A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide [Lasix]. The nurse notes an irregular heart rate of 86 beats/min, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern?

Choice A reason: Insulin does not stimulate the liver to convert glycogen to glucose; instead, it promotes glycogenesis and inhibits glycogenolysis. By facilitating glucose uptake and storage, insulin lowers blood glucose levels, counteracting the process of glycogen breakdown into glucose, which is regulated by glucagon and other hormones, making this choice incorrect.

Choice B reason: Insulin does not promote amino acid synthesis into glucose (gluconeogenesis). It inhibits gluconeogenesis in the liver, reducing glucose production from amino acids and other substrates. By enhancing glucose uptake and storage, insulin maintains glucose homeostasis, making this option incorrect as it misrepresents insulin’s role in glucose metabolism.

Choice C reason: Insulin does not stimulate the pancreas to reabsorb glucose. The pancreas produces insulin, which acts on target tissues like muscle and fat to facilitate glucose uptake. Glucose reabsorption occurs in the kidneys, regulated by sodium-glucose cotransporters, not insulin, making this choice scientifically inaccurate for insulin’s function.

Choice D reason: Insulin promotes glucose uptake into cells by facilitating GLUT4 transporter translocation to cell membranes in muscle and adipose tissue. This allows glucose to enter cells for energy production via glycolysis and the Krebs cycle. This is insulin’s primary role in maintaining blood glucose homeostasis, making it the correct choice for its action.

Choice A reason: Low drug interactions are desirable but unrelated to ease of administration. Adherence is directly tied to administration simplicity, so this is incorrect.

Choice B reason: Low production cost is a manufacturing benefit, not administration ease. Patient adherence is the outcome of easy administration, so this is incorrect.

Choice C reason: Storage stability aids logistics, not administration. Easy administration improves compliance, like taking oral pills, so this is incorrect for the outcome.

Choice D reason: Easy administration, like simple dosing or oral routes, enhances patient adherence by reducing barriers. This is the desired outcome, making it correct.