excretion.

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The nurse is caring for a client with renal dysfunction who requires an oral antidiabetic agent. What drug will the nurse expect to see ordered?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

For which client would the use of a phenothiazine most likely be contraindicated?

Correct Answer is A

Explanation

The nurse is caring for a pediatric client with a new onset of hypercalcemia. What condition would be most likely to cause this altered serum calcium level?

Correct Answer is C

Explanation

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The nurse is caring for a client with renal dysfunction who requires an oral antidiabetic agent.
What drug will the nurse expect to see ordered?