NURS 5663 ADVANCED
PHARMACOLOGY - WEEK 6
QUESTIONS AND ANSWERS
1. A patient with Type 2 Diabetes is prescribed Metformin. Which laboratory value would
require the nurse to withhold the medication and contact the provider?
A. Hemoglobin A1c of 8.2%
B. Aspartate Aminotransferase (AST) of 42 U/L
C. Serum Potassium of 5.1 mEq/L
D. Estimated Glomerular Filtration Rate (eGFR) of 25 mL/min/1.73m2
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR below 30
mL/min/1.73m2 due to the significantly increased risk of lactic acidosis. HbA1c and liver
enzymes in these ranges are not contraindications.
2. When teaching a patient about Insulin Glargine (Lantus), which statement by the patient
indicates a correct understanding of the medication?
A. I should take this 15 minutes before I eat my breakfast.
,B. I will mix this in the same syringe with my Lispro insulin.
C. I should expect this insulin to peak about 4 hours after injection.
D. I will take this once a day at the same time, and it will last all day.
Answer: D
Conceptual Explanation: Insulin Glargine is a long-acting basal insulin with a duration of
24 hours and no pronounced peak. It should not be mixed with other insulins in the same
syringe.
3. A patient is being treated for hyperthyroidism during the first trimester of pregnancy.
Which medication is preferred for this patient?
A. Methimazole
B. Radioactive Iodine (I-131)
C. Propylthiouracil (PTU)
D. Levothyroxine
Answer: C
Conceptual Explanation: PTU is preferred in the first trimester of pregnancy because
Methimazole is associated with birth defects (aplasia cutis). Methimazole is often used in
the second and third trimesters. Radioactive iodine is contraindicated.
, 4. Which mechanism of action describes how SGLT2 inhibitors like Empagliflozin lower blood
glucose levels?
A. By stimulating the pancreas to release more insulin.
B. By increasing the sensitivity of peripheral tissues to insulin.
C. By slowing the gastric emptying rate and increasing satiety.
D. By inhibiting glucose reabsorption in the proximal renal tubules.
Answer: D
Conceptual Explanation: SGLT2 inhibitors block the Sodium-Glucose Co-transporter 2 in
the kidneys, leading to increased urinary glucose excretion.
5. A patient taking chronic high-dose Prednisone for an autoimmune disorder is scheduled for
surgery. What is the most critical intervention regarding their steroid therapy?
A. Discontinue the Prednisone 24 hours before surgery.
B. Switch to an inhaled corticosteroid to reduce systemic effects.
C. Reduce the dose by half the morning of surgery.
D. Administer a ‘stress dose’ of intravenous hydrocortisone.
Answer: D
Conceptual Explanation: Patients on chronic steroids have adrenal suppression. During
periods of physiological stress like surgery, they require ‘stress doses’ of steroids to
prevent adrenal crisis.
PHARMACOLOGY - WEEK 6
QUESTIONS AND ANSWERS
1. A patient with Type 2 Diabetes is prescribed Metformin. Which laboratory value would
require the nurse to withhold the medication and contact the provider?
A. Hemoglobin A1c of 8.2%
B. Aspartate Aminotransferase (AST) of 42 U/L
C. Serum Potassium of 5.1 mEq/L
D. Estimated Glomerular Filtration Rate (eGFR) of 25 mL/min/1.73m2
Answer: D
Conceptual Explanation: Metformin is contraindicated in patients with an eGFR below 30
mL/min/1.73m2 due to the significantly increased risk of lactic acidosis. HbA1c and liver
enzymes in these ranges are not contraindications.
2. When teaching a patient about Insulin Glargine (Lantus), which statement by the patient
indicates a correct understanding of the medication?
A. I should take this 15 minutes before I eat my breakfast.
,B. I will mix this in the same syringe with my Lispro insulin.
C. I should expect this insulin to peak about 4 hours after injection.
D. I will take this once a day at the same time, and it will last all day.
Answer: D
Conceptual Explanation: Insulin Glargine is a long-acting basal insulin with a duration of
24 hours and no pronounced peak. It should not be mixed with other insulins in the same
syringe.
3. A patient is being treated for hyperthyroidism during the first trimester of pregnancy.
Which medication is preferred for this patient?
A. Methimazole
B. Radioactive Iodine (I-131)
C. Propylthiouracil (PTU)
D. Levothyroxine
Answer: C
Conceptual Explanation: PTU is preferred in the first trimester of pregnancy because
Methimazole is associated with birth defects (aplasia cutis). Methimazole is often used in
the second and third trimesters. Radioactive iodine is contraindicated.
, 4. Which mechanism of action describes how SGLT2 inhibitors like Empagliflozin lower blood
glucose levels?
A. By stimulating the pancreas to release more insulin.
B. By increasing the sensitivity of peripheral tissues to insulin.
C. By slowing the gastric emptying rate and increasing satiety.
D. By inhibiting glucose reabsorption in the proximal renal tubules.
Answer: D
Conceptual Explanation: SGLT2 inhibitors block the Sodium-Glucose Co-transporter 2 in
the kidneys, leading to increased urinary glucose excretion.
5. A patient taking chronic high-dose Prednisone for an autoimmune disorder is scheduled for
surgery. What is the most critical intervention regarding their steroid therapy?
A. Discontinue the Prednisone 24 hours before surgery.
B. Switch to an inhaled corticosteroid to reduce systemic effects.
C. Reduce the dose by half the morning of surgery.
D. Administer a ‘stress dose’ of intravenous hydrocortisone.
Answer: D
Conceptual Explanation: Patients on chronic steroids have adrenal suppression. During
periods of physiological stress like surgery, they require ‘stress doses’ of steroids to
prevent adrenal crisis.
