NR566 Exam 2 Questions with 100% Correct
Answers and Detailed Explanations Latest
Version
Question 1
A 58-year-old patient with newly diagnosed type 2 diabetes has an A1C
of 8.1%. Kidney function is normal. According to current treatment
guidelines, which medication is generally recommended as first-line
pharmacologic therapy?
A. Glyburide
B. Metformin
C. Pioglitazone
D. Sitagliptin
✅ Correct Answer: B. Metformin
Rationale:
Metformin is the preferred initial medication for most adults with type 2
diabetes because it:
• Lowers hepatic glucose production
• Improves insulin sensitivity
• Does not usually cause hypoglycemia
• Is weight neutral or may promote modest weight loss
• Has cardiovascular safety data
It should be used cautiously or avoided in patients with significantly
reduced renal function.
,Question 2
A nurse practitioner prescribes metformin. Which patient instruction is
most appropriate?
A. Take it on an empty stomach.
B. Take it with meals to reduce gastrointestinal side effects.
C. Stop taking it if blood glucose normalizes.
D. Double the dose if one is missed.
✅ Correct Answer: B. Take it with meals
Rationale:
Taking metformin with food reduces common adverse effects such as
nausea, abdominal discomfort, and diarrhea.
Question 3
Which laboratory value should be monitored periodically in patients
receiving long-term metformin therapy?
A. Vitamin B12 level
B. Platelet count
C. Serum amylase
D. Troponin
✅ Correct Answer: A. Vitamin B12 level
,Rationale:
Long-term metformin therapy can reduce vitamin B12 absorption,
potentially leading to deficiency and peripheral neuropathy.
Question 4
A patient taking glipizide reports episodes of sweating, tremors, and
confusion. What is the most likely cause?
A. Hyperglycemia
B. Hypoglycemia
C. Diabetic ketoacidosis
D. Hyperthyroidism
✅ Correct Answer: B. Hypoglycemia
Rationale:
Sulfonylureas stimulate insulin secretion regardless of blood glucose
level, increasing the risk of hypoglycemia.
Question 5
Which medication class lowers blood glucose by increasing urinary
glucose excretion?
A. GLP-1 receptor agonists
B. DPP-4 inhibitors
C. SGLT2 inhibitors
, D. Sulfonylureas
✅ Correct Answer: C. SGLT2 inhibitors
Rationale:
SGLT2 inhibitors block glucose reabsorption in the proximal renal
tubule, causing glucose to be excreted in the urine. They also have
cardiovascular and renal benefits in many patients.
Question 6
Which adverse effect should be discussed with patients taking an
SGLT2 inhibitor?
A. Increased risk of genital yeast infections
B. Hearing loss
C. Bradycardia
D. Peptic ulcer disease
✅ Correct Answer: A. Increased risk of genital yeast infections
Rationale:
Because SGLT2 inhibitors increase urinary glucose, they can increase
the risk of genital mycotic infections and urinary tract infections.
Question 7
Which injectable medication class promotes weight loss while
improving glycemic control?
A. Sulfonylureas
Answers and Detailed Explanations Latest
Version
Question 1
A 58-year-old patient with newly diagnosed type 2 diabetes has an A1C
of 8.1%. Kidney function is normal. According to current treatment
guidelines, which medication is generally recommended as first-line
pharmacologic therapy?
A. Glyburide
B. Metformin
C. Pioglitazone
D. Sitagliptin
✅ Correct Answer: B. Metformin
Rationale:
Metformin is the preferred initial medication for most adults with type 2
diabetes because it:
• Lowers hepatic glucose production
• Improves insulin sensitivity
• Does not usually cause hypoglycemia
• Is weight neutral or may promote modest weight loss
• Has cardiovascular safety data
It should be used cautiously or avoided in patients with significantly
reduced renal function.
,Question 2
A nurse practitioner prescribes metformin. Which patient instruction is
most appropriate?
A. Take it on an empty stomach.
B. Take it with meals to reduce gastrointestinal side effects.
C. Stop taking it if blood glucose normalizes.
D. Double the dose if one is missed.
✅ Correct Answer: B. Take it with meals
Rationale:
Taking metformin with food reduces common adverse effects such as
nausea, abdominal discomfort, and diarrhea.
Question 3
Which laboratory value should be monitored periodically in patients
receiving long-term metformin therapy?
A. Vitamin B12 level
B. Platelet count
C. Serum amylase
D. Troponin
✅ Correct Answer: A. Vitamin B12 level
,Rationale:
Long-term metformin therapy can reduce vitamin B12 absorption,
potentially leading to deficiency and peripheral neuropathy.
Question 4
A patient taking glipizide reports episodes of sweating, tremors, and
confusion. What is the most likely cause?
A. Hyperglycemia
B. Hypoglycemia
C. Diabetic ketoacidosis
D. Hyperthyroidism
✅ Correct Answer: B. Hypoglycemia
Rationale:
Sulfonylureas stimulate insulin secretion regardless of blood glucose
level, increasing the risk of hypoglycemia.
Question 5
Which medication class lowers blood glucose by increasing urinary
glucose excretion?
A. GLP-1 receptor agonists
B. DPP-4 inhibitors
C. SGLT2 inhibitors
, D. Sulfonylureas
✅ Correct Answer: C. SGLT2 inhibitors
Rationale:
SGLT2 inhibitors block glucose reabsorption in the proximal renal
tubule, causing glucose to be excreted in the urine. They also have
cardiovascular and renal benefits in many patients.
Question 6
Which adverse effect should be discussed with patients taking an
SGLT2 inhibitor?
A. Increased risk of genital yeast infections
B. Hearing loss
C. Bradycardia
D. Peptic ulcer disease
✅ Correct Answer: A. Increased risk of genital yeast infections
Rationale:
Because SGLT2 inhibitors increase urinary glucose, they can increase
the risk of genital mycotic infections and urinary tract infections.
Question 7
Which injectable medication class promotes weight loss while
improving glycemic control?
A. Sulfonylureas
