Which of the following is a biguanides which is used for the treatment of diabetes mellitus type II:
- A. Repaglinide
- B. Glibenclamide
- C. Metformin
- D. Pioglitazone
Correct Answer: C
Rationale: Metformin is the primary biguanide used for type 2 diabetes, reducing hepatic glucose production and improving insulin sensitivity.
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When administering a prescribed drug to a client, which action would be completely inappropriate? (Select one that does not apply.)
- A. Charting immediately on the MAR after drug administration
- B. Removing a drug from an unlabeled container
- C. Giving a drug that someone else prepared
- D. Crushing tablets or opening capsules
Correct Answer: A
Rationale: The nurse should always record immediately on the MAR after drug administration. The nurse should never remove a drug from an unlabeled container, give a drug that someone else prepared, or crush tablets or open capsules without consulting a pharmacist. The drug's unit dose wrapper should remain on until the nurse arrives at the client's bedside.
Which statement is not correct about rosiglitazon:
- A. Enhance insulin production by pancreatic beta cells
- B. Increase senstivitiy towards insulin
- C. Increase uptake of glucose by tissues
Correct Answer: A
Rationale: Rosiglitazone increases insulin sensitivity, not insulin production, via PPAR-gamma activation.
The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred?
- A. Hyperventilation
- B. Elevated blood pressure
- C. Local pain at the burn site
- D. Local rash at the burn site
Correct Answer: A
Rationale: Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects. An elevated blood pressure may be expected from the pain that occurs with a burn injury.
The nurse is preparing to administer a medication from a multidose bottle. The label is torn and soiled but the name of the medication is still readable. What is the nurses priority action?
- A. Discard the entire bottle and contents and obtain a new bottle.
- B. Find the drug information and create a new label for the bottle.
- C. Ask another nurse to verify the contents of the bottle.
- D. Administer the medication if the name of the drug can be clearly read.
Correct Answer: A
Rationale: When the drug label is soiled obscuring some information the safest action by the nurse is to discard the bottle and contents because drug labels contain a great deal of important information, far more than just the name of the drug. Concentration of the drug, expiration date, administration directions, and precautions may be missing from the label and so put the patient at risk. Looking up drug information in a drug handbook or consulting with another nurse will not supply the expiration date or concentration of medication. Be safe and discard the bottle and its contents.
The nurse is reviewing the patient's medication orders and finds an order stating amoxicillin 250 mg every 8 hours. What would the nurse question regarding this order?
- A. Dose
- B. Route
- C. Frequency of administration
- D. Allowance for generic substitution
Correct Answer: B
Rationale: The order lacks the route (e.g., oral, IV), which is essential for safe administration.