Nokea
A 75-year-old woman with diabetes is taking an oral antidiabetic drug. One day she goes without eating for 18 \mathrm{~h}. Her serum glucose concentration is 48 \mathrm{mg} / \mathrm{dL} (hypoglycemic) upon arrival at the emergency department, where she is deemed to be in critical condition. Which of the following drugs most likely aggravated this fasting hypoglycemia?
- A. Acarbose
- B. Glyburide
- C. Metformin
- D. Pioglitazone
Correct Answer: B
Rationale: Glyburide, a sulfonylurea, can cause severe hypoglycemia, especially during fasting, due to prolonged insulin release.
You may also like to solve these questions
Patients who are on or who will be starting chronic corticosteroid therapy need monitoring of:
- A. Serum glucose
- B. Stool culture
- C. Folate levels
- D. Vitamin B12
Correct Answer: A
Rationale: Corticosteroids raise glucose, requiring monitoring; stool or vitamins aren't routine.
Sadie is a 72-year-old patient who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for:
- A. Megaloblastic anemia
- B. Osteoporosis
- C. Hypertension
- D. Strokes
Correct Answer: B
Rationale: Chronic PPI use like omeprazole reduces calcium absorption, increasing osteoporosis risk; anemia is less direct.
A nursing instructor is observing a nursing student prepare an oral drug for administration. The instructor determines that the student is performing the procedure correctly when the student compares the label of the drug with the MAR how many times?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: B
Rationale: The proper procedure is to compare the drug label with the MAR three times: when the drug is taken from its storage area, immediately before removing the drug from the container, and before administering the drug to the patient.
James tells you that he is confused by his Medicare Part D coverage plan. An appropriate intervention would be:
- A. Order cognitive testing to determine the source of his confusion.
- B. Sit down with him and explain the whole Medicare Part D process.
- C. Refer him to the Medicare specialist in his insurance plan to explain the benefit to him.
- D. Request his son come to the next appointment so you can explain the benefit to him.
Correct Answer: C
Rationale: Referring to a specialist ensures accurate explanation of Medicare Part D.
A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)
- A. 125
- B. 120
- C. 150
- D. 110
Correct Answer: A
Rationale: Calculation: 750 mL ÷ 6 hr = 125 mL/hr, matching the answer.