Correct Answer: A,B,C

Rationale: Blood pressure of 85/55 indicates hypotension, which can compromise perfusion to vital organs such as the brain and kidneys. Immediate assessment is necessary to determine the underlying cause, such as dehydration or internal bleeding. Hemoglobin level of 7 g/dL is critically low, falling below the normal range of 12–16 g/dL for women or 13–18 g/dL for men. This reflects severe anemia, which may require urgent intervention, including blood transfusion or addressing the cause of anemia. Massive bleeding from the right lower leg is an emergency due to the risk of hypovolemic shock and significant blood loss. Stabilization of the bleeding site and monitoring for signs of systemic impact is required immediately. A temperature of 96.5°F (35.8°
C) may signal mild hypothermia or a systemic condition. While it requires follow-up, it is not as immediately life-threatening as the other findings and therefore does not warrant immediate prioritization.

Correct Answer: C

Rationale: Glyburide does not stimulate glucose uptake directly in skeletal muscles. Instead, it acts on pancreatic beta cells, affecting insulin release. Enhancing muscular glucose uptake occurs through insulin's action downstream. Glyburide does not primarily increase insulin sensitivity. Agents like metformin work to sensitize cells to insulin, but Glyburide functions by stimulating endogenous insulin release. Glyburide stimulates insulin release from pancreatic beta cells by closing ATP-sensitive potassium channels, leading to calcium influx and insulin secretion. This increases circulating insulin, aiding glucose uptake and reducing blood glucose levels. Glyburide does not inhibit carbohydrate breakdown in the intestines. Medications like alpha-glucosidase inhibitors target intestinal enzymes to slow carbohydrate digestion, unlike Glyburide's pancreatic action.

Correct Answer: B

Rationale: Mixing insulin glargine and lispro in the same syringe is contraindicated due to their incompatible chemical formulations. Glargine's acidic pH alters lispro's effectiveness when mixed, impairing glycemic control. Separate administration preserves their individual pharmacokinetics and therapeutic actions. Separate injections ensure each insulin maintains its unique action profile. Glargine provides basal control, while lispro manages rapid postprandial spikes. Their chemical incompatibility mandates separate administration, optimizing glycemic management and reducing potential adverse effects from mixed formulations.

Correct Answer: A

Rationale: Loss of sensation to the perineum, buttocks, inner thighs, and back of the legs may indicate cauda equina syndrome, a surgical emergency. This condition involves compression of the spinal nerve roots and can lead to permanent neurological damage if not promptly addressed. Immediate medical intervention is critical. Nausea and delayed voiding postoperatively are common, potentially due to anesthesia effects or limited mobility. While these findings warrant monitoring, they do not typically indicate an urgent issue unless prolonged or associated with other complications. Mild low back pain is expected after lumbar spinal surgery due to manipulation of spinal structures. Pain management with prescribed analgesics and gradual mobilization is part of the standard postoperative care plan, and it does not usually necessitate immediate reporting. A single episode of emesis can result from anesthesia effects or medication. Unless accompanied by persistent vomiting, signs of aspiration, or electrolyte imbalances, isolated emesis is not typically urgent and should be managed with antiemetics if necessary.

Correct Answer: B

Rationale: Staying with the patient and rechecking blood glucose delays immediate corrective action required for severe hypoglycemia (40 mg/dL). While safety is important, prompt treatment with glucose is the priority to prevent further complications. Following the hypoglycemia protocol ensures immediate glucose administration, either orally, intravenously, or intramuscularly, to stabilize the patient. This is critical as glucose levels below 40 mg/dL require urgent intervention to prevent neuronal damage or coma. Monitoring and rechecking glucose after treating is essential but not sufficient as the first action. Hypoglycemia this severe needs immediate treatment before monitoring, ensuring prompt glucose replacement to prevent worsening symptoms. Notifying the physician without treating the hypoglycemia risks unnecessary delays. Immediate action, such as administering glucose per protocol, is vital in this emergency scenario for patient safety.