A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. The patient has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, the pneumonia has resolved, but when monitoring the blood glucose levels, the nurse notices that the level is still elevated. What is the best explanation for this elevation?

The hypoxia caused by the COPD causes an increased need for insulin.

The corticosteroids may cause an increase in glucose levels.

The antibiotics may cause an increase in glucose levels.

His type 2 diabetes has converted to type 1.

Answer and Explanation

The Correct Answer is B

Choice A reason: This is incorrect because hypoxia does not cause an increased need for insulin, but rather a decreased utilization of glucose by the cells. Hypoxia can also impair the secretion of insulin by the pancreas.

Choice B reason: This is correct because corticosteroids are known to cause hyperglycemia by stimulating gluconeogenesis, inhibiting glucose uptake, and increasing insulin resistance. The patient may need to adjust his insulin dose or switch to oral antidiabetic agents while on corticosteroid therapy.

Choice C reason: This is incorrect because antibiotics do not cause an increase in glucose levels, unless they are combined with other drugs that affect glucose metabolism, such as sulfonamides or fluoroquinolones.

Choice D reason: This is incorrect because type 2 diabetes does not convert to type 1 diabetes, as they are different types of diabetes with different causes and mechanisms. Type 1 diabetes is caused by autoimmune destruction of the beta cells of the pancreas, resulting in absolute insulin deficiency. Type 2 diabetes is caused by insulin resistance and relative insulin deficiency.

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Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: Respiratory rate and heart rate are not specific indicators of oxygen saturation. They can be affected by many other factors, such as pain, anxiety, or dehydration.

Choice B reason: Blood pressure and temperature are not directly related to oxygen saturation. They can be influenced by other conditions, such as infection, inflammation, or shock.

Choice C reason: Lung sounds and chest expansion are relevant parameters to monitor for a client with low oxygen saturation. They can indicate the presence of respiratory problems, such as pneumonia, asthma, or atelectasis, that can impair gas exchange and oxygen delivery.

Choice D reason: Hemoglobin and hematocrit are measures of red blood cell count and volume. They can affect the oxygen-carrying capacity of the blood, but they are not directly affected by oxygen saturation. They can be altered by other factors, such as bleeding, dehydration, or anemia.

A. The patient needs to be warned that alopecia is a common adverse effect. B. It is given by deep intramuscular injection to avoid tissue irritation. C. It must not be handled by pregnant women. D. It must be taken on an empty stomach.

Correct Answer is C

Explanation

Choice A reason: This is incorrect because alopecia is not a common or serious adverse effect of finasteride. However, the patient should be informed that finasteride may cause decreased hair growth or loss of hair in some cases.

Choice B reason: This is incorrect because finasteride is not given by injection, but by oral route. The patient should take one tablet daily with or without food.

Choice C reason: This is correct because finasteride can cause birth defects in male fetuses if it is absorbed through the skin or ingested by pregnant women. The patient should wear gloves when handling the tablets and avoid contact with crushed or broken tablets.

Choice D reason: This is incorrect because finasteride can be taken with or without food. However, the patient should take it at the same time each day and follow the provider's instructions.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a 58-year-old client who has a low oxygen saturation. The nurse is reviewing the client's data to create a plan of care. Complete the diagram by drawing arrows to connect the condition and two parameters the nurse should monitor to assess the client's progress.

Correct Answer is C

Explanation

During the administration of finasteride, the nurse must remember which important precaution?

Correct Answer is C

Explanation

During a follow-up visit, a patient who has been on estrogen therapy admits that she has continued to smoke cigarettes. The nurse will remind the patient that smoking while on estrogen may lead to increased:

A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication?

A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs?

A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance?

A nurse is preparing to administer lispro insulin to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take?

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes mellitus. When mixing the two types of insulin, which of the following actions should the nurse take first?