NUR612/NUR612 Exam 4 V3 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient with Type 2 Diabetes is prescribed Metformin. Which laboratory result would be
the most significant contraindication for starting this medication?
A. Alanine Aminotransferase (ALT) of 45 U/L
B. Hemoglobin A1c of 9.0%
C. Glomerular Filtration Rate (GFR) of 25 mL/min
D. Serum Potassium of 5.2 mEq/L
Answer: C
Rationale: Metformin is contraindicated in patients with severe renal impairment due to
the increased risk of lactic acidosis. A GFR below 30 mL/min is the specific threshold where
the drug should be avoided entirely. Healthcare providers must monitor renal function
before and during therapy to ensure patient safety.
2. When teaching a patient about taking Levothyroxine for hypothyroidism, which instruction
is most important?
A. Take the medication with a high-calcium meal
B. Take the medication on an empty stomach 30-60 minutes before breakfast
C. Take the medication at bedtime with a snack
,D. Wait at least 15 minutes after eating to take the dose
Answer: B
Rationale: Levothyroxine absorption is significantly decreased by food, certain minerals,
and other medications. Taking it on an empty stomach in the morning ensures consistent
absorption and therapeutic thyroid levels. Patients should wait at least 30 to 60 minutes
before consuming any food or other supplements to avoid interference.
3. Which of the following is a potential serious adverse effect associated with the use of
Propylthiouracil (PTU) for hyperthyroidism?
A. Hyperglycemia
B. Peripheral neuropathy
C. Hepatotoxicity
D. Weight gain
Answer: C
Rationale: PTU carries a boxed warning for severe liver injury and acute liver failure.
Patients should be monitored for signs of jaundice, dark urine, or abdominal pain while on
this medication. Methimazole is generally preferred over PTU except in specific situations
like the first trimester of pregnancy due to this risk profile.
4. A patient is prescribed Lispro insulin. When should the nurse instruct the patient to
administer this dose?
A. 30 to 45 minutes before a meal
, B. Immediately after the meal is finished
C. 15 minutes before or immediately with a meal
D. At bedtime to cover overnight needs
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of approximately 15 minutes. It
must be administered in close proximity to a meal to prevent hypoglycemia. If the patient
does not eat shortly after administration, their blood glucose levels may drop dangerously
low.
5. What is the primary mechanism of action of Sulfonylureas, such as Glipizide?
A. Increasing glucose excretion in the urine
B. Improving insulin sensitivity in peripheral tissues
C. Decreasing glucose production in the liver
D. Stimulating the release of insulin from pancreatic beta cells
Answer: D
Rationale: Sulfonylureas work by binding to receptors on pancreatic beta cells to trigger
the release of endogenous insulin. This mechanism requires the patient to have functioning
beta cells, which is why they are not used in Type 1 Diabetes. Because they stimulate
insulin secretion regardless of blood glucose levels, they carry a risk of hypoglycemia.
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient with Type 2 Diabetes is prescribed Metformin. Which laboratory result would be
the most significant contraindication for starting this medication?
A. Alanine Aminotransferase (ALT) of 45 U/L
B. Hemoglobin A1c of 9.0%
C. Glomerular Filtration Rate (GFR) of 25 mL/min
D. Serum Potassium of 5.2 mEq/L
Answer: C
Rationale: Metformin is contraindicated in patients with severe renal impairment due to
the increased risk of lactic acidosis. A GFR below 30 mL/min is the specific threshold where
the drug should be avoided entirely. Healthcare providers must monitor renal function
before and during therapy to ensure patient safety.
2. When teaching a patient about taking Levothyroxine for hypothyroidism, which instruction
is most important?
A. Take the medication with a high-calcium meal
B. Take the medication on an empty stomach 30-60 minutes before breakfast
C. Take the medication at bedtime with a snack
,D. Wait at least 15 minutes after eating to take the dose
Answer: B
Rationale: Levothyroxine absorption is significantly decreased by food, certain minerals,
and other medications. Taking it on an empty stomach in the morning ensures consistent
absorption and therapeutic thyroid levels. Patients should wait at least 30 to 60 minutes
before consuming any food or other supplements to avoid interference.
3. Which of the following is a potential serious adverse effect associated with the use of
Propylthiouracil (PTU) for hyperthyroidism?
A. Hyperglycemia
B. Peripheral neuropathy
C. Hepatotoxicity
D. Weight gain
Answer: C
Rationale: PTU carries a boxed warning for severe liver injury and acute liver failure.
Patients should be monitored for signs of jaundice, dark urine, or abdominal pain while on
this medication. Methimazole is generally preferred over PTU except in specific situations
like the first trimester of pregnancy due to this risk profile.
4. A patient is prescribed Lispro insulin. When should the nurse instruct the patient to
administer this dose?
A. 30 to 45 minutes before a meal
, B. Immediately after the meal is finished
C. 15 minutes before or immediately with a meal
D. At bedtime to cover overnight needs
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of approximately 15 minutes. It
must be administered in close proximity to a meal to prevent hypoglycemia. If the patient
does not eat shortly after administration, their blood glucose levels may drop dangerously
low.
5. What is the primary mechanism of action of Sulfonylureas, such as Glipizide?
A. Increasing glucose excretion in the urine
B. Improving insulin sensitivity in peripheral tissues
C. Decreasing glucose production in the liver
D. Stimulating the release of insulin from pancreatic beta cells
Answer: D
Rationale: Sulfonylureas work by binding to receptors on pancreatic beta cells to trigger
the release of endogenous insulin. This mechanism requires the patient to have functioning
beta cells, which is why they are not used in Type 1 Diabetes. Because they stimulate
insulin secretion regardless of blood glucose levels, they carry a risk of hypoglycemia.
