NUR 100/NUR100 Exam 4 V1 | Pharmacology Q&A
with Rationale | Fortis College
1. A patient with type 2 diabetes is prescribed metformin. Which statement by the patient
indicates a need for further teaching?
A. I will take this medication with my morning and evening meals.
B. I should stop taking this medication 48 hours before any CT scan with contrast.
C. This medication will help my pancreas produce more insulin to lower my blood sugar.
D. I might experience some stomach upset when I first start taking this drug.
Correct Answer: C
Explanation: Metformin is a biguanide that works by decreasing glucose production in the
liver and increasing insulin sensitivity in peripheral tissues. It does not stimulate the
pancreas to produce more insulin, which is the mechanism of sulfonylureas. The patient’s
misunderstanding of the mechanism of action requires correction to ensure they
understand how the drug manages their condition.
2. When administering Lispro (Humalog) insulin, at what time should the nurse ensure the
patient eats a meal?
A. 30 to 60 minutes after administration
B. 2 hours after administration
C. Within 15 minutes of administration
,D. Immediately before the administration
Correct Answer: C
Explanation: Lispro is a rapid-acting insulin with an onset of action between 15 to 30
minutes. Therefore, the patient must have food available and eat within 15 minutes of the
injection to prevent a rapid drop in blood glucose levels. Providing food too late can lead to
severe hypoglycemia during the peak of the insulin activity.
3. A patient is receiving levothyroxine for hypothyroidism. Which assessment finding would
suggest the dose is too high?
A. Bradycardia and hypotension
B. Weight gain and lethargy
C. Constipation and cold intolerance
D. Tachycardia and palpitations
Correct Answer: D
Explanation: Levothyroxine toxicity or over-replacement manifests as signs of
hyperthyroidism, such as tachycardia, tremors, heat intolerance, and palpitations. Weight
gain and lethargy are symptoms of under-replacement or continuing hypothyroidism.
Monitoring the heart rate is a critical nursing intervention when initiating or adjusting the
dose of this medication.
, 4. What is the primary rationale for instructing a patient to rinse their mouth after using a
fluticasone inhaler?
A. To prevent systemic absorption of the corticosteroid
B. To improve the taste of the medication in the mouth
C. To reduce the risk of dental caries and enamel erosion
D. To prevent the development of oral candidiasis (thrush)
Correct Answer: D
Explanation: Inhaled corticosteroids can suppress the local immune response in the oral
cavity, leading to fungal overgrowth. Rinsing the mouth and spitting out the water helps
remove residual medication from the oral mucosa. This simple hygiene step significantly
reduces the incidence of painful oral yeast infections in patients with asthma or COPD.
5. The nurse is preparing to administer vancomycin. Which action is most important to
prevent ‘Red Man Syndrome’?
A. Administer an antihistamine 30 minutes before the infusion.
B. Infuse the medication over at least 60 minutes or longer.
C. Monitor the patient’s blood pressure every 5 minutes during infusion.
D. Dilute the medication in a minimum of 500 mL of normal saline.
Correct Answer: B
with Rationale | Fortis College
1. A patient with type 2 diabetes is prescribed metformin. Which statement by the patient
indicates a need for further teaching?
A. I will take this medication with my morning and evening meals.
B. I should stop taking this medication 48 hours before any CT scan with contrast.
C. This medication will help my pancreas produce more insulin to lower my blood sugar.
D. I might experience some stomach upset when I first start taking this drug.
Correct Answer: C
Explanation: Metformin is a biguanide that works by decreasing glucose production in the
liver and increasing insulin sensitivity in peripheral tissues. It does not stimulate the
pancreas to produce more insulin, which is the mechanism of sulfonylureas. The patient’s
misunderstanding of the mechanism of action requires correction to ensure they
understand how the drug manages their condition.
2. When administering Lispro (Humalog) insulin, at what time should the nurse ensure the
patient eats a meal?
A. 30 to 60 minutes after administration
B. 2 hours after administration
C. Within 15 minutes of administration
,D. Immediately before the administration
Correct Answer: C
Explanation: Lispro is a rapid-acting insulin with an onset of action between 15 to 30
minutes. Therefore, the patient must have food available and eat within 15 minutes of the
injection to prevent a rapid drop in blood glucose levels. Providing food too late can lead to
severe hypoglycemia during the peak of the insulin activity.
3. A patient is receiving levothyroxine for hypothyroidism. Which assessment finding would
suggest the dose is too high?
A. Bradycardia and hypotension
B. Weight gain and lethargy
C. Constipation and cold intolerance
D. Tachycardia and palpitations
Correct Answer: D
Explanation: Levothyroxine toxicity or over-replacement manifests as signs of
hyperthyroidism, such as tachycardia, tremors, heat intolerance, and palpitations. Weight
gain and lethargy are symptoms of under-replacement or continuing hypothyroidism.
Monitoring the heart rate is a critical nursing intervention when initiating or adjusting the
dose of this medication.
, 4. What is the primary rationale for instructing a patient to rinse their mouth after using a
fluticasone inhaler?
A. To prevent systemic absorption of the corticosteroid
B. To improve the taste of the medication in the mouth
C. To reduce the risk of dental caries and enamel erosion
D. To prevent the development of oral candidiasis (thrush)
Correct Answer: D
Explanation: Inhaled corticosteroids can suppress the local immune response in the oral
cavity, leading to fungal overgrowth. Rinsing the mouth and spitting out the water helps
remove residual medication from the oral mucosa. This simple hygiene step significantly
reduces the incidence of painful oral yeast infections in patients with asthma or COPD.
5. The nurse is preparing to administer vancomycin. Which action is most important to
prevent ‘Red Man Syndrome’?
A. Administer an antihistamine 30 minutes before the infusion.
B. Infuse the medication over at least 60 minutes or longer.
C. Monitor the patient’s blood pressure every 5 minutes during infusion.
D. Dilute the medication in a minimum of 500 mL of normal saline.
Correct Answer: B
