A nurse is caring for a client who has hypertension and nephropathy due to type 2 diabetes mellitus. The nurse should expect to administer which of the following medications to slow the progression of the nephropathy?
Sitagliptin.
Glipizide.
Metoprolol.
Losartan.
The Correct Answer is D
Choice A rationale
Sitagliptin is a DPP-4 inhibitor used to manage blood sugar levels in type 2 diabetes but does not specifically slow the progression of nephropathy.
Choice B rationale
Glipizide is a sulfonylurea that helps control blood sugar levels but does not have a direct effect on slowing nephropathy progression.
Choice C rationale
Metoprolol is a beta-blocker used to manage hypertension but does not specifically target nephropathy progression.
Choice D rationale
Losartan is an angiotensin II receptor blocker (ARB) that helps manage hypertension and has been shown to slow the progression of nephropathy in patients with type 2 diabetes.
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Correct Answer is A
Explanation
Choice A rationale
Elevated alanine aminotransferase (ALT) is an adverse effect of simvastatin therapy. Statins, including simvastatin, can cause liver damage, which is indicated by elevated liver enzymes such as ALT2.
Choice B rationale
Elevated troponin T is not typically associated with simvastatin therapy. Troponin T is a marker for cardiac muscle damage, not a common adverse effect of statins.
Choice C rationale
Elevated WBC count is not a known adverse effect of simvastatin therapy. An elevated WBC count usually indicates an infection or inflammation.
Choice D rationale
Elevated thyroid-stimulating hormone (TSH) is not associated with simvastatin therapy. TSH levels are related to thyroid function, not the effects of statins.
Correct Answer is D
Explanation
Choice A rationale
Taking ibandronate immediately after a meal is incorrect because food and beverages can significantly decrease the absorption of ibandronate. It should be taken on an empty stomach at least 60 minutes before any food or drink.
Choice B rationale
Drinking 8 ounces of milk when taking ibandronate is incorrect because calcium in milk can interfere with the absorption of the medication. It should be taken with plain water only.
Choice C rationale
Taking ibandronate before bedtime is incorrect because the patient needs to remain upright for at least 60 minutes after taking the medication to prevent esophageal irritation.
Choice D rationale
Taking one tablet of ibandronate on the same date each month is correct. This ensures consistent dosing and helps maintain the medication’s effectiveness.