The nurse is caring for a client with renal dysfunction who requires an oral antidiabetic agent.
What drug will the nurse expect to see ordered?
Tolbutamide.
Tolazamide.
Chlorpropamide.
Chlorpromazine.
The Correct Answer is A
Tolbutamide is preferred for clients with renal dysfunction, who may not be able to excrete chlorpropamide, because it is more easily cleared from the body.
Choice B. Tolazamide is wrong because it is a first-generation sulfonylurea that is used less frequently and is usually tried after tolbutamide and chlorpropamide have been shown to be ineffective.
Choice C. Chlorpropamide is wrong because it is a first-generation sulfonylurea that may accumulate in clients with renal dysfunction and cause hypoglycemia.
Choice D. Chlorpromazine is wrong because it is an antipsychotic agent, not an oral antidiabetic agent.
First-generation sulfonylureas are oral antidiabetic agents that stimulate insulin secretion from the pancreas.
They are used to treat type 2 diabetes mellitus.
The normal range of blood glucose level is 70 to 110 mg/dL.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The nurse should question the administration of human insulin to this client because they do not need exogenous insulin to maintain normal blood glucose levels. Human insulin is indicated for clients who have type 1 diabetes or type 2 diabetes that cannot be controlled by oral antidiabetic agents, diet, or exercise.
Choice A is wrong because a client who has been diagnosed with gestational diabetes may need human insulin to control their blood glucose levels during pregnancy, as oral antidiabetic agents are contraindicated.
Choice B is wrong because a client with type 2 diabetes, controlled with oral antidiabetic agents, who has a systemic infection may need human insulin to manage their blood glucose levels during periods of stress, as infection can increase blood glucose levels and impair the action of oral antidiabetic agents.
Choice D is wrong because a client who has been living with type 1 diabetes for 20 years needs human insulin to replace the endogenous insulin that their pancreas cannot produce.
Correct Answer is C
Explanation
A. A 12-year-old child with obsessive-compulsive disorder is not typically a candidate for misoprostol, as it is not indicated for this condition.
B. A 46-year-old trial lawyer with hypertension might need caution when using misoprostol, as it can cause diarrhea and abdominal pain, which could be problematic.
C. An 83-year-old client with rheumatoid arthritis is the best candidate for misoprostol, particularly if they are taking nonsteroidal anti-inflammatory drugs (NSAIDs) for their condition. Misoprostol is often used to prevent NSAID-induced gastric ulcers in patients at high risk, such as elderly individuals or those with a history of ulcers.
D. A 22-year-old pregnant client should not be given misoprostol unless it is used for specific obstetric indications under close supervision. Misoprostol can induce uterine contractions and is contraindicated in pregnancy unless used for medical reasons like inducing labor or treating postpartum hemorrhage.
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