Which of the following is important for the nurse to assess and monitor in a patient prescribed metformin (Glucophage)? (Select All that Apply.)

Presence of renal or hepatic disease

Fluid retention

Need for diagnostic tests involving use of contrast dyes

Weight gain

Presence of heart failure

Answer and Explanation

Correct Answer : A,C,E

A. Presence of renal or hepatic disease: Metformin, commonly prescribed for type 2 diabetes, is primarily excreted by the kidneys. Patients with renal impairment are at increased risk of metformin accumulation, potentially leading to lactic acidosis. Assessing for the presence of renal or hepatic disease helps determine the appropriate dosage of metformin and reduces the risk of adverse effects.
B. Fluid retention: Metformin does not typically cause fluid retention; however, monitoring for signs of fluid retention is important, especially in patients with underlying conditions such as heart failure, as fluid retention can exacerbate their condition.
C. Need for diagnostic tests involving the use of contrast dyes: Metformin can increase the risk of lactic acidosis, particularly in patients undergoing procedures involving contrast dyes. Temporarily discontinuing metformin before such procedures reduces the risk of adverse effects.
D. Weight gain: Metformin is associated with weight neutrality or even modest weight loss. Monitoring weight changes can help assess treatment response and overall health.
E. Presence of heart failure: Metformin is contraindicated in patients with severe heart failure due to the potential risk of lactic acidosis. Assessing for the presence of heart failure helps ensure safe prescribing practices and avoids potential complications associated with metformin use in this population.

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Correct Answer is C

Explanation

A. Treat the urinary tract infection with another drug: This might be necessary if ciprofloxacin interacts significantly with birth control pills, but it's not the first line of action.

B. Continue with both therapies simultaneously: Some antibiotics can decrease the effectiveness of birth control pills. It's important to advise using a backup method during and for a short time after ciprofloxacin therapy.

C. Complete the ciprofloxacin therapy and use a backup method of contraception: This is the most appropriate advice. Jennifer should finish the antibiotic to treat the infection, but a backup method (like condoms) is needed to prevent pregnancy because ciprofloxacin might decrease the effectiveness of birth control pills.

D. Abstain from sexual activity until the end of ciprofloxacin therapy: While this would be completely effective, it might not be realistic for everyone. Using a backup method offers protection while still allowing sexual activity.

A. Ketoacids B. Hyperglycemia C. Hypoglycemia D. Glucagon

Correct Answer is B

Explanation

A. Ketoacids: This is incorrect. While ketoacids are a by-product of fat metabolism that occurs when insulin is low, they do not directly stimulate insulin secretion.
B. Hyperglycaemia: This is correct. Elevated blood glucose levels (hyperglycaemia) directly stimulate the pancreas to secrete insulin to help lower blood glucose levels.
C. Hypoglycaemia: This is incorrect. Low blood glucose levels (hypoglycaemia) would reduce insulin secretion and might increase glucagon secretion to raise blood glucose levels.
D. Glucagon: This is incorrect in the context of directly stimulating insulin secretion. Glucagon is a hormone secreted by the alpha cells of the pancreas when blood glucose levels are low. Its primary role is to increase blood glucose levels by stimulating glycogenolysis and gluconeogenesis in the liver.

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Which of the following is important for the nurse to assess and monitor in a patient prescribed metformin (Glucophage)? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Jennifer takes birth control pills. Recently she was diagnosed with a urinary tract infection and is taking ciprofloxacin (Cipro). To maximize the therapeutic effects of both types of drugs, what should the nurse tell Jennifer?

Correct Answer is C

Explanation

Which of the following stimulates the pancreas to secrete insulin?

Correct Answer is B

Explanation

Your patient is allergic to penicillin. He may also have a cross-allergy to which class of antibiotics?

Which hormones that regulate blood glucose levels are secreted by the pancreas? (Select all that apply.)

If injection sites are not rotated regularly, the patient with diabetes mellitus may suffer from which of the following?

.A nurse is preparing to administer vitamin K 1mg IM to a newborn. Available is vitamin K injection 1 mg/0.5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

The nurse is caring for a client with a diagnosis of urinary tract infection. The physician has ordered an antibiotic. What is the priority prior to administering this medication?

The nurse is admitting a client to the acute care floor with methicillin-resistant S. aureus. The nurse would expect the physician to order which of the following medications for the client?

Which class of antibiotic is associated with cartilage toxicity and rupture of the Achilles tendon?

Which of the following complaints by a man taking gentamycin would be most indicative that he is experiencing ototoxicity?