After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months?

Hemoglobin A1C level

Serum insulin level

Fingerstick fasting blood glucose level

Hemoglobin level

Answer and Explanation

The Correct Answer is A

Choice A reason: This is correct because hemoglobin A1C level reflects the average blood glucose level over the past 2 to 3 months. It is a reliable indicator of the patient's glycemic control and adherence to the antidiabetic therapy. The goal for most patients with type 2 diabetes is to keep the hemoglobin A1C level below 7%.

Choice B reason: This is incorrect because serum insulin level is not a good measure of the patient's adherence to the antidiabetic therapy, as it may vary depending on the type, dose, and timing of the insulin or oral antidiabetic agents. Serum insulin level may also be affected by other factors, such as stress, infection, or exercise.

Choice C reason: This is incorrect because fingerstick fasting blood glucose level only reflects the blood glucose level at a single point in time. It does not provide information about the patient's long-term glycemic control or adherence to the antidiabetic therapy. Fingerstick fasting blood glucose level may also be influenced by the patient's diet, activity, or medication intake before the test.

Choice D reason: This is incorrect because hemoglobin level is not related to the patient's adherence to the antidiabetic therapy, as it measures the amount of oxygen-carrying protein in the red blood cells. Hemoglobin level may be affected by conditions such as anemia, dehydration, or blood loss.

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Correct Answer is D

Explanation

Choice A reason: You should avoid alcohol intake while taking codeine, not limit it to 12 ounces daily. Alcohol can increase the risk of side effects such as drowsiness, dizziness, and respiratory depression.

Choice B reason: You should not expect to experience diarrhea while taking codeine. Codeine can cause constipation, not diarrhea. You should increase your fluid and fiber intake and use laxatives as prescribed to prevent constipation.

Choice C reason: You should not take the medication on an empty stomach to prevent nausea. Codeine can cause nausea and vomiting, especially on an empty stomach. You should take the medication with food or milk to reduce nausea.

Choice D reason: You should change positions slowly while taking codeine. Codeine can cause orthostatic hypotension, which is a sudden drop in blood pressure when you stand up. This can cause dizziness, fainting, and falls. You should change positions slowly and use caution when walking or climbing stairs.

A. Reduced effectiveness of the sildenafil B. Significant increase in pulse rate C. Increased risk of bleeding D. Significant decrease in blood pressure

Correct Answer is D

Explanation

Choice A reason: This is incorrect because sildenafil and nitrates do not affect each other's effectiveness, but rather their side effects. Sildenafil is a phosphodiesterase-5 inhibitor that enhances the effect of nitric oxide, which causes vasodilation and increases blood flow to the penis. Nitrates are vasodilators that also increase nitric oxide levels and reduce the workload of the heart.

Choice B reason: This is incorrect because sildenafil and nitrates do not cause a significant increase in pulse rate, but rather a decrease. This is because the vasodilation caused by both drugs lowers the blood pressure and the cardiac output, which reduces the heart rate.

Choice C reason: This is incorrect because sildenafil and nitrates do not increase the risk of bleeding, unless they are combined with other drugs that affect the blood clotting process, such as anticoagulants or antiplatelets.

Choice D reason: This is correct because sildenafil and nitrates can cause a significant decrease in blood pressure when taken together, as they both cause vasodilation and increase nitric oxide levels. This can lead to hypotension, dizziness, fainting, or even a heart attack or stroke. The patient should avoid taking sildenafil and nitrates within 24 hours of each other.

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After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has a new prescription for codeine. Which of the following instructions should the nurse include in the teaching?

Correct Answer is D

Explanation

A 73-year-old male patient is in the clinic for a yearly physical and is asking for a prescription for sildenafil. He has listed on his health history that he is taking a nitrate for angina. The nurse is aware that which problem may occur if sildenafil is taken with a nitrate?

Correct Answer is D

Explanation

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