A client with type 2 diabetes mellitus is feeling diaphoretic, anxious, and hungry, unable to swallow or follow commands. The nurse noticed these symptoms occurred 45 minutes after an insulin injection. The nurse suspects the client is experiencing insulin toxicity. Which of the following medication should the nurse have available for this client?

Regular insulin

Diphenhydramine (Benadryl)

Metformin (Glucophage)

Glucagon (GlucaGen)

Answer and Explanation

The Correct Answer is D

A. Regular insulin – This is incorrect. Regular insulin would exacerbate hypoglycemia since it lowers blood glucose levels. Administering insulin in this scenario would worsen the client's condition.

B. Diphenhydramine (Benadryl) – This is incorrect. Diphenhydramine is an antihistamine and has no role in treating hypoglycemia or insulin toxicity.

C. Metformin (Glucophage) – This is incorrect. Metformin is an oral hypoglycemic agent and is not suitable for immediate treatment of insulin-induced hypoglycemia.

D. Glucagon (GlucaGen) – This is correct. Glucagon raises blood glucose by promoting glycogen breakdown in the liver and is the treatment of choice for severe hypoglycemia in clients unable to swallow or follow commands.

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Correct Answer is ["C","D"]

Explanation

A. Glucagon (Glucagen): Glucagon is used to treat severe hypoglycemia and is not indicated for managing EPS or involuntary muscle spasms.

B. Metformin (Glucophage): Metformin is an oral hypoglycemic agent used to manage diabetes mellitus and is not relevant for treating EPS or involuntary muscle spasms.

C. Benztropine (Cogentin): Benztropine is an anticholinergic medication used to treat extrapyramidal symptoms (EPS), such as involuntary muscle spasms, caused by antipsychotic medications like prochlorperazine2.

D. Diphenhydramine (Benadryl): Diphenhydramine is an antihistamine with anticholinergic properties that can also be used to manage EPS, including dystonic reactions2.

A. Hypoglycemia B. Somnolence C. Fluid retention D. Hyperglycemia

Correct Answer is B

Explanation

A. Metformin does not typically cause hypoglycemia because it works by decreasing hepatic glucose production and improving insulin sensitivity, not directly lowering blood sugar levels.

B. Somnolence could indicate lactic acidosis, a rare but serious adverse effect of metformin that warrants immediate medical attention.

C. Fluid retention is not a known adverse effect of metformin. Other medications, such as certain thiazolidinediones, are associated with this complication.

D. Hyperglycemia is not a typical adverse effect of metformin; instead, it helps manage blood glucose levels in clients with type 2 diabetes mellitus.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["C","D"]

Explanation

A nurse is teaching a client with a new prescription for metformin (Glucophage). Which of the following findings should the nurse instruct the client to report as an adverse effect of metformin? (Select All That Apply.)

Correct Answer is B

Explanation

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