NURS 251 Module 5 Exam V3 | NURS 251
Module 5 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 5 Exam)
1. A patient with Type 2 diabetes is prescribed Metformin. Which of the following is the most
significant risk when the patient is scheduled for a CT scan with intravenous contrast dye?
A. Acute hypoglycemia
B. Thyroid storm
C. Lactic acidosis
D. Hyperglycemic hyperosmolar state
Answer: C
Rationale: Metformin must be held for 48 hours before and after procedures involving IV
contrast dye. The combination of contrast-induced renal failure and Metformin can lead to
a dangerous buildup of lactic acid in the blood. This condition, known as lactic acidosis, is a
medical emergency with high mortality rates.
2. When teaching a patient about Levothyroxine (Synthroid) therapy for hypothyroidism,
which instruction is most important?
A. Take the medication with a full meal to prevent GI upset.
B. Take the medication at bedtime with a glass of milk.
,C. Take the medication in the morning on an empty stomach.
D. Take the medication only when symptoms of fatigue occur.
Answer: C
Rationale: Levothyroxine absorption is significantly impacted by the presence of food and
other medications in the stomach. Patients should take it 30 to 60 minutes before breakfast
to ensure consistent therapeutic levels. Consistency in timing and stomach environment is
key to maintaining a stable TSH level.
3. A nurse is preparing to administer Lispro (Humalog) insulin to a patient. When should the
nurse instruct the patient to eat?
A. Within 15 minutes of the injection
B. 30 to 60 minutes after the injection
C. 2 hours after the injection
D. Immediately before the next scheduled dose
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of 10 to 30 minutes. If the patient
does not eat shortly after administration, they are at high risk for rapid-onset
hypoglycemia. The nurse must ensure the meal tray is present on the unit before giving the
dose.
, 4. Which clinical finding would indicate that a patient’s dose of Levothyroxine is too high?
A. Bradycardia and constipation
B. Palpitations and insomnia
C. Weight gain and cold intolerance
D. Lethargy and dry skin
Answer: B
Rationale: Excessive thyroid hormone replacement results in symptoms of
hyperthyroidism. Palpitations, tremors, insomnia, and tachycardia are classic signs of
thyroid hormone toxicity. Patients experiencing these symptoms require a TSH check and a
likely dose reduction.
5. A patient is prescribed Prednisone for an acute exacerbation of COPD. Why is it vital to
taper this medication rather than stopping it abruptly?
A. To prevent the development of Cushing’s syndrome
B. To avoid rebound hypertension
C. To prevent acute adrenal insufficiency
D. To ensure the infection does not return
Answer: C
Rationale: Exogenous glucocorticoids suppress the hypothalamic-pituitary-adrenal (HPA)
axis, causing the adrenal glands to stop producing endogenous cortisol. Abrupt withdrawal
Module 5 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 5 Exam)
1. A patient with Type 2 diabetes is prescribed Metformin. Which of the following is the most
significant risk when the patient is scheduled for a CT scan with intravenous contrast dye?
A. Acute hypoglycemia
B. Thyroid storm
C. Lactic acidosis
D. Hyperglycemic hyperosmolar state
Answer: C
Rationale: Metformin must be held for 48 hours before and after procedures involving IV
contrast dye. The combination of contrast-induced renal failure and Metformin can lead to
a dangerous buildup of lactic acid in the blood. This condition, known as lactic acidosis, is a
medical emergency with high mortality rates.
2. When teaching a patient about Levothyroxine (Synthroid) therapy for hypothyroidism,
which instruction is most important?
A. Take the medication with a full meal to prevent GI upset.
B. Take the medication at bedtime with a glass of milk.
,C. Take the medication in the morning on an empty stomach.
D. Take the medication only when symptoms of fatigue occur.
Answer: C
Rationale: Levothyroxine absorption is significantly impacted by the presence of food and
other medications in the stomach. Patients should take it 30 to 60 minutes before breakfast
to ensure consistent therapeutic levels. Consistency in timing and stomach environment is
key to maintaining a stable TSH level.
3. A nurse is preparing to administer Lispro (Humalog) insulin to a patient. When should the
nurse instruct the patient to eat?
A. Within 15 minutes of the injection
B. 30 to 60 minutes after the injection
C. 2 hours after the injection
D. Immediately before the next scheduled dose
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of 10 to 30 minutes. If the patient
does not eat shortly after administration, they are at high risk for rapid-onset
hypoglycemia. The nurse must ensure the meal tray is present on the unit before giving the
dose.
, 4. Which clinical finding would indicate that a patient’s dose of Levothyroxine is too high?
A. Bradycardia and constipation
B. Palpitations and insomnia
C. Weight gain and cold intolerance
D. Lethargy and dry skin
Answer: B
Rationale: Excessive thyroid hormone replacement results in symptoms of
hyperthyroidism. Palpitations, tremors, insomnia, and tachycardia are classic signs of
thyroid hormone toxicity. Patients experiencing these symptoms require a TSH check and a
likely dose reduction.
5. A patient is prescribed Prednisone for an acute exacerbation of COPD. Why is it vital to
taper this medication rather than stopping it abruptly?
A. To prevent the development of Cushing’s syndrome
B. To avoid rebound hypertension
C. To prevent acute adrenal insufficiency
D. To ensure the infection does not return
Answer: C
Rationale: Exogenous glucocorticoids suppress the hypothalamic-pituitary-adrenal (HPA)
axis, causing the adrenal glands to stop producing endogenous cortisol. Abrupt withdrawal
