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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This is incorrect because insulin can be given intravenously in certain situations, such as diabetic ketoacidosis, hyperglycemic hyperosmolar state, or perioperative care.
Choice B reason: This is correct because regular insulin is the only type of insulin that can be administered intravenously, as it is a short-acting insulin that has a rapid onset and peak. Other types of insulin, such as intermediate-acting or long-acting, are not suitable for intravenous use, as they have a delayed onset and peak and may cause hypoglycemia.
Choice C reason: This is incorrect because insulin aspart and insulin lispro are rapid-acting insulins that have a faster onset and peak than regular insulin. They are not recommended for intravenous use, as they may cause severe hypoglycemia. They are usually given subcutaneously before meals to control postprandial blood glucose levels.
Choice D reason: This is incorrect because not all forms of insulin can be administered intravenously, as explained above. Only regular insulin can be given intravenously, and the dose may differ from the subcutaneous dose depending on the patient's blood glucose level and insulin sensitivity.
Correct Answer is B
Explanation
Choice A reason: Constipation is not an adverse effect of tamoxifen. Tamoxifen does not affect the gastrointestinal motility or function. Constipation may be caused by other factors such as dehydration, low-fiber diet, or lack of exercise.
Choice B reason: Clotting is an adverse effect of tamoxifen. Tamoxifen can increase the risk of thromboembolic events such as deep vein thrombosis, pulmonary embolism, or stroke. Clotting can cause serious complications such as pain, swelling, shortness of breath, chest pain, or neurological deficits.
Choice C reason: Tinnitus is not an adverse effect of tamoxifen. Tamoxifen does not affect the auditory system or cause hearing loss. Tinnitus may be caused by other factors such as noise exposure, ear infection, or medication toxicity.
Choice D reason: Urinary retention is not an adverse effect of tamoxifen. Tamoxifen does not affect the urinary system or cause bladder dysfunction. Urinary retention may be caused by other factors such as prostate enlargement, nerve damage, or medication side effects.
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