Metformin primarily works by:
Increasing insulin secretion.
Decreasing hepatic glucose production.
Increasing carbohydrate absorption.
Increasing insulin sensitivity.
The Correct Answer is B
Choice A rationale
Metformin, a biguanide, does not increase insulin secretion from the pancreas. Instead, it works independently of insulin secretion and is often used in patients with type 2 diabetes who still produce their own insulin, which is why it has a low risk of causing hypoglycemia.
Choice B rationale
Metformin's primary mechanism of action is to decrease the production of glucose by the liver, a process known as hepatic gluconeogenesis. By reducing this overproduction of glucose, it helps to lower elevated blood glucose levels in patients with type 2 diabetes.
Choice C rationale
Metformin does not increase carbohydrate absorption from the gastrointestinal tract. In fact, it has been shown to slightly decrease glucose absorption, which contributes to its overall glucose-lowering effect and may also be responsible for some of its gastrointestinal side effects.
Choice D rationale
While metformin does modestly increase insulin sensitivity in peripheral tissues, its primary and most significant effect is the reduction of hepatic glucose production. This is the main mechanism by which it lowers blood sugar, making it a cornerstone of type 2 diabetes treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Beta-blockers are used in heart failure to reduce myocardial oxygen demand and improve left ventricular ejection fraction. However, they are not the primary choice for immediate reduction of preload and pulmonary congestion, which are more effectively addressed by medications that directly reduce fluid volume.
Choice B rationale
Diuretics, such as loop diuretics like furosemide, are commonly used in heart failure to reduce preload by increasing sodium and water excretion from the body. This reduction in intravascular volume decreases venous return to the heart, thereby lowering pulmonary congestion and relieving symptoms like dyspnea and edema.
Choice C rationale
ACE inhibitors (angiotensin-converting enzyme inhibitors) are foundational for long-term heart failure management. They reduce afterload and slow disease progression by inhibiting the renin-angiotensin-aldosterone system. While they have some effect on fluid balance, they are not as effective as diuretics for rapid preload reduction and symptom relief.
Choice D rationale
Calcium channel blockers are generally not recommended for systolic heart failure. While some can reduce afterload, most may have negative inotropic effects, which could worsen heart failure symptoms by weakening the heart's pumping action. Their use is limited in specific types of heart failure.
Correct Answer is B
Explanation
Choice A rationale
A patient reporting an increase in suicidal ideation after starting an antidepressant requires immediate and careful assessment. Encouraging them to continue the medication without evaluation could be dangerous and goes against the principle of patient safety. The patient's report is a critical red flag that must be addressed.
Choice B rationale
The black box warning for many antidepressants highlights the risk of increased suicidal thoughts and behaviors in some patients, particularly children, adolescents, and young adults. Documenting the patient's report and notifying the healthcare provider immediately is the appropriate and safest course of action to ensure proper management.
Choice C rationale
Discontinuing an antidepressant abruptly can lead to withdrawal symptoms and rebound depression, potentially worsening the patient's condition. It is not within the nurse's scope of practice to unilaterally discontinue a prescription medication. The healthcare provider must be consulted for a new treatment plan.
Choice D rationale
Increasing the dose of an antidepressant in a patient who reports increased suicidal ideation is contraindicated. This action could potentially exacerbate the side effects and the patient's symptoms, increasing the risk of self-harm. The provider must evaluate the patient's response and adjust the treatment plan accordingly.
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