A nurse is teaching a client who is taking metformin XR for type II diabetes mellitus. Which of the following instructions should the nurse include in the teaching?
"You may crush or chew the medication."
"This medication may turn your urine orange."
"This medication may cause an increase in perspiration."
"Take the medication with a meal."
The Correct Answer is D
Rationale:
A. "You may crush or chew the medication": Metformin XR is an extended-release formulation and should not be crushed or chewed. Altering the tablet disrupts the extended-release mechanism, leading to rapid absorption, increased side effects, and loss of therapeutic benefit.
B. "This medication may turn your urine orange": Orange-colored urine is commonly associated with rifampin or phenazopyridine use, not metformin. Metformin does not cause urine discoloration, so this teaching would not be accurate for a client with type II diabetes.
C. "This medication may cause an increase in perspiration": Increased sweating is linked to hypoglycemia, especially with sulfonylureas or insulin, but metformin does not usually cause this effect. Its side effects are more commonly gastrointestinal, such as diarrhea, nausea, and abdominal discomfort.
D. "Take the medication with a meal": Taking metformin with meals helps reduce gastrointestinal side effects, which are the most common complaints with this drug. Food improves tolerability without decreasing the drug’s effectiveness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. 0815: Giving breakfast an hour after administering regular insulin increases the risk of hypoglycemia because the insulin’s onset of action typically begins within 30 minutes. Delaying food until this time would not align well with the medication’s activity.
B. 0730: Regular insulin begins to lower blood glucose about 30 minutes after injection. Providing breakfast at this time ensures food is available to balance the insulin’s effect, reducing the risk of hypoglycemia while supporting glucose control.
C. 0720: Offering breakfast only five minutes after insulin administration does not match the insulin’s onset. The client would not yet need the glucose intake, and it could lead to a mismatch between peak insulin action and nutrient absorption.
D. 0745: Serving breakfast 30 minutes after insulin administration comes slightly late, as insulin action may already be beginning. This could still put the client at risk of mild hypoglycemia before the meal is absorbed.
Correct Answer is B
Explanation
Rationale:
A. A client who has muscle hypertrophy: Hypercortisolism, as seen in Cushing’s syndrome, leads to muscle wasting and weakness rather than hypertrophy. Cortisol causes protein catabolism, resulting in thin extremities and loss of muscle mass.
B. Moon face: Excess cortisol causes fat redistribution to the face, trunk, and upper back. The rounded “moon face” appearance is a classic physical manifestation of hypercortisolism.
C. A client who has a butterfly rash on his face: A butterfly rash across the cheeks and nose is a hallmark sign of systemic lupus erythematosus, an autoimmune disorder, and is not associated with cortisol excess.
D. A client who has a positive Chvostek’s sign: Chvostek’s sign indicates hypocalcemia due to neuromuscular irritability. It is not a manifestation of hypercortisolism and does not occur as a result of cortisol excess.
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