A patient who has type 2 diabetes will begin taking glipizide (Glucotrol). Which statement by the patient is concerning to the nurse?
“I will need to check my blood sugar once daily or more?”
“I may continue to have a glass of wine with dinner.”
“I will begin by taking this once daily with breakfast.”
“It is safe to drink grapefruit juice while taking this drug.”
The Correct Answer is D
Choice A reason: Checking blood sugar daily or more is appropriate for diabetes management with glipizide. This shows understanding, so it is not concerning and incorrect.
Choice B reason: Moderate alcohol (e.g., one glass of wine) is generally safe with glipizide if blood sugar is controlled. This is less concerning than grapefruit, so it’s incorrect.
Choice C reason: Taking glipizide once daily with breakfast is correct, as it enhances insulin release with meals. This is appropriate, so it is not concerning and incorrect.
Choice D reason: Grapefruit juice can inhibit CYP enzymes, potentially increasing glipizide levels and hypoglycemia risk. This misunderstanding is dangerous, making it the correct concerning statement.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Lipid-soluble drugs cross cell membranes quickly due to their affinity for lipid bilayers, leading to predictable, rapid absorption. Their onset is not unpredictable but typically faster than water-soluble drugs, especially via routes like intravenous or transdermal, making this choice incorrect for lipid-soluble drugs.
Choice B reason: Lipid-soluble drugs, like fentanyl, rapidly cross lipid-rich cell membranes, including the blood-brain barrier, leading to quick onset of action. This is due to their high partition coefficient, allowing fast diffusion into tissues, making rapid effect onset the correct expectation for the nurse.
Choice C reason: Lipid-soluble drugs have faster onset than water-soluble drugs due to easier membrane penetration. Slow effects are more typical of water-soluble or poorly absorbed drugs. Lipid solubility enhances rapid distribution and action, making this choice incorrect for the expected effect timeline.
Choice D reason: Osmosis refers to water movement across membranes, not drug absorption. Lipid-soluble drugs diffuse through lipid bilayers, not via osmosis, which is irrelevant to their pharmacokinetics. This choice is scientifically inaccurate for describing the onset of lipid-soluble drug effects.
Correct Answer is B
Explanation
Choice A reason: Glargine provides basal, not insulin, coverage; meal coverage. It maintains steady glucose control, so this is incorrect.
Choice B reason: Insulin glargine offers 24-hour basal glucose control, stabilizing blood sugar without peaks. This is its primary effect, making it the correct outcome.
Choice C reason: Glargine requires regular monitoring, not less frequent monitoring, to ensure control. This is incorrect for the therapeutic outcome.
Choice D reason: Glargine has no peak, unlike short-acting insulins, with effects lasting 24 hours. A 2–4 hour peak is incorrect, so incorrect.
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