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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Correct Answer is D

Explanation

Choice A reason: This is incorrect because reporting symptoms that last longer than 2 days is not specific to guaifenesin. This is a general instruction for any patient with a sinus infection, regardless of the medication they are taking.

Choice B reason: This is incorrect because reporting clear-colored sputum to the prescriber is not necessary. Clear-colored sputum indicates that the infection is improving and the mucus is thinning. This is a desired effect of guaifenesin, not a problem that needs to be reported.

Choice C reason: This is incorrect because guaifenesin does not have sedating effects. Guaifenesin is an expectorant that helps to break up and expel mucus from the respiratory tract. It does not cause drowsiness or impair the ability to drive or operate machinery.

Choice D reason: This is correct because increasing fluid intake is an important instruction for a patient taking guaifenesin. Fluids help to hydrate the body and thin the mucus, making it easier to cough up and clear the sinuses. Fluids also help to prevent dehydration and dryness of the mucous membranes.

A. "I should rotate the injection sites within the same location for a week." B. "I should store the unopened vials of insulin in the freezer." C. "I should draw up the regular insulin before the NPH insulin." D. "I should inject the insulin into the muscle for faster absorption."

Correct Answer is C

Explanation

Choice A reason: Rotating the injection sites within the same location for a week is not correct. The client should rotate the injection sites within the same location each day to prevent lipodystrophy and ensure consistent absorption.

Choice B reason: Storing the unopened vials of insulin in the freezer is not correct. The client should store the unopened vials of insulin in the refrigerator, not the freezer, to prevent damage to the insulin.

Choice C reason: Drawing up the regular insulin before the NPH insulin is correct. The client should draw up the clear (regular) insulin before the cloudy (NPH) insulin to prevent contamination of the regular insulin with the NPH insulin.

Choice D reason: Injecting the insulin into the muscle for faster absorption is not correct. The client should inject the insulin into the subcutaneous tissue, not the muscle, to ensure appropriate absorption and prevent hypoglycemia.

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Naxlex Comprehensive Predictor Exams

A patient is taking guaifenesin as part of treatment for a sinus infection. Which instruction will the nurse include during patient teaching?

Correct Answer is D

Explanation

A nurse is teaching a client who has type 1 diabetes about insulin administration. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is C

Explanation

A 51-year-old woman will be taking selective estrogen receptor modulators (SERMs) as part of treatment for postmenopausal osteoporosis. The nurse reviews potential contraindications, including which condition?

A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects?

A nurse is teaching a client who has a new prescription for prednisone to treat rheumatoid arthritis. The nurse should inform the client that which of the following is a therapeutic effect of this medication?

A nurse is reviewing contraception options for four clients. The nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives?

A nurse is teaching a client who is to begin taking tamoxifen to treat breast cancer. The nurse should instruct the client to expect which of the following findings as an adverse effect of the medication?

During a routine checkup, a patient states that she is unable to take the prescribed antihistamine because of one of its most common adverse effects. The nurse suspects that which adverse effect has been bothering this patient?

A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

A nurse is preparing to administer levothyroxine 0.175 mg PO once a day. The amount available is levothyroxine 8 mcg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)