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 D
Explanation
Choice A rationale
Immediate-release exenatide pens should be discarded 30 days after the first use, not two months. This ensures the medication remains effective and free from contamination.
Choice B rationale
Exenatide is administered subcutaneously, not intramuscularly. The preferred injection sites are the abdomen, thigh, or upper arm.
Choice C rationale
Open exenatide pens should be stored at room temperature, but this is not the most critical aspect of patient education. Proper storage ensures the medication’s stability and effectiveness.
Choice D rationale
Immediate-release exenatide should be taken one hour before morning and evening meals to optimize its glucose-lowering effects by enhancing insulin secretion in response to meals.
Correct Answer is C
Explanation
Choice A rationale
Rifampin is an antibiotic used to treat tuberculosis and other bacterial infections. It does not have a known interaction with St. John’s wort.
Choice B rationale
Furosemide is a diuretic used to treat fluid retention and high blood pressure. It does not have a known interaction with St. John’s wort.
Choice C rationale
Citalopram is a selective serotonin reuptake inhibitor (SSRI) used to treat depression. St. John’s wort can interact with SSRIs like citalopram, potentially leading to serotonin syndrome, a serious condition caused by excessive levels of serotonin in the brain.
Choice D rationale
Allopurinol is used to treat gout and kidney stones. It does not have a known interaction with St. John’s wort.