NR 565 FINAL EXAM WEEK 5 2026 SPRING TEST QUESTIONS WITH ACCURATE
SOLUTIONS
How are ACE inhibitors beneficial in treating nephropathy r/t T1DM?
They decrease glomerular filtration pressure by decreasing levels of angiotensin II, which
lowers BP. Decreased glomerular filtration pressures slows development
What are key considerations when initiating ACEIs in DM for diabetic nephropathy?
They are not protective against early kidney disease and cannot be used as primary
prevention.
ACEIs are CI in pregnancy
SEs: hyperkalemia, cough, angioedema, renal failure, hypotension
What are examples of DDP-4 inhibitor drugs for DM?
"Gliptins":
sitagliptin (Januvia)
saxagliptin (Onglyza)
linagliptin (Tradjenta)
alogliptin (Nesina)
What are the AEs of DDP-4 inhibitors?
URIs, HA, sinusitis (most common)
pancreatitis - severe abd pain w/ or w/o vomiting
hypersensitivity - anaphylaxis, angioedema, SJS
, What is the MOA of DDP-4 inhibitors?
inhibits the enzyme dipeptidyl peptidase-4 which l/t prolonged activity of incretin
hormones to enhance their actions
incretin hormones help increase insulin release in response to meals and decrease hepatic
glucose production without directly releasing insulin
How can the risk of hypoglycemia be minimized in patients on sulfonylurea therapy?
Patient education s/s of hypoglycemia like sweating, shaking, confusion, and dizziness &
how to respond to low BG promptly
Regularly monitor BG
Start with low dose & adjust based on needs - can prevent excessive insulin release & ¯ risk
of hypoglycemia
Take w/ meals to stabilize BG levels
Consume a balanced diet that includes carbs to help prevent hypoglycemia
Avoid alcohol - increased risk of hypoglycemia when combined w/ sulfonylureas
Be aware of interactions with drugs that can risk of hypoglycemia - ex: beta blockers mask
hypoglycemia symptoms
Switch therapy regimen to DDP-4 or GLP-1RAs if patient experiences frequent
hypoglycemia episodes
Monitor renal function because sulfonylureas are excreted by kidneys & renal impairment
can l/t accumulation & subsequent hypoglycemia
When considering prescribing a sulfonylurea, how would you decide between a first- or
second-generation agent for your patient?
2nd generation drugs:
SOLUTIONS
How are ACE inhibitors beneficial in treating nephropathy r/t T1DM?
They decrease glomerular filtration pressure by decreasing levels of angiotensin II, which
lowers BP. Decreased glomerular filtration pressures slows development
What are key considerations when initiating ACEIs in DM for diabetic nephropathy?
They are not protective against early kidney disease and cannot be used as primary
prevention.
ACEIs are CI in pregnancy
SEs: hyperkalemia, cough, angioedema, renal failure, hypotension
What are examples of DDP-4 inhibitor drugs for DM?
"Gliptins":
sitagliptin (Januvia)
saxagliptin (Onglyza)
linagliptin (Tradjenta)
alogliptin (Nesina)
What are the AEs of DDP-4 inhibitors?
URIs, HA, sinusitis (most common)
pancreatitis - severe abd pain w/ or w/o vomiting
hypersensitivity - anaphylaxis, angioedema, SJS
, What is the MOA of DDP-4 inhibitors?
inhibits the enzyme dipeptidyl peptidase-4 which l/t prolonged activity of incretin
hormones to enhance their actions
incretin hormones help increase insulin release in response to meals and decrease hepatic
glucose production without directly releasing insulin
How can the risk of hypoglycemia be minimized in patients on sulfonylurea therapy?
Patient education s/s of hypoglycemia like sweating, shaking, confusion, and dizziness &
how to respond to low BG promptly
Regularly monitor BG
Start with low dose & adjust based on needs - can prevent excessive insulin release & ¯ risk
of hypoglycemia
Take w/ meals to stabilize BG levels
Consume a balanced diet that includes carbs to help prevent hypoglycemia
Avoid alcohol - increased risk of hypoglycemia when combined w/ sulfonylureas
Be aware of interactions with drugs that can risk of hypoglycemia - ex: beta blockers mask
hypoglycemia symptoms
Switch therapy regimen to DDP-4 or GLP-1RAs if patient experiences frequent
hypoglycemia episodes
Monitor renal function because sulfonylureas are excreted by kidneys & renal impairment
can l/t accumulation & subsequent hypoglycemia
When considering prescribing a sulfonylurea, how would you decide between a first- or
second-generation agent for your patient?
2nd generation drugs:
