NUR 378 Exam 3 V1 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 3) |
Concordia
1. ENDOCRINE: DIABETES MELLITUS - A nurse is preparing to administer NPH insulin to a
patient at 0800. At what time is the patient at the highest risk for a hypoglycemic reaction?
A. 0900 to 1000
B. 0830 to 0900
C. 1200 to 2000
D. 2200 to 2400
Correct Answer: C
This question assesses the nurse’s knowledge of insulin pharmacokinetics, specifically the
peak action of intermediate-acting insulin. Understanding peaks is essential for patient
safety to prevent hypoglycemia during the period of maximum drug effect. Students must
differentiate between rapid, short, intermediate, and long-acting insulin profiles. Rationale:
NPH is an intermediate-acting insulin with a peak effect typically occurring 4 to 12 hours
after administration. If given at 0800, the peak occurs between 1200 and 2000. Option A
and C reflect rapid or short-acting peaks. Option D is beyond the typical peak window.
,2. A patient with Type 1 Diabetes is prescribed Insulin Lispro (Humalog). Which statements by
the nurse correctly describe the administration and characteristics of this medication? (Select
All That Apply)
A. This insulin should be administered 15 minutes before a meal.
B. The nurse must ensure the patient’s food tray is present before injecting.
C. This medication can be administered intravenously in emergency situations.
D. Lispro is considered a rapid-acting insulin.
E. This insulin has a peak effect of 4 to 10 hours.
F. The duration of action is approximately 3 to 5 hours.
Correct Answer: A, B, D, F
Selecting the correct interventions for rapid-acting insulin is a high-priority safety
competency in nursing pharmacology. This SATA question requires the student to
distinguish the unique onset, peak, and duration of Lispro compared to other classes.
Failure to time the injection with food intake can lead to life-threatening hypoglycemia.
Rationale: Lispro is rapid-acting (D) with an onset of 15 minutes, requiring administration
15 mins before or immediately with meals (A, B). Its duration is 3-5 hours (F). Regular
insulin, not Lispro, is typically used for IV administration (C). The peak for Lispro is 0.5 to
2.5 hours, not 4-10 (E).
,3. The nurse is providing education to a patient starting Insulin Glargine (Lantus). Which
instruction is most important for the nurse to include?
A. Mix this insulin with NPH to reduce the number of injections.
B. Do not mix this insulin in the same syringe with any other insulin.
C. Expect a peak effect about 6 hours after the injection.
D. Only take this insulin if your pre-meal blood glucose is above 150 mg/dL.
Correct Answer: B
This question focuses on the unique administration requirements of long-acting basal
insulins. Glargine’s low pH prevents it from being compatible with other insulins in the
same syringe. Recognizing these specific contraindications is vital for maintaining
medication efficacy and safety. Rationale: Insulin glargine is a long-acting insulin that must
not be mixed with any other insulin (C) because it will precipitate. It does not have a peak
(B) and is meant for basal coverage, not as a sliding scale based on immediate pre-meal
readings (D). Mixing it (A) is strictly contraindicated.
4. A patient is found unconscious and clammy with a blood glucose level of 42 mg/dL. Which
medication should the nurse prepare to administer first?
A. Subcutaneous Lispro insulin
B. Intramuscular Glucagon
C. Oral orange juice with a sugar packet
D. Intravenous Dextrose 50% (D50W)
, E. Normal Saline bolus
Correct Answer: D
Emergency management of severe hypoglycemia is a critical nursing intervention that
requires immediate prioritization based on patient consciousness. In an acute care setting
with IV access, D50W is the fastest method to restore glucose levels. This scenario tests the
application of the hypoglycemia protocol for an unconscious patient. Rationale: For an
unconscious patient with IV access, IV D50W (B) is the treatment of choice for rapid
glucose elevation. Oral intake (C) is contraindicated due to aspiration risk. Glucagon (D) is
used if IV access is unavailable. Lispro (A) would further lower blood sugar, and Saline (E)
does not treat hypoglycemia.
5. A nurse is teaching a patient about the proper storage of insulin. Which statement by the
patient indicates a need for further teaching?
A. I can keep my current bottle of insulin at room temperature for up to one month.
B. I will keep my unopened insulin bottles in the refrigerator.
C. I should freeze my extra bottles of insulin to keep them fresh longer.
D. I need to keep my insulin out of direct sunlight and heat.
Correct Answer: C
Insulin stability is highly sensitive to temperature extremes, making storage education a
key component of diabetic teaching. Nurses must ensure patients understand how to
preserve medication potency through proper environmental control. This question
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 3) |
Concordia
1. ENDOCRINE: DIABETES MELLITUS - A nurse is preparing to administer NPH insulin to a
patient at 0800. At what time is the patient at the highest risk for a hypoglycemic reaction?
A. 0900 to 1000
B. 0830 to 0900
C. 1200 to 2000
D. 2200 to 2400
Correct Answer: C
This question assesses the nurse’s knowledge of insulin pharmacokinetics, specifically the
peak action of intermediate-acting insulin. Understanding peaks is essential for patient
safety to prevent hypoglycemia during the period of maximum drug effect. Students must
differentiate between rapid, short, intermediate, and long-acting insulin profiles. Rationale:
NPH is an intermediate-acting insulin with a peak effect typically occurring 4 to 12 hours
after administration. If given at 0800, the peak occurs between 1200 and 2000. Option A
and C reflect rapid or short-acting peaks. Option D is beyond the typical peak window.
,2. A patient with Type 1 Diabetes is prescribed Insulin Lispro (Humalog). Which statements by
the nurse correctly describe the administration and characteristics of this medication? (Select
All That Apply)
A. This insulin should be administered 15 minutes before a meal.
B. The nurse must ensure the patient’s food tray is present before injecting.
C. This medication can be administered intravenously in emergency situations.
D. Lispro is considered a rapid-acting insulin.
E. This insulin has a peak effect of 4 to 10 hours.
F. The duration of action is approximately 3 to 5 hours.
Correct Answer: A, B, D, F
Selecting the correct interventions for rapid-acting insulin is a high-priority safety
competency in nursing pharmacology. This SATA question requires the student to
distinguish the unique onset, peak, and duration of Lispro compared to other classes.
Failure to time the injection with food intake can lead to life-threatening hypoglycemia.
Rationale: Lispro is rapid-acting (D) with an onset of 15 minutes, requiring administration
15 mins before or immediately with meals (A, B). Its duration is 3-5 hours (F). Regular
insulin, not Lispro, is typically used for IV administration (C). The peak for Lispro is 0.5 to
2.5 hours, not 4-10 (E).
,3. The nurse is providing education to a patient starting Insulin Glargine (Lantus). Which
instruction is most important for the nurse to include?
A. Mix this insulin with NPH to reduce the number of injections.
B. Do not mix this insulin in the same syringe with any other insulin.
C. Expect a peak effect about 6 hours after the injection.
D. Only take this insulin if your pre-meal blood glucose is above 150 mg/dL.
Correct Answer: B
This question focuses on the unique administration requirements of long-acting basal
insulins. Glargine’s low pH prevents it from being compatible with other insulins in the
same syringe. Recognizing these specific contraindications is vital for maintaining
medication efficacy and safety. Rationale: Insulin glargine is a long-acting insulin that must
not be mixed with any other insulin (C) because it will precipitate. It does not have a peak
(B) and is meant for basal coverage, not as a sliding scale based on immediate pre-meal
readings (D). Mixing it (A) is strictly contraindicated.
4. A patient is found unconscious and clammy with a blood glucose level of 42 mg/dL. Which
medication should the nurse prepare to administer first?
A. Subcutaneous Lispro insulin
B. Intramuscular Glucagon
C. Oral orange juice with a sugar packet
D. Intravenous Dextrose 50% (D50W)
, E. Normal Saline bolus
Correct Answer: D
Emergency management of severe hypoglycemia is a critical nursing intervention that
requires immediate prioritization based on patient consciousness. In an acute care setting
with IV access, D50W is the fastest method to restore glucose levels. This scenario tests the
application of the hypoglycemia protocol for an unconscious patient. Rationale: For an
unconscious patient with IV access, IV D50W (B) is the treatment of choice for rapid
glucose elevation. Oral intake (C) is contraindicated due to aspiration risk. Glucagon (D) is
used if IV access is unavailable. Lispro (A) would further lower blood sugar, and Saline (E)
does not treat hypoglycemia.
5. A nurse is teaching a patient about the proper storage of insulin. Which statement by the
patient indicates a need for further teaching?
A. I can keep my current bottle of insulin at room temperature for up to one month.
B. I will keep my unopened insulin bottles in the refrigerator.
C. I should freeze my extra bottles of insulin to keep them fresh longer.
D. I need to keep my insulin out of direct sunlight and heat.
Correct Answer: C
Insulin stability is highly sensitive to temperature extremes, making storage education a
key component of diabetic teaching. Nurses must ensure patients understand how to
preserve medication potency through proper environmental control. This question
