NCLEX-RN Endocrine Pharmacology
Practice Questions |
20 NGN-Style Pharmacology MCQs with
Detailed Rationales |
ATI Nursing Exam Prep
Question 1
Clinical Scenario
A 54-year-old client with newly diagnosed type 2 diabetes
mellitus is prescribed metformin. Baseline laboratory results
show serum creatinine 0.9 mg/dL, HbA1c 9.1%, and fasting
glucose 210 mg/dL. The client asks how the medication
works.
Question Stem
Which statement best describes the primary mechanism of
action of metformin?
,A. Stimulates pancreatic beta cells to release insulin
B. Increases peripheral insulin sensitivity and decreases
hepatic glucose production
C. Delays intestinal carbohydrate absorption only
D. Replaces endogenous insulin production
Correct Answer
Correct Answer: B. Increases peripheral insulin
sensitivity and decreases hepatic glucose production
Detailed Rationale
Metformin is a biguanide that primarily decreases hepatic
gluconeogenesis and improves insulin sensitivity in muscle
and adipose tissue. It does not stimulate insulin secretion,
making hypoglycemia less likely when used alone. This
mechanism helps reduce fasting and postprandial glucose
levels and is why metformin is considered first-line therapy
for many clients with type 2 diabetes.
Option A is incorrect because sulfonylureas stimulate
insulin release from pancreatic beta cells. Option C is
incorrect because alpha-glucosidase inhibitors delay
carbohydrate absorption in the intestine. Option D is
incorrect because insulin therapy replaces or supplements
endogenous insulin and is not the mechanism of metformin.
,Nurses should monitor renal function before and during
therapy because impaired kidney function increases the risk
for lactic acidosis, a rare but serious adverse effect. Patients
should be instructed to take metformin with meals to reduce
gastrointestinal adverse effects such as nausea and
diarrhea.
Learning Objective
After completing this question, the learner should be able
to:
• Explain the mechanism of action of metformin.
• Differentiate metformin from insulin secretagogues.
• Identify key monitoring parameters for metformin
therapy.
• Educate patients regarding safe administration.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A nurse is preparing to administer regular insulin to a
hospitalized client with type 1 diabetes. The client's blood
, glucose is 58 mg/dL, and the client reports sweating and
shakiness.
Question Stem
Which nursing action is the priority?
A. Administer the scheduled insulin dose
B. Notify the provider after administering insulin
C. Hold the insulin and treat the hypoglycemia
D. Recheck blood glucose in 4 hours
Correct Answer
Correct Answer: C. Hold the insulin and treat the
hypoglycemia
Detailed Rationale
A blood glucose of 58 mg/dL indicates hypoglycemia. The
nurse's priority is preventing further glucose reduction and
treating the hypoglycemic episode. Administration of insulin
would worsen the condition and could lead to seizures, loss
of consciousness, or death.
Option A is unsafe because insulin administration would
further lower glucose levels. Option B delays appropriate
treatment. Option D postpones necessary intervention.
Treatment depends on the client's level of consciousness
and ability to swallow. Fast-acting carbohydrates are
Practice Questions |
20 NGN-Style Pharmacology MCQs with
Detailed Rationales |
ATI Nursing Exam Prep
Question 1
Clinical Scenario
A 54-year-old client with newly diagnosed type 2 diabetes
mellitus is prescribed metformin. Baseline laboratory results
show serum creatinine 0.9 mg/dL, HbA1c 9.1%, and fasting
glucose 210 mg/dL. The client asks how the medication
works.
Question Stem
Which statement best describes the primary mechanism of
action of metformin?
,A. Stimulates pancreatic beta cells to release insulin
B. Increases peripheral insulin sensitivity and decreases
hepatic glucose production
C. Delays intestinal carbohydrate absorption only
D. Replaces endogenous insulin production
Correct Answer
Correct Answer: B. Increases peripheral insulin
sensitivity and decreases hepatic glucose production
Detailed Rationale
Metformin is a biguanide that primarily decreases hepatic
gluconeogenesis and improves insulin sensitivity in muscle
and adipose tissue. It does not stimulate insulin secretion,
making hypoglycemia less likely when used alone. This
mechanism helps reduce fasting and postprandial glucose
levels and is why metformin is considered first-line therapy
for many clients with type 2 diabetes.
Option A is incorrect because sulfonylureas stimulate
insulin release from pancreatic beta cells. Option C is
incorrect because alpha-glucosidase inhibitors delay
carbohydrate absorption in the intestine. Option D is
incorrect because insulin therapy replaces or supplements
endogenous insulin and is not the mechanism of metformin.
,Nurses should monitor renal function before and during
therapy because impaired kidney function increases the risk
for lactic acidosis, a rare but serious adverse effect. Patients
should be instructed to take metformin with meals to reduce
gastrointestinal adverse effects such as nausea and
diarrhea.
Learning Objective
After completing this question, the learner should be able
to:
• Explain the mechanism of action of metformin.
• Differentiate metformin from insulin secretagogues.
• Identify key monitoring parameters for metformin
therapy.
• Educate patients regarding safe administration.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A nurse is preparing to administer regular insulin to a
hospitalized client with type 1 diabetes. The client's blood
, glucose is 58 mg/dL, and the client reports sweating and
shakiness.
Question Stem
Which nursing action is the priority?
A. Administer the scheduled insulin dose
B. Notify the provider after administering insulin
C. Hold the insulin and treat the hypoglycemia
D. Recheck blood glucose in 4 hours
Correct Answer
Correct Answer: C. Hold the insulin and treat the
hypoglycemia
Detailed Rationale
A blood glucose of 58 mg/dL indicates hypoglycemia. The
nurse's priority is preventing further glucose reduction and
treating the hypoglycemic episode. Administration of insulin
would worsen the condition and could lead to seizures, loss
of consciousness, or death.
Option A is unsafe because insulin administration would
further lower glucose levels. Option B delays appropriate
treatment. Option D postpones necessary intervention.
Treatment depends on the client's level of consciousness
and ability to swallow. Fast-acting carbohydrates are
