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: This describes changes more typical of asthma or chronic bronchitis, not emphysema. Emphysema involves destruction of alveolar walls rather than mucosal thickening or epithelial desquamation.
Choice B reason: Emphysema is characterized by permanent enlargement of airspaces distal to the terminal bronchioles due to destruction of alveolar walls. Smoking triggers an inflammatory response that activates proteases like elastase, which degrade alveolar structures, leading to reduced surface area for gas exchange and loss of elastic recoil. This results in irreversible airflow obstruction.
Choice C reason: This describes the pathophysiology of asthma, which involves reversible airway obstruction due to inflammation, mucus plugging, and bronchial smooth muscle contraction. Emphysema does not involve mucus plug formation or reversible obstruction.
Choice D reason: This describes the mechanism of acute respiratory distress syndrome (ARDS), not emphysema. ARDS involves alveolar-capillary membrane damage due to infection or trauma, leading to fluid leakage and decreased lung compliance.
Correct Answer is D
Explanation
Choice A reason: While polydipsia and polyuria are consistent with central diabetes insipidus, extreme hunger and weight loss are more characteristic of uncontrolled diabetes mellitus. Hunger is not a hallmark symptom of diabetes insipidus.
Choice B reason: Irritability, lack of appetite, and vomiting may be seen in various pediatric or metabolic conditions but are not typical features of central diabetes insipidus, which primarily affects fluid balance.
Choice C reason: Fatigue, depression, and sensitivity to cold are symptoms more consistent with hypothyroidism or other endocrine disorders involving decreased metabolic rate. They do not reflect the hallmark features of diabetes insipidus.
Choice D reason: Central diabetes insipidus is characterized by a deficiency of antidiuretic hormone (ADH), leading to excessive urination (polyuria), excessive thirst (polydipsia), and frequent nighttime urination (nocturia). These symptoms result from the kidneys' inability to concentrate urine, making this the most accurate choice.
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.