Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 that their albuterol MDI (Proventil) is used:

Choice A reason: Meperidine, an opioid, crosses the placenta, risking neonatal respiratory depression. Monitoring breathing is critical post-delivery, making this the correct observation for the infant.

Choice B reason: Hypothyroidism is not associated with meperidine exposure. Opioids primarily affect respiration, so this is irrelevant and incorrect for the expected effect.

Choice C reason: Tremors and hyperreflexia are not typical meperidine effects in newborns; respiratory depression is the primary concern. This is incorrect for the nurse’s focus.

Choice D reason: Congenital anomalies result from chronic exposure, not acute labor analgesia. Meperidine’s immediate risk is respiratory, so this is incorrect for monitoring.

Choice A reason: Insulin does not stimulate the liver to convert glycogen to glucose; instead, it promotes glycogenesis and inhibits glycogenolysis. By facilitating glucose uptake and storage, insulin lowers blood glucose levels, counteracting the process of glycogen breakdown into glucose, which is regulated by glucagon and other hormones, making this choice incorrect.

Choice B reason: Insulin does not promote amino acid synthesis into glucose (gluconeogenesis). It inhibits gluconeogenesis in the liver, reducing glucose production from amino acids and other substrates. By enhancing glucose uptake and storage, insulin maintains glucose homeostasis, making this option incorrect as it misrepresents insulin’s role in glucose metabolism.

Choice C reason: Insulin does not stimulate the pancreas to reabsorb glucose. The pancreas produces insulin, which acts on target tissues like muscle and fat to facilitate glucose uptake. Glucose reabsorption occurs in the kidneys, regulated by sodium-glucose cotransporters, not insulin, making this choice scientifically inaccurate for insulin’s function.

Choice D reason: Insulin promotes glucose uptake into cells by facilitating GLUT4 transporter translocation to cell membranes in muscle and adipose tissue. This allows glucose to enter cells for energy production via glycolysis and the Krebs cycle. This is insulin’s primary role in maintaining blood glucose homeostasis, making it the correct choice for its action.