A client with type 2 diabetes is prescribed glipizide, a sulfonylurea. The nurse should monitor the client for which of the following potential adverse effects?
Hypoglycemia
Hyperkalemia
Weight loss
Hypertension
The Correct Answer is A
Choice A reason: Glipizide, a sulfonylurea, stimulates insulin release from pancreatic beta cells by blocking ATP-sensitive potassium channels, increasing insulin secretion. This can cause hypoglycemia, especially if meals are skipped or with excessive dosing. Monitoring blood glucose is critical, as hypoglycemia can lead to symptoms like sweating, shakiness, or confusion, making this the primary adverse effect.
Choice B reason: Glipizide does not significantly affect potassium levels. Hyperkalemia is more associated with drugs like ACE inhibitors or potassium-sparing diuretics. Sulfonylureas primarily impact glucose metabolism, not electrolyte balance, making this an inaccurate adverse effect to monitor in patients taking glipizide.
Choice C reason: Glipizide often causes weight gain, not weight loss, due to increased insulin levels promoting glucose uptake and fat storage. Weight loss is more associated with drugs like metformin or SGLT-2 inhibitors. This statement is inaccurate, as weight gain is a more likely concern with sulfonylureas.
Choice D reason: Hypertension is not a common adverse effect of glipizide. Sulfonylureas primarily affect glucose metabolism, not blood pressure. While diabetes increases cardiovascular risk, glipizide does not directly cause hypertension, making this an inaccurate adverse effect to prioritize in monitoring for this medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: A complete break with both ends aligned is a simple or non-displaced fracture, not a greenstick fracture. Greenstick fractures involve partial breakage with bending, common in children due to flexible bones. This description does not match the characteristic bending of greenstick fractures.
Choice B reason: A greenstick fracture is a partial break where one side of the bone bends and the other cracks, like a green twig. This occurs in children due to pliable bones with a thick periosteum. This description accurately depicts a greenstick fracture, making it the correct choice.
Choice C reason: A break with bone piercing the skin is a compound (open) fracture, not a greenstick fracture. Compound fractures involve complete bone disruption and skin penetration, unlike the partial, bending nature of greenstick fractures, making this description incorrect for the fracture type.
Choice D reason: A spiral break from twisting force is a spiral fracture, characterized by a helical pattern around the bone. Greenstick fractures involve bending, not twisting, and are partial breaks. This description is inaccurate, as it describes a different fracture mechanism unrelated to greenstick fractures.
Correct Answer is A
Explanation
Choice A reason: Escherichia coli (E. coli) is the most common cause of urinary tract infections (UTIs), accounting for 70-90% of cases. This gram-negative bacillus, found in the gastrointestinal tract, ascends the urethra to the bladder, adhering to uroepithelial cells via fimbriae. Its prevalence in fecal flora and ability to colonize the urinary tract make it the primary pathogen.
Choice B reason: Staphylococcus aureus is a gram-positive coccus that can cause UTIs, particularly in catheterized or hospitalized patients, but it accounts for less than 5% of cases. It is more commonly associated with skin or bloodstream infections. Its lower prevalence in UTIs compared to E. coli makes it a less likely cause.
Choice C reason: Pseudomonas aeruginosa, a gram-negative bacillus, is an opportunistic pathogen causing UTIs primarily in immunocompromised or catheterized patients. It accounts for less than 10% of UTIs. Its resistance to antibiotics and preference for nosocomial settings make it less common than E. coli in community-acquired infections.
Choice D reason: Klebsiella pneumoniae, another gram-negative bacillus, causes about 5-10% of UTIs, often in hospitalized or immunocompromised patients. While it can adhere to urinary epithelium, its prevalence is significantly lower than E. coli, which dominates due to its ubiquitous presence in the gut and urogenital proximity.
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