A patient with type 2 diabetes asks how metformin decreases blood sugar. What is the best response by the nurse?
The medication decreases glucose production in the liver
The medication blocks carbohydrate absorption in the intestine
The medication stimulates insulin release from the pancreas
The medication increases insulin resistance of the cells in the body
The Correct Answer is A
Choice A reason: Metformin reduces blood sugar primarily by inhibiting hepatic gluconeogenesis, decreasing liver glucose production. It also enhances insulin sensitivity in peripheral tissues, reducing hyperglycemia in type 2 diabetes without causing hypoglycemia, as it does not stimulate insulin secretion, making this the accurate mechanism.
Choice B reason: Metformin does not block carbohydrate absorption in the intestine. Drugs like alpha-glucosidase inhibitors (e.g., acarbose) slow carbohydrate breakdown, but metformin primarily acts on the liver to reduce gluconeogenesis and improve insulin sensitivity, not directly affecting intestinal absorption.
Choice C reason: Metformin does not stimulate insulin release from the pancreas. This is the mechanism of sulfonylureas, which enhance beta-cell insulin secretion. Metformin works by reducing hepatic glucose output and increasing insulin sensitivity, making this statement incorrect for its mechanism of action.
Choice D reason: Metformin decreases, not increases, insulin resistance. It enhances insulin sensitivity in muscle and liver cells, improving glucose uptake and utilization. Increasing insulin resistance would worsen type 2 diabetes, making this statement incorrect, as metformin’s goal is to counteract insulin resistance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Influenza increases metabolic stress, elevating blood glucose in type 1 diabetes due to stress hormones like cortisol and catecholamines, which promote gluconeogenesis. Frequent glucose monitoring ensures timely insulin adjustments, preventing hyperglycemia or diabetic ketoacidosis, critical for managing acute illness in insulin-dependent patients.
Choice B reason: Discontinuing insulin in type 1 diabetes, even during reduced food intake, is dangerous. Insulin is essential to prevent diabetic ketoacidosis, as the body continues gluconeogenesis and fat metabolism without it, leading to severe acidosis and metabolic collapse, making this instruction incorrect.
Choice C reason: Reducing food intake to diminish nausea may worsen glycemic control in type 1 diabetes. Illness increases glucose levels, requiring consistent carbohydrate intake to prevent hypoglycemia or ketosis. This approach ignores the need for balanced nutrition and insulin adjustments during illness, making it inappropriate.
Choice D reason: Taking half the insulin dose is unsafe, as illness often increases insulin requirements due to stress-induced hyperglycemia. Arbitrary dose reduction risks diabetic ketoacidosis, as insufficient insulin fails to counter gluconeogenesis and ketogenesis, making this instruction dangerous for type 1 diabetes management during influenza.
Correct Answer is B
Explanation
Choice A reason: A high-protein diet supports tissue repair but is not the priority in chronic pancreatitis. Excessive protein can increase pancreatic enzyme demand, potentially exacerbating inflammation, as the pancreas struggles to produce sufficient enzymes, making this less critical than fat restriction for symptom control.
Choice B reason: A low-fat diet is essential in chronic pancreatitis to minimize pancreatic stimulation. Dietary fat triggers cholecystokinin release, stimulating pancreatic enzyme secretion, which can worsen inflammation and pain in a damaged pancreas, making this the priority to reduce exacerbations and promote comfort.
Choice C reason: A high-carbohydrate diet provides energy but may increase glucose levels, complicating diabetes, a common pancreatitis complication. It does not address pancreatic inflammation or enzyme secretion, making it less critical than a low-fat diet for managing chronic pancreatitis symptoms effectively.
Choice D reason: A low-sodium diet prevents fluid retention in conditions like heart failure but is not primary in chronic pancreatitis. While fluid balance is important, sodium restriction does not directly reduce pancreatic inflammation or pain, making it less relevant than fat restriction in this condition.
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