NURS 251 Module 9 Exam V3 | NURS 251
Module 9 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 9 Exam)
1. A patient is prescribed Insulin Lispro (Humalog). At what time should the nurse instruct the
patient to administer this medication?
A. 30 to 60 minutes before a meal
B. Two hours after the largest meal of the day
C. At bedtime regardless of food intake
D. Immediately before or within 15 minutes of eating
Answer: D
Rationale: Insulin Lispro is a rapid-acting insulin with an onset of action between 15 to 30
minutes. Administering it too early before a meal can lead to severe hypoglycemia because
the drug begins working very quickly. Therefore, the patient must have their food ready
and consume it almost immediately after the injection.
2. Which laboratory value is the primary indicator for the long-term management of a patient
with Diabetes Mellitus?
A. Glycosylated hemoglobin (HbA1c)
B. Fasting blood glucose
,C. Postprandial blood glucose
D. Serum creatinine
Answer: A
Rationale: The HbA1c test measures the average blood glucose level over the previous 2 to
3 months. It provides a more comprehensive view of glucose control than single daily
finger-stick tests. A target of less than 7% is typically desired for most non-pregnant adults
with diabetes.
3. A patient with hypothyroidism is started on Levothyroxine (Synthroid). Which statement
by the patient indicates a need for further teaching?
A. I will need to have my TSH levels checked periodically.
B. I should report any chest pain or palpitations to my doctor.
C. It might take several weeks before I feel the full effects of this drug.
D. I will take this medicine every morning with my breakfast.
Answer: D
Rationale: Levothyroxine should be taken on an empty stomach, typically 30 to 60 minutes
before breakfast, to ensure optimal absorption. Taking it with food or calcium-rich
beverages can significantly impair the drug’s bioavailability. The patient needs to
understand that consistency in timing and an empty stomach are crucial for maintaining
therapeutic levels.
, 4. Metformin (Glucophage) is contraindicated in patients with which of the following
conditions?
A. Hypertension
B. Hypothyroidism
C. Hyperlipidemia
D. Renal impairment
Answer: D
Rationale: Metformin is primarily excreted by the kidneys and can accumulate in patients
with renal dysfunction. This accumulation significantly increases the risk of lactic acidosis,
a rare but life-threatening metabolic complication. Therefore, renal function must be
assessed via serum creatinine or GFR before and during therapy.
5. What is the mechanism of action for Sulfonylureas, such as Glyburide?
A. Increasing insulin sensitivity in the peripheral tissues
B. Delaying the absorption of carbohydrates in the small intestine
C. Decreasing glucose production in the liver
D. Stimulating the pancreas to secrete more insulin
Answer: D
Rationale: Sulfonylureas work by binding to specific receptors on the pancreatic beta cells
to stimulate the release of insulin. Because they force insulin secretion regardless of blood
Module 9 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 9 Exam)
1. A patient is prescribed Insulin Lispro (Humalog). At what time should the nurse instruct the
patient to administer this medication?
A. 30 to 60 minutes before a meal
B. Two hours after the largest meal of the day
C. At bedtime regardless of food intake
D. Immediately before or within 15 minutes of eating
Answer: D
Rationale: Insulin Lispro is a rapid-acting insulin with an onset of action between 15 to 30
minutes. Administering it too early before a meal can lead to severe hypoglycemia because
the drug begins working very quickly. Therefore, the patient must have their food ready
and consume it almost immediately after the injection.
2. Which laboratory value is the primary indicator for the long-term management of a patient
with Diabetes Mellitus?
A. Glycosylated hemoglobin (HbA1c)
B. Fasting blood glucose
,C. Postprandial blood glucose
D. Serum creatinine
Answer: A
Rationale: The HbA1c test measures the average blood glucose level over the previous 2 to
3 months. It provides a more comprehensive view of glucose control than single daily
finger-stick tests. A target of less than 7% is typically desired for most non-pregnant adults
with diabetes.
3. A patient with hypothyroidism is started on Levothyroxine (Synthroid). Which statement
by the patient indicates a need for further teaching?
A. I will need to have my TSH levels checked periodically.
B. I should report any chest pain or palpitations to my doctor.
C. It might take several weeks before I feel the full effects of this drug.
D. I will take this medicine every morning with my breakfast.
Answer: D
Rationale: Levothyroxine should be taken on an empty stomach, typically 30 to 60 minutes
before breakfast, to ensure optimal absorption. Taking it with food or calcium-rich
beverages can significantly impair the drug’s bioavailability. The patient needs to
understand that consistency in timing and an empty stomach are crucial for maintaining
therapeutic levels.
, 4. Metformin (Glucophage) is contraindicated in patients with which of the following
conditions?
A. Hypertension
B. Hypothyroidism
C. Hyperlipidemia
D. Renal impairment
Answer: D
Rationale: Metformin is primarily excreted by the kidneys and can accumulate in patients
with renal dysfunction. This accumulation significantly increases the risk of lactic acidosis,
a rare but life-threatening metabolic complication. Therefore, renal function must be
assessed via serum creatinine or GFR before and during therapy.
5. What is the mechanism of action for Sulfonylureas, such as Glyburide?
A. Increasing insulin sensitivity in the peripheral tissues
B. Delaying the absorption of carbohydrates in the small intestine
C. Decreasing glucose production in the liver
D. Stimulating the pancreas to secrete more insulin
Answer: D
Rationale: Sulfonylureas work by binding to specific receptors on the pancreatic beta cells
to stimulate the release of insulin. Because they force insulin secretion regardless of blood
