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: Semaglutide, a GLP-1 receptor agonist, is not considered safe in pregnancy due to limited data and potential fetal risks. Animal studies suggest possible teratogenicity, and it is typically avoided in pregnant patients with type 2 diabetes, making this statement inaccurate and irrelevant to its mechanism.
Choice B reason: Semaglutide mimics GLP-1, enhancing glucose-dependent insulin secretion, suppressing glucagon release, slowing gastric emptying, and promoting satiety. These actions lower blood glucose and support weight loss in type 2 diabetes. This statement is accurate, as GLP-1-mediated insulin production is central to its mechanism of action.
Choice C reason: Semaglutide is primarily used for type 2 diabetes, not type 1, as it relies on functional beta cells to enhance insulin secretion. Type 1 diabetes involves absolute insulin deficiency, rendering GLP-1 agonists ineffective. This statement is inaccurate, as semaglutide is not indicated for type 1 diabetes.
Choice D reason: Semaglutide requires regular blood sugar monitoring, as hypoglycemia can occur, especially with concomitant insulin or sulfonylureas. Its glucose-lowering effects necessitate careful management to prevent adverse events. This statement is inaccurate, as monitoring remains critical to ensure safe and effective diabetes control.
Correct Answer is D
Explanation
Choice A reason: Prednisone reduces pain by inhibiting prostaglandin synthesis via phospholipase A2 suppression, not increasing it. Discontinuing prednisone may worsen autoimmune joint pain. This statement is inaccurate, as prednisone’s anti-inflammatory action is beneficial, and the issue lies in its combination with NSAIDs.
Choice B reason: Alternate-day prednisone dosing reduces side effects but may not adequately control chronic autoimmune joint pain, as consistent suppression of inflammation is needed. This statement is less appropriate, as it does not address the primary concern of gastrointestinal risk from combining prednisone with ibuprofen.
Choice C reason: Ibuprofen is a potent NSAID, but its strength is not the issue. Combining it with prednisone increases gastrointestinal bleeding risk due to additive mucosal damage. Suggesting stronger ibuprofen is inappropriate and ignores the ulcer risk, making this statement inaccurate for safe pain management.
Choice D reason: Prednisone and NSAIDs like ibuprofen increase gastric ulcer risk by suppressing mucosal protective prostaglandins and increasing acid production. This combination can lead to bleeding or perforation, especially in autoimmune patients on chronic steroids. This statement is accurate, as it prioritizes discussing safer pain management alternatives.
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