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 A
Explanation
This is because proton pump inhibitors (PPIs) are drugs that block the enzyme that produces hydrochloric acid in the stomach, thereby reducing the amount of acid secreted into the lumen. PPIs are commonly used to treat peptic ulcer disease and gastroesophageal reflux disease.
Choice B. Histamine-2 antagonist is wrong because histamine-2 antagonists (H blockers) are drugs that block the action of histamine on the parietal cells of the stomach, thereby reducing the amount of acid secreted into the lumen.
However, PPIs are more potent and effective than H blockers in suppressing acid secretion.
Choice C. Prostaglandin is wrong because prostaglandins are substances that protect the stomach lining from the damaging effects of acid and other factors.
Prostaglandins do not directly affect the secretion of acid into the lumen, but they may increase the production of mucus and bicarbonate that buffer the acid.
Choice D. Antipeptic agent is wrong because antipeptic agents are drugs that form a protective barrier over the ulcer crater, preventing further damage from acid and pepsin.
Antipeptic agents do not affect the secretion of acid into the lumen, but they may enhance healing by creating a favorable environment for tissue repair.
Normal ranges for hydrochloric acid secretion in the stomach are 1.5 to 3.5 liters per day, with a pH of 1.5 to 3.53.
Correct Answer is A
Explanation
This is because phenothiazines are contraindicated in patients with suspected or established subcortical brain damage. Phenothiazines can cause central nervous system effects such as drowsiness, dizziness, and extrapyramidal symptoms that may worsen the condition of a client with a brain injury.
Choice B is wrong because phenothiazines are not contraindicated in clients with ischemic heart disease.
However, they should be used with caution as they can cause hypotension and cardiac arrhythmias.
Choice C is wrong because phenothiazines are not contraindicated in pediatric clients.
However, they should be used with caution as they can cause sedation, anticholinergic effects, and paradoxical excitement.
Choice D is wrong because phenothiazines are not contraindicated in clients with type 2 diabetes.
However, they should be used with caution as they can cause hyperglycemia and alter the effects of antidiabetic drugs.
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