NU578 Exam 4 Practice Questions & Answers
(Verified Updated)
This comprehensive study guide covers the core domains tested on NU578 Exam
4, aligned with the 2026–2027 curriculum at the University of South Alabama. It
includes original practice questions with detailed rationales, organized by topic:
Diabetes Pharmacotherapy, Thyroid Disorders, Corticosteroids & Anti-
Inflammatory Agents, Gout & Rheumatoid Arthritis, and Special Topics
(Reproductive & Bone Health) .
The exam covers 100 total questions with a passing score of 90%, spanning
diabetes pharmacotherapy (insulin, metformin, sulfonylureas, DPP-4 inhibitors,
SGLT-2 inhibitors, GLP-1 agonists, acarbose), thyroid disorders, steroids and
glucocorticoids, gout treatment, rheumatoid arthritis and immunosuppressants,
reproductive and bone health, and CNS neurotransmitters.
Section 1: Diabetes Pharmacotherapy (Q1–Q45)
1.1 Insulin Pharmacology
Q1. Insulin is used to treat which types of diabetes?
A. Type 2 diabetes only
B. Gestational diabetes only
C. Type 1 diabetes only
D. Type 1 diabetes and many patients with type 2 diabetes
Answer: D
Rationale: Insulin is used to treat all patients with type 1
diabetes and many with type 2 diabetes. Insulin consists of two
amino acid chains linked by two disulfide bridges and is
,synthesized in the pancreas by beta cells within the islets of
Langerhans. It is released by a rise in blood sugar from eating a
meal and promotes anabolic reactions, conserving energy and
building up energy stores.
Q2. What are the metabolic actions of insulin?
A. Glycogen into glucose, proteins into amino acids, fats into
glycerol
B. Glucose into glycogen, amino acids into proteins, fatty acids
into triglycerides
C. Glucose into fatty acids, proteins into glucose, fats into
proteins
D. Glycogen into proteins, glucose into fats, amino acids into
glucose
Answer: B
Rationale: Insulin promotes the conversion of glucose into
glycogen, amino acids into proteins, and fatty acids into
triglycerides. In contrast, insulin deficiency promotes the
breakdown of glycogen into glucose, proteins into amino acids,
and fats into glycerol.
Q3. A patient is prescribed insulin lispro to be taken before
meals. The nurse practitioner should instruct the patient to
administer the injection at which time?
A. 60 minutes before eating
B. 30 minutes before eating
,C. 0 to 15 minutes before eating
D. Immediately after eating only
Answer: C
Rationale: Insulin lispro is a rapid-acting insulin with an onset of
action within 15 minutes, so it should be administered within 0
to 15 minutes before a meal. Waiting 30 to 60 minutes would
increase the risk of hypoglycemia before food intake. It may be
given immediately after eating in some pediatric cases, but the
standard instruction is before the meal.
Q4. Which insulin is classified as long-acting and provides a
relatively flat, peakless glucose-lowering effect?
A. Regular insulin
B. NPH insulin
C. Insulin glargine
D. Insulin aspart
Answer: C
Rationale: Insulin glargine is a long-acting basal insulin with a
duration of approximately 24 hours and no pronounced peak,
making it ideal for basal coverage. NPH has a distinct peak and
intermediate duration. Regular and aspart insulins are shorter-
acting agents used for prandial coverage.
Q5. A nurse practitioner is teaching a patient about NPH insulin.
Which statement best describes its onset and peak?
A. Onset 15 minutes, peak 1 hour
, B. Onset 30 minutes, peak 2 to 3 hours
C. Onset 1 to 2 hours, peak 4 to 12 hours
D. Onset 6 hours, peak 18 hours
Answer: C
Rationale: NPH is an intermediate-acting insulin with an onset
of 1 to 2 hours and a peak effect occurring between 4 and 12
hours. This delayed and broad peak increases the risk of
nocturnal hypoglycemia if dosed at bedtime. Rapid-acting
insulins have much faster onset and peak times.
Q6. What is the difference between rapid-acting insulins (lispro
and aspart) and longer-acting insulins (glargine)?
A. Rapid-acting insulins are used for basal coverage; longer-
acting insulins are used for prandial coverage
B. Rapid-acting insulins are used for prandial coverage; longer-
acting insulins are used for basal coverage
C. Both are used interchangeably
D. Rapid-acting insulins last 24 hours
Answer: B
Rationale: Rapid-acting insulins (lispro, aspart) are used for
prandial (mealtime) coverage and have a short duration of 3-5
hours. Longer-acting insulins (glargine) are used for basal
coverage and may last up to 24 hours.
Q7. A patient using a basal-bolus insulin regimen asks why two
different insulins are needed. The best explanation is that:
(Verified Updated)
This comprehensive study guide covers the core domains tested on NU578 Exam
4, aligned with the 2026–2027 curriculum at the University of South Alabama. It
includes original practice questions with detailed rationales, organized by topic:
Diabetes Pharmacotherapy, Thyroid Disorders, Corticosteroids & Anti-
Inflammatory Agents, Gout & Rheumatoid Arthritis, and Special Topics
(Reproductive & Bone Health) .
The exam covers 100 total questions with a passing score of 90%, spanning
diabetes pharmacotherapy (insulin, metformin, sulfonylureas, DPP-4 inhibitors,
SGLT-2 inhibitors, GLP-1 agonists, acarbose), thyroid disorders, steroids and
glucocorticoids, gout treatment, rheumatoid arthritis and immunosuppressants,
reproductive and bone health, and CNS neurotransmitters.
Section 1: Diabetes Pharmacotherapy (Q1–Q45)
1.1 Insulin Pharmacology
Q1. Insulin is used to treat which types of diabetes?
A. Type 2 diabetes only
B. Gestational diabetes only
C. Type 1 diabetes only
D. Type 1 diabetes and many patients with type 2 diabetes
Answer: D
Rationale: Insulin is used to treat all patients with type 1
diabetes and many with type 2 diabetes. Insulin consists of two
amino acid chains linked by two disulfide bridges and is
,synthesized in the pancreas by beta cells within the islets of
Langerhans. It is released by a rise in blood sugar from eating a
meal and promotes anabolic reactions, conserving energy and
building up energy stores.
Q2. What are the metabolic actions of insulin?
A. Glycogen into glucose, proteins into amino acids, fats into
glycerol
B. Glucose into glycogen, amino acids into proteins, fatty acids
into triglycerides
C. Glucose into fatty acids, proteins into glucose, fats into
proteins
D. Glycogen into proteins, glucose into fats, amino acids into
glucose
Answer: B
Rationale: Insulin promotes the conversion of glucose into
glycogen, amino acids into proteins, and fatty acids into
triglycerides. In contrast, insulin deficiency promotes the
breakdown of glycogen into glucose, proteins into amino acids,
and fats into glycerol.
Q3. A patient is prescribed insulin lispro to be taken before
meals. The nurse practitioner should instruct the patient to
administer the injection at which time?
A. 60 minutes before eating
B. 30 minutes before eating
,C. 0 to 15 minutes before eating
D. Immediately after eating only
Answer: C
Rationale: Insulin lispro is a rapid-acting insulin with an onset of
action within 15 minutes, so it should be administered within 0
to 15 minutes before a meal. Waiting 30 to 60 minutes would
increase the risk of hypoglycemia before food intake. It may be
given immediately after eating in some pediatric cases, but the
standard instruction is before the meal.
Q4. Which insulin is classified as long-acting and provides a
relatively flat, peakless glucose-lowering effect?
A. Regular insulin
B. NPH insulin
C. Insulin glargine
D. Insulin aspart
Answer: C
Rationale: Insulin glargine is a long-acting basal insulin with a
duration of approximately 24 hours and no pronounced peak,
making it ideal for basal coverage. NPH has a distinct peak and
intermediate duration. Regular and aspart insulins are shorter-
acting agents used for prandial coverage.
Q5. A nurse practitioner is teaching a patient about NPH insulin.
Which statement best describes its onset and peak?
A. Onset 15 minutes, peak 1 hour
, B. Onset 30 minutes, peak 2 to 3 hours
C. Onset 1 to 2 hours, peak 4 to 12 hours
D. Onset 6 hours, peak 18 hours
Answer: C
Rationale: NPH is an intermediate-acting insulin with an onset
of 1 to 2 hours and a peak effect occurring between 4 and 12
hours. This delayed and broad peak increases the risk of
nocturnal hypoglycemia if dosed at bedtime. Rapid-acting
insulins have much faster onset and peak times.
Q6. What is the difference between rapid-acting insulins (lispro
and aspart) and longer-acting insulins (glargine)?
A. Rapid-acting insulins are used for basal coverage; longer-
acting insulins are used for prandial coverage
B. Rapid-acting insulins are used for prandial coverage; longer-
acting insulins are used for basal coverage
C. Both are used interchangeably
D. Rapid-acting insulins last 24 hours
Answer: B
Rationale: Rapid-acting insulins (lispro, aspart) are used for
prandial (mealtime) coverage and have a short duration of 3-5
hours. Longer-acting insulins (glargine) are used for basal
coverage and may last up to 24 hours.
Q7. A patient using a basal-bolus insulin regimen asks why two
different insulins are needed. The best explanation is that:
