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 C
Explanation
Choice A reason: A sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). While furosemide can cause hyponatremia, this value is not concerning. Hypokalemia is a greater risk with furosemide and digoxin, as it potentiates digoxin toxicity, making this choice less critical than potassium.
Choice B reason: Oxygen saturation of 95% is normal (95-100%). Crackles suggest pulmonary edema, but this saturation doesn’t indicate severe hypoxia requiring immediate action. Hypokalemia poses a greater risk with digoxin and furosemide, as it increases toxicity potential, making this choice less concerning.
Choice C reason: A potassium level of 3.0 mEq/L (normal: 3.5-5.0 mEq/L) indicates hypokalemia, exacerbated by furosemide’s diuretic effect. In digoxin use, low potassium increases cardiac toxicity risk, causing arrhythmias, especially with an irregular heart rate noted, making this the most concerning value requiring immediate attention.
Choice D reason: A blood glucose level of 100 mg/dL is normal (70-110 mg/dL fasting). It’s unrelated to digoxin or furosemide’s primary risks (e.g., electrolyte imbalances, arrhythmias). Hypokalemia is a more immediate concern due to its synergistic toxicity with digoxin, making this choice less critical.
Correct Answer is A
Explanation
Choice A reason: Mannitol, an osmotic diuretic, reduces intracranial pressure by drawing fluid from brain tissue into the bloodstream. This is its primary use in head injuries, making it correct.
Choice B reason: Mannitol is not primarily for peripheral edema; it targets cerebral edema. Furosemide is used for peripheral fluid, so this is incorrect for mannitol’s purpose.
Choice C reason: Mannitol removes fluid, not restores it. extracellular fluid, aiming to reduce brain swelling. Restoring fluid is opposite its effect, so this is incorrect.
Choice D reason: Mannitol increases renal perfusion by promoting diuresis, not reducing it. Its main goal is intracranial pressure reduction, so this is incorrect.
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