NCLEX-RN Endocrine Pharmacology
Practice Questions |
20 Original NGN MCQs with Rationales |
Nursing Exam Prep
Question 1
Clinical Scenario
A 58-year-old man with newly diagnosed type 2 diabetes
mellitus is prescribed metformin 500 mg orally twice
daily. His medical history includes hypertension and
obesity. Laboratory results reveal: serum creatinine 0.9
mg/dL, estimated glomerular filtration rate (eGFR) 78
mL/min/1.73 m², fasting blood glucose 196 mg/dL, and
HbA1c 8.6%. During discharge teaching, he asks how the
medication works and what precautions he should take.
Question Stem
Which instruction should the nurse provide as the highest
priority regarding metformin therapy?
,A. Take the medication on an empty stomach for maximum
absorption.
B. Stop the medication whenever blood glucose becomes
normal.
C. Take the medication with meals and notify the provider
before procedures involving iodinated contrast dye.
D. Increase carbohydrate intake to prevent hypoglycemia.
Correct Answer
C. Take the medication with meals and notify the provider
before procedures involving iodinated contrast dye.
Detailed Rationale
Metformin is the recommended first-line medication for
many adults with type 2 diabetes because it decreases
hepatic glucose production, improves insulin sensitivity, and
modestly reduces intestinal glucose absorption. Taking
metformin with meals minimizes common gastrointestinal
adverse effects such as nausea, diarrhea, and abdominal
discomfort. An important safety consideration is temporary
discontinuation before or at the time of iodinated contrast
procedures in patients at risk for acute kidney injury
because impaired renal function may increase the risk of the
rare but serious complication of lactic acidosis. Renal
function should be reassessed before restarting therapy.
,Option A is incorrect because taking metformin on an empty
stomach increases gastrointestinal discomfort without
improving therapeutic benefit. Option B is incorrect because
diabetes medications should never be stopped without
provider guidance; glucose control requires ongoing
evaluation using HbA1c and home glucose monitoring.
Option D is incorrect because metformin alone rarely
causes hypoglycemia, so routine increases in carbohydrate
intake are unnecessary and may worsen glycemic control.
Nurses should also reinforce lifestyle modifications,
including diet, exercise, and regular monitoring of renal
function and blood glucose.
Learning Objectives
After completing this question, the learner should be able
to:
• Explain the mechanism of action of metformin.
• Identify key patient education points for metformin
therapy.
• Recognize situations requiring temporary
discontinuation of metformin.
• Promote safe medication administration in adults with
diabetes.
Medication Safety Focus
, Medication administration and monitoring
Question 2
Clinical Scenario
A 67-year-old woman with type 1 diabetes mellitus is
admitted with pneumonia. She receives insulin glargine
once daily and insulin lispro before meals. Before lunch,
her blood glucose is 62 mg/dL. She is awake, alert, and
reports sweating, tremors, and hunger.
Question Stem
What is the nurse's priority action?
A. Administer the scheduled insulin lispro before lunch.
B. Give 15 g of a rapid-acting carbohydrate and recheck
blood glucose in 15 minutes.
C. Notify the provider before treating the patient.
D. Administer glucagon intramuscularly immediately.
Correct Answer
B. Give 15 g of a rapid-acting carbohydrate and recheck
blood glucose in 15 minutes.
Detailed Rationale
Practice Questions |
20 Original NGN MCQs with Rationales |
Nursing Exam Prep
Question 1
Clinical Scenario
A 58-year-old man with newly diagnosed type 2 diabetes
mellitus is prescribed metformin 500 mg orally twice
daily. His medical history includes hypertension and
obesity. Laboratory results reveal: serum creatinine 0.9
mg/dL, estimated glomerular filtration rate (eGFR) 78
mL/min/1.73 m², fasting blood glucose 196 mg/dL, and
HbA1c 8.6%. During discharge teaching, he asks how the
medication works and what precautions he should take.
Question Stem
Which instruction should the nurse provide as the highest
priority regarding metformin therapy?
,A. Take the medication on an empty stomach for maximum
absorption.
B. Stop the medication whenever blood glucose becomes
normal.
C. Take the medication with meals and notify the provider
before procedures involving iodinated contrast dye.
D. Increase carbohydrate intake to prevent hypoglycemia.
Correct Answer
C. Take the medication with meals and notify the provider
before procedures involving iodinated contrast dye.
Detailed Rationale
Metformin is the recommended first-line medication for
many adults with type 2 diabetes because it decreases
hepatic glucose production, improves insulin sensitivity, and
modestly reduces intestinal glucose absorption. Taking
metformin with meals minimizes common gastrointestinal
adverse effects such as nausea, diarrhea, and abdominal
discomfort. An important safety consideration is temporary
discontinuation before or at the time of iodinated contrast
procedures in patients at risk for acute kidney injury
because impaired renal function may increase the risk of the
rare but serious complication of lactic acidosis. Renal
function should be reassessed before restarting therapy.
,Option A is incorrect because taking metformin on an empty
stomach increases gastrointestinal discomfort without
improving therapeutic benefit. Option B is incorrect because
diabetes medications should never be stopped without
provider guidance; glucose control requires ongoing
evaluation using HbA1c and home glucose monitoring.
Option D is incorrect because metformin alone rarely
causes hypoglycemia, so routine increases in carbohydrate
intake are unnecessary and may worsen glycemic control.
Nurses should also reinforce lifestyle modifications,
including diet, exercise, and regular monitoring of renal
function and blood glucose.
Learning Objectives
After completing this question, the learner should be able
to:
• Explain the mechanism of action of metformin.
• Identify key patient education points for metformin
therapy.
• Recognize situations requiring temporary
discontinuation of metformin.
• Promote safe medication administration in adults with
diabetes.
Medication Safety Focus
, Medication administration and monitoring
Question 2
Clinical Scenario
A 67-year-old woman with type 1 diabetes mellitus is
admitted with pneumonia. She receives insulin glargine
once daily and insulin lispro before meals. Before lunch,
her blood glucose is 62 mg/dL. She is awake, alert, and
reports sweating, tremors, and hunger.
Question Stem
What is the nurse's priority action?
A. Administer the scheduled insulin lispro before lunch.
B. Give 15 g of a rapid-acting carbohydrate and recheck
blood glucose in 15 minutes.
C. Notify the provider before treating the patient.
D. Administer glucagon intramuscularly immediately.
Correct Answer
B. Give 15 g of a rapid-acting carbohydrate and recheck
blood glucose in 15 minutes.
Detailed Rationale
