What is the action of Metformin?

Correct Answer: D

Rationale: Metformin is a commonly prescribed medication for managing Type 2 diabetes. The correct answer is D) All of the above. Metformin works through multiple mechanisms to help control blood sugar levels in individuals with diabetes. A) Decrease intestinal glucose absorption is not the primary action of Metformin. Instead, it primarily works in the liver and muscles to reduce glucose production and increase glucose uptake. B) Increase sensitivity to insulin is one of the key actions of Metformin. It helps the body's cells respond better to insulin, which in turn helps lower blood sugar levels. C) Decrease hepatic glucose production is another crucial action of Metformin. By reducing the amount of glucose produced by the liver, it helps lower blood sugar levels. Educationally, understanding the mechanisms of action of medications like Metformin is essential for healthcare professionals to make informed decisions when managing patients with diabetes. Knowing how Metformin works helps in optimizing treatment plans and educating patients on the importance of medication adherence and lifestyle modifications in managing their condition effectively.

Correct Answer: C

Rationale: The correct instruction for the nurse to give the client regarding discontinuing a beta blocker is that it should NOT be abruptly stopped; the dose should be tapered down. Suddenly stopping a beta blocker can lead to rebound hypertension, angina, and even heart attack in some cases. Tapering down the dose helps the body adjust gradually and reduces the risk of adverse effects associated with abrupt discontinuation. It is important for the client to follow the healthcare provider's guidance on how to safely decrease the dose of the beta blocker.

Correct Answer: D

Rationale: The loading dose of a drug required to reach an initial target blood concentration is based on the volume of distribution (Vd) of the drug. The volume of distribution represents the theoretical volume that would be necessary to contain the total amount of the administered drug at the same concentration as in the blood plasma. The loading dose is calculated by multiplying the target blood concentration by the volume of distribution of the drug. This initial dose helps to rapidly achieve the desired drug concentration in the body, especially when a drug has a long half-life or when steady-state levels need to be reached more quickly. Understanding the volume of distribution of a drug is crucial in dosage calculation to ensure therapeutic efficacy and avoid potential toxicity.

Correct Answer: D

Rationale: Acetylcysteine is the antidote for acetaminophen (paracetamol) overdose. Acetaminophen overdose can lead to hepatic necrosis, and acetylcysteine is effective in preventing or reversing this hepatotoxicity. It works by replenishing depleted hepatic stores of glutathione, which is essential for detoxifying the reactive metabolite of acetaminophen. This helps to protect the liver cells from damage caused by the toxic metabolite of acetaminophen. Naloxone, vitamin K, warfarin, and diphenhydramine are not effective in reversing the hepatic necrosis caused by paracetamol overdose.

Correct Answer: B

Rationale: The common side effects of amitriptyline (Elavil) include constipation and dry mouth. Increasing fluid intake can help alleviate these symptoms. Adequate hydration can aid in promoting bowel regularity and relieving dry mouth. It is important for the nurse to give the patient instructions to increase their fluid intake to manage these side effects rather than immediately discontinuing the medication or requesting a change in antidepressants. If the constipation and dry mouth persist or worsen despite increasing fluid intake, then the provider may need to be notified for further evaluation and management.