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: F

Rationale: Dextrose IVP is unnecessary with hyperglycemia. It increases the glucose level further, risking complications like hyperosmolar hyperglycemic state. This treatment is reserved for severe hypoglycemia. Glucagon raises blood glucose and is contraindicated for hyperglycemia. It is used to treat hypoglycemia, not elevated glucose levels seen here. Holding insulin neglects hyperglycemia management, allowing complications like ketoacidosis or delayed glucose control. Insulin is necessary to address elevated blood sugar. Calling the MD delays hyperglycemia treatment unnecessarily, as nurses can administer insulin per protocols in cases like this. Administering 15 units of Humalog risks inducing hypoglycemia. It is an excessive dose given the glucose level of 243 mg/dL. Administering 4 units of Humalog is an appropriate corrective dose for a pre-meal glucose of 243 mg/dL. Rapid-acting insulin efficiently reduces glucose to safer levels, aligning with treatment protocols. Administering 9 units of Humalog risks overcorrecting hyperglycemia, potentially causing hypoglycemia, as it exceeds typical sliding scale guidelines for this glucose level. Administering 5 units of Humalog could be reasonable for slight hyperglycemia, but it is not specifically aligned with the sliding scale dose appropriate for 243 mg/dL.

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: Checking plantar and dorsiflexion assesses neurological status requiring nursing expertise and cannot be delegated to UAP. Log rolling every 2 hours maintains spinal alignment post-laminectomy, a straightforward, standardized task suitable for experienced UAP. PCA assessment involves evaluating pain control methods, which require critical nursing judgments and is not appropriate to delegate. Determining readiness to ambulate involves comprehensive assessment skills, evaluating multiple factors like pain, strength, and hemodynamic stability, beyond UAP's scope of practice.

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.