NR293 Exam 4 Actual Exam Style V1
NR293 Exam 4 Actual Exam Style V1
NR293 Exam 4 Actual Exam Style V1
1. A patient is prescribed Insulin Lispro for mealtime coverage. When should the nurse
instruct the patient to take this medication?
A. 30 to 45 minutes before eating
B. Only when blood glucose is above 200 mg/dL
C. Once daily at bedtime
D. 15 minutes before or immediately after a meal
Answer: D
Rationale: Insulin Lispro is a rapid-acting insulin with an onset of 15 minutes. It must be
administered in close proximity to a meal to prevent hypoglycemia. Patients should ensure
that food is present before or immediately after the injection.
2. Which instruction is most important for a patient starting Levothyroxine for
hypothyroidism?
A. Take the medication with a full meal to avoid GI upset.
B. Expect the full therapeutic effect to occur within 24 hours.
C. Take the medication in the morning on an empty stomach.
,D. Stop the medication if you feel your heart racing.
Answer: C
Rationale: Levothyroxine absorption is increased when taken on an empty stomach,
ideally 30 to 60 minutes before breakfast. It is a lifelong therapy that requires consistent
daily administration. Taking it at night or with food can lead to fluctuating hormone levels.
3. A patient with Type 2 Diabetes is scheduled for a CT scan with intravenous contrast. Which
medication should be withheld for 48 hours after the procedure?
A. Glipizide
B. Sitagliptin
C. Pioglitazone
D. Metformin
Answer: D
Rationale: Metformin must be held before and for 48 hours after procedures involving
iodine-based contrast media. This precaution is necessary to prevent the development of
lactic acidosis in the event of contrast-induced renal failure. The nurse must monitor serum
creatinine levels before resuming the medication.
4. What is the primary therapeutic goal of Desmopressin (DDAVP) in a patient with Diabetes
Insipidus?
A. To decrease urine output
, B. To increase blood glucose levels
C. To stimulate the release of growth hormone
D. To lower serum potassium levels
Answer: A
Rationale: Desmopressin is a synthetic form of antidiuretic hormone used to treat
Diabetes Insipidus. It works by increasing water reabsorption in the kidneys, which leads
to a decrease in urine volume. Successful therapy is indicated by a decrease in thirst and an
increase in urine specific gravity.
5. A nurse is teaching a patient about Prednisone. Which side effect should the nurse
emphasize?
A. Hypoglycemia
B. Weight loss
C. Hypotension
D. Increased risk of infection
Answer: D
Rationale: Glucocorticoids like Prednisone suppress the immune response, making
patients more susceptible to infections. They also commonly cause hyperglycemia, weight
gain, and fluid retention. Patients should be taught to avoid crowds and report any signs of
fever immediately.
NR293 Exam 4 Actual Exam Style V1
NR293 Exam 4 Actual Exam Style V1
1. A patient is prescribed Insulin Lispro for mealtime coverage. When should the nurse
instruct the patient to take this medication?
A. 30 to 45 minutes before eating
B. Only when blood glucose is above 200 mg/dL
C. Once daily at bedtime
D. 15 minutes before or immediately after a meal
Answer: D
Rationale: Insulin Lispro is a rapid-acting insulin with an onset of 15 minutes. It must be
administered in close proximity to a meal to prevent hypoglycemia. Patients should ensure
that food is present before or immediately after the injection.
2. Which instruction is most important for a patient starting Levothyroxine for
hypothyroidism?
A. Take the medication with a full meal to avoid GI upset.
B. Expect the full therapeutic effect to occur within 24 hours.
C. Take the medication in the morning on an empty stomach.
,D. Stop the medication if you feel your heart racing.
Answer: C
Rationale: Levothyroxine absorption is increased when taken on an empty stomach,
ideally 30 to 60 minutes before breakfast. It is a lifelong therapy that requires consistent
daily administration. Taking it at night or with food can lead to fluctuating hormone levels.
3. A patient with Type 2 Diabetes is scheduled for a CT scan with intravenous contrast. Which
medication should be withheld for 48 hours after the procedure?
A. Glipizide
B. Sitagliptin
C. Pioglitazone
D. Metformin
Answer: D
Rationale: Metformin must be held before and for 48 hours after procedures involving
iodine-based contrast media. This precaution is necessary to prevent the development of
lactic acidosis in the event of contrast-induced renal failure. The nurse must monitor serum
creatinine levels before resuming the medication.
4. What is the primary therapeutic goal of Desmopressin (DDAVP) in a patient with Diabetes
Insipidus?
A. To decrease urine output
, B. To increase blood glucose levels
C. To stimulate the release of growth hormone
D. To lower serum potassium levels
Answer: A
Rationale: Desmopressin is a synthetic form of antidiuretic hormone used to treat
Diabetes Insipidus. It works by increasing water reabsorption in the kidneys, which leads
to a decrease in urine volume. Successful therapy is indicated by a decrease in thirst and an
increase in urine specific gravity.
5. A nurse is teaching a patient about Prednisone. Which side effect should the nurse
emphasize?
A. Hypoglycemia
B. Weight loss
C. Hypotension
D. Increased risk of infection
Answer: D
Rationale: Glucocorticoids like Prednisone suppress the immune response, making
patients more susceptible to infections. They also commonly cause hyperglycemia, weight
gain, and fluid retention. Patients should be taught to avoid crowds and report any signs of
fever immediately.
