NUR 210 Exam 4 V3 | NUR 210 Principles
of Pharmacology | Q&A with Rationale
(NUR210 Exam 4) | Galen College of
Nursing
1. A nurse is preparing to administer insulin lispro to a client with type 1 diabetes mellitus. At
which time should the nurse provide the injection?
A. 30 to 60 minutes before a meal
B. 15 minutes before or immediately after a meal
C. At bedtime with a snack
D. Once daily at the same time every morning
Answer: B
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 15 minutes. It is critical
that the client eats shortly after administration to prevent hypoglycemia. This medication is
specifically used to manage postprandial glucose levels and is not used as a long-acting
basal insulin.
2. A client is prescribed metformin for type 2 diabetes. Which diagnostic test is the priority
for the nurse to review before the client undergoes a CT scan with intravenous contrast dye?
A. Liver function tests
B. Serum potassium
,C. Glycosylated hemoglobin (HbA1c)
D. Serum creatinine
Answer: D
Rationale: Metformin is primarily excreted by the kidneys and can cause lactic acidosis if
renal function is impaired. Contrast dye also carries a risk of acute kidney injury, which
increases the risk of metformin accumulation. Nurses must monitor creatinine levels and
ensure metformin is held for 48 hours after the procedure to ensure renal safety.
3. A nurse is teaching a client about the administration of levothyroxine for hypothyroidism.
Which instruction is most important to include?
A. Take the medication with a full meal to avoid GI upset.
B. Wait at least 30 to 60 minutes before eating breakfast.
C. Take the medication at night to maximize absorption.
D. Discontinue the drug if you experience a heart rate over 100 bpm.
Answer: B
Rationale: Levothyroxine should be taken on an empty stomach in the morning to ensure
optimal absorption. Food, especially minerals like calcium and iron, can significantly
decrease the bioavailability of the drug. Consistency in administration timing is key to
maintaining stable thyroid-stimulating hormone (TSH) levels.
, 4. A client is receiving propylthiouracil (PTU) for hyperthyroidism. Which laboratory result
should the nurse monitor most closely for adverse effects?
A. Prothrombin time (PT)
B. Complete blood count (CBC)
C. Serum sodium
D. Blood urea nitrogen (BUN)
Answer: B
Rationale: A serious adverse effect of PTU is agranulocytosis, which is a significant drop in
white blood cell counts. The nurse should instruct the client to report any signs of infection,
such as fever or sore throat, immediately. Regular monitoring of the CBC is necessary to
detect this potentially life-threatening complication.
5. A nurse is instructing a client on the use of an albuterol inhaler for asthma. What is the
primary action of this medication?
A. Reduction of airway inflammation
B. Thinning of pulmonary secretions
C. Bronchodilation through beta-2 stimulation
D. Blockage of leukotriene receptors
Answer: C
of Pharmacology | Q&A with Rationale
(NUR210 Exam 4) | Galen College of
Nursing
1. A nurse is preparing to administer insulin lispro to a client with type 1 diabetes mellitus. At
which time should the nurse provide the injection?
A. 30 to 60 minutes before a meal
B. 15 minutes before or immediately after a meal
C. At bedtime with a snack
D. Once daily at the same time every morning
Answer: B
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 15 minutes. It is critical
that the client eats shortly after administration to prevent hypoglycemia. This medication is
specifically used to manage postprandial glucose levels and is not used as a long-acting
basal insulin.
2. A client is prescribed metformin for type 2 diabetes. Which diagnostic test is the priority
for the nurse to review before the client undergoes a CT scan with intravenous contrast dye?
A. Liver function tests
B. Serum potassium
,C. Glycosylated hemoglobin (HbA1c)
D. Serum creatinine
Answer: D
Rationale: Metformin is primarily excreted by the kidneys and can cause lactic acidosis if
renal function is impaired. Contrast dye also carries a risk of acute kidney injury, which
increases the risk of metformin accumulation. Nurses must monitor creatinine levels and
ensure metformin is held for 48 hours after the procedure to ensure renal safety.
3. A nurse is teaching a client about the administration of levothyroxine for hypothyroidism.
Which instruction is most important to include?
A. Take the medication with a full meal to avoid GI upset.
B. Wait at least 30 to 60 minutes before eating breakfast.
C. Take the medication at night to maximize absorption.
D. Discontinue the drug if you experience a heart rate over 100 bpm.
Answer: B
Rationale: Levothyroxine should be taken on an empty stomach in the morning to ensure
optimal absorption. Food, especially minerals like calcium and iron, can significantly
decrease the bioavailability of the drug. Consistency in administration timing is key to
maintaining stable thyroid-stimulating hormone (TSH) levels.
, 4. A client is receiving propylthiouracil (PTU) for hyperthyroidism. Which laboratory result
should the nurse monitor most closely for adverse effects?
A. Prothrombin time (PT)
B. Complete blood count (CBC)
C. Serum sodium
D. Blood urea nitrogen (BUN)
Answer: B
Rationale: A serious adverse effect of PTU is agranulocytosis, which is a significant drop in
white blood cell counts. The nurse should instruct the client to report any signs of infection,
such as fever or sore throat, immediately. Regular monitoring of the CBC is necessary to
detect this potentially life-threatening complication.
5. A nurse is instructing a client on the use of an albuterol inhaler for asthma. What is the
primary action of this medication?
A. Reduction of airway inflammation
B. Thinning of pulmonary secretions
C. Bronchodilation through beta-2 stimulation
D. Blockage of leukotriene receptors
Answer: C
