Which class of oral glucose-lowering agents is most commonly used for people with type 2 diabetes because it reduces hepatic glucose production and enhances tissue uptake of glucose?

Correct Answer: B

Rationale: The correct answer is B) Meglitinide. Meglitinides are a class of oral glucose-lowering agents commonly used for people with type 2 diabetes because they work by stimulating insulin secretion from pancreatic beta cells. This action helps to reduce hepatic glucose production and enhance the uptake of glucose by tissues, thereby lowering blood sugar levels. Meglitinides are particularly useful for individuals who have irregular meal schedules or who struggle with hypoglycemia. A) Insulin is not the most commonly used oral glucose-lowering agent for type 2 diabetes. Insulin is typically administered via injection and is reserved for cases where oral medications are insufficient in controlling blood sugar levels. C) Biguanides, like metformin, work by decreasing hepatic glucose production and increasing insulin sensitivity in peripheral tissues. While a commonly prescribed medication for type 2 diabetes, it does not directly stimulate insulin secretion like meglitinides. D) Sulfonylureas work by stimulating insulin secretion from pancreatic beta cells similar to meglitinides. However, sulfonylureas have a longer duration of action and are associated with a higher risk of hypoglycemia compared to meglitinides. In an educational context, understanding the mechanisms of action of different classes of oral glucose-lowering agents is crucial for healthcare professionals managing patients with type 2 diabetes. By knowing how each medication works, healthcare providers can make informed decisions to tailor treatment plans to individual patient needs, considering factors such as meal schedules, risk of hypoglycemia, and overall efficacy in controlling blood sugar levels.

Correct Answer: A

Rationale: Graves' disease is an autoimmune disorder that leads to overactivity of the thyroid gland (hyperthyroidism). Option A, "Exophthalmos occurs in Graves' disease," is the correct statement. Exophthalmos, or bulging eyes, is a classic symptom of Graves' disease due to inflammation and swelling of the eye muscles and tissues behind the eyes. Option B is incorrect because Graves' disease is actually the most common cause of hyperthyroidism, not uncommon. Option C is incorrect as hyperthyroidism in Graves' disease results from the production of stimulating antibodies, not tissue desensitization to the sympathetic nervous system. Option D is also incorrect because in Graves' disease, there is a decreased TSH level due to negative feedback from elevated thyroid hormone levels. From an educational standpoint, understanding the specific manifestations of Graves' disease is crucial for healthcare providers to accurately diagnose and manage patients with this condition. Recognizing exophthalmos as a hallmark sign can aid in early detection and appropriate treatment, highlighting the importance of detailed knowledge of endocrine disorders in clinical practice.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Calcium supplements with vitamin D can effectively maintain calcium balance. This is the most appropriate teaching for a patient with hypoparathyroidism post-surgical treatment for hyperparathyroidism because it addresses the specific issue of calcium imbalance that arises from the reduced parathyroid function. Option A) is incorrect because increasing dairy intake alone may not provide sufficient calcium and vitamin D to maintain the required balance, especially in cases of hypoparathyroidism. Option B) is incorrect as routine parenteral replacement of parathyroid hormone is not typically required for life and is not the standard of care. Option D) is incorrect as bran and whole-grain foods are not specifically indicated for managing the GI effects of replacement therapy in hypoparathyroidism. Educationally, it is essential for nurses to understand the specific dietary and therapeutic needs of patients with endocrine disorders. Providing accurate and tailored education to patients empowers them to manage their condition effectively and prevent complications. By explaining the rationale behind the correct answer, patients can make informed decisions about their health and well-being.

Correct Answer: C

Rationale: The correct answer is C) void one-half hour before the test, then at the time of the test. Rationale: For an accurate urine test for glucose and acetone, it is essential to instruct the patient to void one-half hour before the test and then at the time of the test. Voiding before the test helps to ensure that the urine sample is not contaminated with residual urine from the bladder, which could give false results. This practice helps obtain a more accurate representation of the body's current status in terms of glucose and acetone levels. Explanation of other options: A) Performing the urine test one-half hour after meals and at bedtime may not provide a clear indication of the baseline glucose and acetone levels in the urine because they can be influenced by recent food intake. B) Drinking three glasses of water before the test may dilute the urine sample, affecting the concentration of glucose and acetone, leading to inaccurate results. D) Increasing carbohydrate intake if the results are negative is not a correct practice as it does not address the immediate need for an accurate urine test and could potentially skew the results. Educational context: Understanding the correct timing and preparation for urine tests is crucial for healthcare professionals to accurately assess a patient's health status. Educating patients on the proper procedures for urine testing helps ensure reliable results and effective monitoring of conditions such as diabetes or ketosis. Proper instructions contribute to better patient outcomes and informed decision-making in healthcare.

Correct Answer: C

Rationale: In the case of Mrs. Jones, a 46-year-old diabetic who is overweight, managing her diet should assume the greatest priority. This is because diet plays a crucial role in controlling blood sugar levels in diabetics. By educating Mrs. Jones on the importance of a balanced diet, low in sugar and carbohydrates, she can better manage her diabetes and potentially lose weight, which can further improve her condition. Exercise, while important, may not be the immediate priority as dietary changes can have a more significant impact on blood sugar levels. Foot care and eye care are also important aspects of diabetes management, but they are secondary to diet in terms of immediate importance. In an educational context, this question highlights the significance of dietary management in diabetes care. It emphasizes the need for healthcare providers to prioritize teaching patients about nutrition and its impact on their condition. By focusing on diet first, patients like Mrs. Jones can take proactive steps towards better managing their diabetes and overall health.