NURS 305 Exam 3 V3 | NURS 305
Pharmacology | Actual Q&A with Rationale
(NURS305 Exam 3) | Liberty University
1. A patient is prescribed Lispro (Humalog) insulin for mealtime coverage. When should the
nurse instruct the patient to administer this medication?
A. Within 15 minutes of eating
B. 30 to 45 minutes before eating
C. Immediately after finishing the meal
D. One hour before breakfast
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of action within 15 to 30 minutes.
Administering it too early can lead to severe hypoglycemia before the meal’s glucose is
absorbed. The nurse must ensure the patient has their meal tray ready or is about to eat
within 15 minutes of the dose.
2. Which lab value is the most critical for the nurse to monitor in a patient receiving
Metformin (Glucophage)?
A. Serum Potassium
B. Liver Enzymes (AST/ALT)
C. Glomerular Filtration Rate (GFR)
,D. Serum Sodium
Answer: C
Rationale: Metformin is primarily excreted by the kidneys and can accumulate in the
presence of renal impairment. This accumulation increases the risk of lactic acidosis, a rare
but life-threatening complication. Nurses should monitor GFR and creatinine levels
regularly to ensure the kidneys can handle the drug load.
3. A patient is scheduled for a CT scan with intravenous contrast and takes Metformin. What
action should the nurse take?
A. Hold the Metformin 48 hours before and after the procedure.
B. Double the dose the day before the procedure.
C. Administer the Metformin as scheduled.
D. Switch to insulin for the duration of the hospital stay.
Answer: A
Rationale: Contrast dye can cause temporary renal insufficiency, which poses a high risk
for lactic acidosis in patients taking Metformin. The medication must be held for at least 48
hours prior to and after the scan. It is only resumed after renal function tests return to
baseline.
4. What is the primary mechanism of action for Glyburide (DiaBeta)?
A. Decreases hepatic glucose production
, B. Stimulates insulin release from the pancreas
C. Increases peripheral insulin sensitivity
D. Slows carbohydrate absorption in the gut
Answer: B
Rationale: Glyburide is a sulfonylurea that acts by stimulating the beta cells of the
pancreas to secrete more insulin. Because it increases insulin levels regardless of blood
glucose concentration, it carries a significant risk of hypoglycemia. Patients should be
taught to recognize signs of low blood sugar and carry a fast-acting glucose source.
5. A patient is prescribed Levothyroxine (Synthroid) for hypothyroidism. Which statement by
the patient indicates a need for further teaching?
A. I will take this first thing in the morning.
B. I will take it with my morning calcium supplement.
C. I will wait 30 minutes before eating breakfast.
D. I will report any chest pain to my doctor.
Answer: B
Rationale: Calcium and iron supplements interfere significantly with the absorption of
Levothyroxine. The medication should be taken on an empty stomach with a full glass of
water, usually 30-60 minutes before any food or other medications. Taking it with calcium
reduces the effectiveness of the thyroid replacement therapy.
Pharmacology | Actual Q&A with Rationale
(NURS305 Exam 3) | Liberty University
1. A patient is prescribed Lispro (Humalog) insulin for mealtime coverage. When should the
nurse instruct the patient to administer this medication?
A. Within 15 minutes of eating
B. 30 to 45 minutes before eating
C. Immediately after finishing the meal
D. One hour before breakfast
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of action within 15 to 30 minutes.
Administering it too early can lead to severe hypoglycemia before the meal’s glucose is
absorbed. The nurse must ensure the patient has their meal tray ready or is about to eat
within 15 minutes of the dose.
2. Which lab value is the most critical for the nurse to monitor in a patient receiving
Metformin (Glucophage)?
A. Serum Potassium
B. Liver Enzymes (AST/ALT)
C. Glomerular Filtration Rate (GFR)
,D. Serum Sodium
Answer: C
Rationale: Metformin is primarily excreted by the kidneys and can accumulate in the
presence of renal impairment. This accumulation increases the risk of lactic acidosis, a rare
but life-threatening complication. Nurses should monitor GFR and creatinine levels
regularly to ensure the kidneys can handle the drug load.
3. A patient is scheduled for a CT scan with intravenous contrast and takes Metformin. What
action should the nurse take?
A. Hold the Metformin 48 hours before and after the procedure.
B. Double the dose the day before the procedure.
C. Administer the Metformin as scheduled.
D. Switch to insulin for the duration of the hospital stay.
Answer: A
Rationale: Contrast dye can cause temporary renal insufficiency, which poses a high risk
for lactic acidosis in patients taking Metformin. The medication must be held for at least 48
hours prior to and after the scan. It is only resumed after renal function tests return to
baseline.
4. What is the primary mechanism of action for Glyburide (DiaBeta)?
A. Decreases hepatic glucose production
, B. Stimulates insulin release from the pancreas
C. Increases peripheral insulin sensitivity
D. Slows carbohydrate absorption in the gut
Answer: B
Rationale: Glyburide is a sulfonylurea that acts by stimulating the beta cells of the
pancreas to secrete more insulin. Because it increases insulin levels regardless of blood
glucose concentration, it carries a significant risk of hypoglycemia. Patients should be
taught to recognize signs of low blood sugar and carry a fast-acting glucose source.
5. A patient is prescribed Levothyroxine (Synthroid) for hypothyroidism. Which statement by
the patient indicates a need for further teaching?
A. I will take this first thing in the morning.
B. I will take it with my morning calcium supplement.
C. I will wait 30 minutes before eating breakfast.
D. I will report any chest pain to my doctor.
Answer: B
Rationale: Calcium and iron supplements interfere significantly with the absorption of
Levothyroxine. The medication should be taken on an empty stomach with a full glass of
water, usually 30-60 minutes before any food or other medications. Taking it with calcium
reduces the effectiveness of the thyroid replacement therapy.
