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 C
Explanation
Choice A rationale
Calling 911 immediately upon the first symptom of chest pain is not the standard protocol unless the pain is severe or accompanied by other serious symptoms like shortness of breath or dizziness. The patient's protocol is to first stop the activity and sit down. If the pain persists, they are instructed to take one nitroglycerin tablet. Nitroglycerin is a vasodilator that should alleviate chest pain caused by angina.
Choice B rationale
Waiting until the pain becomes more severe before calling 911 is an unsafe practice. Angina is chest pain that occurs when the heart muscle doesn't get enough blood. If it does not respond to initial treatment, it may indicate a more serious condition, such as a myocardial infarction (heart attack). Delaying emergency medical services in this situation can lead to irreversible heart damage or even death. The established protocol is time-sensitive.
Choice C rationale
This is the correct action based on current guidelines for stable angina. If a patient experiences chest pain, they should stop their activity and sit down. If the pain is not relieved after five minutes of rest and one dose of sublingual nitroglycerin, they should call 911. This protocol is in place to ensure a timely response to a potential myocardial infarction, which is indicated if the chest pain does not respond to standard angina treatment.
Choice D rationale
Waiting until the patient has taken three sublingual nitroglycerin tablets, 15 minutes apart, is an outdated protocol. The updated guidelines emphasize prompt medical intervention. The standard is to call emergency services if the first dose does not relieve the pain within five minutes. Delaying treatment by waiting to take two more tablets can significantly worsen the outcome if the patient is experiencing a myocardial infarction.
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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