The client who has been taking glipizide for 6 months reports to the nurse that his urine has become darker since starting the medication. What is the nurse's first action?
Test a sample of urine for the presence of occult blood
Check the client's weight
Instruct the client to increase his water intake
Review results of liver function studies
The Correct Answer is D
A. While testing for occult blood can help rule out hematuria (blood in the urine), it’s not the immediate priority. Dark urine could be related to several factors, including dehydration or changes in liver function, making this not the best first step.
B. While monitoring weight is important, it doesn't directly address the issue of dark urine. Weight changes might indicate fluid retention or loss but are not as immediately relevant to the urine color change.
C. Increasing water intake can help dilute the urine and may help with hydration. However, before suggesting this, it's important to understand the underlying cause of the urine change.
D. Glipizide and other sulfonylureas can affect liver function, and dark urine can indicate potential liver issues, such as bilirubinuria (bilirubin in the urine). Reviewing liver function studies would provide critical information to assess if the change in urine color is related to liver dysfunction or other serious issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B"]
Explanation
A. Limited access to fresh fruits and vegetables can contribute to poor dietary habits, which are linked to obesity and diabetes. Communities with food deserts often have higher rates of diabetes due to reduced access to nutritious food, leading to diets high in processed and unhealthy foods.
B. Living in disadvantaged communities is associated with increased diabetes prevalence and complications. Factors such as lower socioeconomic status, limited access to healthcare, poor health education, and environmental stressors can exacerbate health issues, including diabetes.
C. Having adequate health insurance is generally correlated with better health outcomes, including access to preventive care, regular monitoring, and treatment for diabetes. It does not contribute to increased prevalence or complications; rather, it mitigates them.
D. While certain viral infections have been studied for their potential role in triggering autoimmune diabetes (such as Type 1 diabetes), viral infections themselves are not a social inequity and do not directly correlate with increased diabetes prevalence in the same way that socioeconomic factors do.
E. Autoimmune disorders can be associated with Type 1 diabetes and some cases of Type 2 diabetes; however, this option does not reflect a social inequity. Instead, autoimmune disorders are more related to individual health conditions and genetics.
Correct Answer is ["C","D","E"]
Explanation
A. Clients on warfarin should generally avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen, as these can increase the risk of bleeding. Instead, acetaminophen is often recommended for pain relief, but it should be used cautiously and under a healthcare provider’s guidance.
B. While vitamin K found in green, leafy vegetables can affect warfarin levels, clients do not need to eliminate these foods entirely. Instead, they should maintain a consistent intake of vitamin K-rich foods to help manage their INR levels. Sudden changes in diet can lead to fluctuations in anticoagulation control.
C. It is important for clients taking warfarin to wear a medical alert bracelet. This alerts healthcare providers in case of an emergency, as the client may require special care due to their anticoagulant therapy.
D. Using an electric razor is a safer option for clients on warfarin as it reduces the risk of cuts and bleeding compared to using a traditional razor. This is an important safety measure for those on anticoagulation therapy.
E. Monitoring prothrombin time (PT) and International Normalized Ratio (INR) is essential for clients on warfarin to ensure they are within the therapeutic range. Regular testing helps to manage the dosage effectively and minimize the risk of bleeding or thrombosis.
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