Correct Answer: A

Rationale: Strict monitoring of intake and output in CHF patients with furosemide therapy prevents fluid overload and underhydration. Foley catheter placement accurately quantifies urine output, crucial in critically ill patients with diuretic-induced fluid shifts. This ensures precise fluid balance adjustments, improving patient outcomes. Omitting Foley catheter placement in CHF patients risks inaccurate fluid balance monitoring. Furosemide causes frequent, unpredictable urination, complicating intake-output tracking without direct measurement. This approach undermines effective management of diuretic therapy and fluid overload prevention in critical settings.

Correct Answer: A

Rationale: Metformin primarily increases peripheral insulin sensitivity, particularly in muscle and adipose tissues, facilitating glucose uptake and utilization. It inhibits hepatic glucose production through AMPK activation, reducing gluconeogenesis. Metformin also improves lipid profiles and insulin resistance without promoting insulin secretion, which minimizes the risk of hypoglycemia. Its actions target metabolic pathways, enhancing cellular glucose management for type 2 diabetes control. Metformin does not stimulate pancreatic insulin release. It acts independently of insulin production mechanisms, focusing on improving peripheral sensitivity and reducing hepatic glucose output. Drugs like sulfonylureas target beta cells for insulin release, unlike metformin, which avoids direct engagement with the pancreas, minimizing hypoglycemia risks associated with excessive insulin secretion. Stimulating glucose uptake in skeletal muscles is a partial outcome of improved insulin sensitivity induced by metformin. However, metformin's mechanism extends beyond this, involving significant hepatic effects. It does not directly stimulate glucose uptake as a sole action; rather, it enhances overall metabolic efficiency and glucose management through multiple pathways. Metformin decreases hepatic glucose production rather than increasing it. It inhibits gluconeogenesis by activating AMPK, suppressing the production of glucose from non-carbohydrate sources. This inhibition aids in reducing fasting glucose levels, which are often elevated in type 2 diabetes. The opposite action described contradicts its therapeutic role in managing hyperglycemia effectively.

Correct Answer: D

Rationale: Biologic response modifiers are primarily used for autoimmune diseases like rheumatoid arthritis due to their ability to target specific components of the immune system. They are not standard for osteoarthritis, as OA is a degenerative joint disease without a significant autoimmune component. These treatments do not address the inflammation or pain related to OA effectively. Opiates are used for severe, short-term pain management but carry risks such as addiction and tolerance. They do not address the underlying inflammation in osteoarthritis. Long-term use is generally avoided for OA as safer options like NSAIDs are more effective for managing chronic symptoms without these risks. Disease-Modifying Antirheumatic Drugs (DMARDs) are more effective for autoimmune conditions like rheumatoid arthritis, not osteoarthritis. OA lacks the autoimmune pathology targeted by DMARDs, making them unsuitable for managing OA symptoms like pain or stiffness. NSAIDs are the first-line therapy for OA as they effectively reduce both inflammation and pain associated with the condition. By inhibiting cyclooxygenase enzymes, NSAIDs decrease prostaglandin production, leading to improved joint function and symptom control, making them the most common choice for OA symptom management.

Correct Answer: A

Rationale: Using a Foley catheter can help prevent skin breakdown caused by prolonged contact with urine in incontinent patients, especially if they are confused or non-ambulatory and unable to use other urinary devices. Maintaining intact skin is crucial to avoiding infections and pressure injuries, making a Foley catheter a suitable intervention in specific cases when prescribed. Foley catheters are not inherently inappropriate but must be prescribed judiciously due to risks like urinary tract infections. While alternative methods may be preferable, this intervention is justified for incontinent, immobile patients with compromised mental status to protect skin integrity. It aligns with clinical guidelines and patient-specific needs.

Correct Answer: B

Rationale: Estimating carbohydrate content rather than measuring can lead to inaccuracies in blood sugar control for diabetic patients. Precise carbohydrate counting is essential for maintaining glycemic control and preventing hyperglycemia or hypoglycemia, making this approach unsuitable in diabetes education. Balancing carbohydrate intake with insulin or medication is a critical aspect of diabetes management. This ensures stable blood glucose levels as insulin dosage or medication is adjusted according to the patient's carbohydrate consumption, providing personalized glycemic control effectively. Avoiding all carbohydrates is not a realistic or scientifically sound recommendation, as carbohydrates are essential for energy production. Teaching portion control and healthy carbohydrate choices is more effective for diabetic management than complete avoidance. Counting carbohydrates from sugary foods alone ignores the contribution of complex carbohydrates to blood glucose levels. A comprehensive approach that considers all sources of carbohydrates ensures accurate diabetes education and better long-term blood sugar control.