A 59-year-old man with type 2 diabetes mellitus presents to the nurse practitioner with complaints of reduced libido, weight gain, and depression. His most recent HgbA1C is 7.9, and he scored 4 on the PHQ-9. Which of the following is the most appropriate at this time?
Bupropion (Wellbutrin)
Testosterone
Fluoxetine (Prozac)
Dulaglutide (Trulicity)
The Correct Answer is B
Choice A reason: Bupropion is an antidepressant that may improve energy and libido, but the PHQ-9 score of 4 indicates minimal depressive symptoms. The primary concern here is reduced libido and weight gain, which may be better addressed by evaluating testosterone levels.
Choice B reason: Testosterone deficiency is common in men with type 2 diabetes and can contribute to reduced libido, weight gain, and mood changes. Given the low PHQ-9 score and symptoms suggestive of hypogonadism, testosterone replacement therapy is the most appropriate next step after confirming low serum testosterone levels.
Choice C reason: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used for depression. However, SSRIs can further reduce libido and are not indicated for mild depressive symptoms. This choice does not address the patient's primary concerns.
Choice D reason: Dulaglutide is a GLP-1 receptor agonist used to improve glycemic control and promote weight loss. While it may help with weight, it does not address libido or mood directly and is not the most targeted intervention for the current symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Celiac disease can cause iron deficiency anemia due to malabsorption, but it is less likely to present with overt gastrointestinal bleeding, especially in older adults. While it should be considered in chronic anemia, it is not the most likely cause in this context.
Choice B reason: Malignancy, particularly colorectal cancer, is a leading cause of iron deficiency anemia and gastrointestinal bleeding in men over 50. Occult or overt bleeding from a tumor can lead to chronic iron loss, and this presentation warrants urgent investigation for gastrointestinal malignancy.
Choice C reason: Parasitic infestation is a more common cause of iron deficiency anemia in children or individuals in endemic areas. It is less likely to be the cause in an older adult in a non-endemic setting, especially when gastrointestinal bleeding is present.
Choice D reason: Increased systemic requirements for iron are typically seen in growth phases, pregnancy, or chronic blood loss. In older men, this is not a common cause of iron deficiency anemia and does not explain gastrointestinal bleeding.
Correct Answer is A
Explanation
Choice A reason: Minocycline is a tetracycline antibiotic and has not been established as a treatment for autonomic dysreflexia. While it has neuroprotective and anti-inflammatory properties in experimental models, it is not part of the clinical management protocol for autonomic dysreflexia.
Choice B reason: OnabotulinumtoxinA (Botox) has been used in patients with neurogenic bladder or spasticity, which can contribute to autonomic dysreflexia. It helps reduce bladder overactivity and prevent triggering episodes.
Choice C reason: Nifedipine, a calcium channel blocker, is commonly used to manage acute hypertension in autonomic dysreflexia. It reduces blood pressure quickly and is considered a first-line agent in emergent settings.
Choice D reason: Lidocaine may be used to suppress afferent stimuli during procedures such as catheterization, which can trigger autonomic dysreflexia. It helps block nociceptive input and prevent reflex sympathetic discharge.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.