The nurse is administering sulfonylurea drugs to four different patients diagnosed with type 2 diabetes. Which patient should not receive the medication as ordered?

A 42-year-old man with hypertension

A 37-year-old man with a blood glucose level of 140

A 50-year-old woman with shingles

An 80-year-old woman with an allergy to sulfa

Answer and Explanation

The Correct Answer is D

A. Hypertension does not contraindicate the use of sulfonylureas.
B. A blood glucose level of 140 mg/dL is a common finding in type 2 diabetes, and sulfonylureas are used to control such levels.
C. Shingles (herpes zoster) does not directly contraindicate the use of sulfonylureas.
D. Sulfonylureas should not be given to patients with a sulfa allergy because these medications contain sulfa compounds, which could cause an allergic reaction.

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Correct Answer is B

Explanation

A. A 2-hour blood glucose of 132 mg/dL is within normal limits, as levels under 140 mg/dL are considered normal after an oral glucose tolerance test.
B. A fasting blood glucose level of 155 mg/dL is above the normal threshold (greater than 126 mg/dL indicates diabetes).
C. A casual blood glucose of 178 mg/dL suggests hyperglycemia but does not meet the diagnostic criteria for diabetes unless associated with symptoms.
D. An HbA1c of 5.2% is well within the normal range (below 5.7%).

A. Decreased calcium level B. Decreased parathyroid hormone level C. Increased phosphate level D. Increased magnesium level

Correct Answer is D

Explanation

A. Decreased calcium level is incorrect. Hyperparathyroidism leads to increased calcium levels (hypercalcemia) due to excessive parathyroid hormone (PTH), which increases calcium release from bones, absorption in the intestines, and reabsorption in the kidneys.

B. Decreased parathyroid hormone level is incorrect. In hyperparathyroidism, PTH levels are elevated, not decreased, due to excessive secretion by the parathyroid glands.

C. Increased phosphate level is incorrect. PTH causes renal phosphate excretion, leading to low or normal phosphate levels, rather than increased levels.

D. Increased magnesium level is correct. Parathyroid hormone increases magnesium reabsorption in the kidneys, leading to elevated magnesium levels in hyperparathyroidism.

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The nurse is administering sulfonylurea drugs to four different patients diagnosed with type 2 diabetes. Which patient should not receive the medication as ordered?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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