NUR 210 Exam 4 V1 | NUR 210 Pharmacology | Actual Q&A with
Rationale (NUR 210 Exam 4) | Galen
1. A patient is prescribed Levothyroxine (Synthroid) for hypothyroidism. Which instruction
should the nurse include in the teaching plan?
A. Take the medication on an empty stomach 30 to 60 minutes before breakfast.
B. Take the medication with a full meal to avoid gastric upset.
C. If a dose is missed, double the next dose to maintain blood levels.
D. Expect to see full therapeutic effects within 24 to 48 hours.
Answer: A
Rationale: Levothyroxine is best absorbed when taken on an empty stomach, typically 30
to 60 minutes before breakfast. This medication is a lifelong therapy for most patients with
hypothyroidism. It usually takes several weeks for the patient to reach a steady-state
therapeutic level.
2. Which lab value should the nurse monitor most closely for a patient receiving
Desmopressin (DDAVP) for the treatment of Diabetes Insipidus?
A. Serum Potassium
B. Serum Calcium
C. Serum Sodium
D. Blood Urea Nitrogen (BUN)
Answer: C
Rationale: Desmopressin is an antidiuretic hormone that can cause water retention and
subsequent hyponatremia. The nurse must monitor serum sodium levels to prevent water
intoxication and seizures. It is also important to monitor daily weights and intake and
output for these patients.
3. A nurse is teaching a patient about Metformin (Glucophage). Which statement by the
patient indicates a need for further teaching?
A. I will stop taking this medication 48 hours before my scheduled CT scan with contrast.
B. This medication will stimulate my pancreas to produce more insulin.
C. I might experience some abdominal bloating or diarrhea when I first start this.
D. I should not drink excessive amounts of alcohol while on this drug.
Answer: B
,Rationale: Metformin does not stimulate insulin secretion; instead, it decreases glucose
production by the liver and increases insulin sensitivity in the tissues. Medications that
stimulate insulin secretion are secretagogues, such as Sulfonylureas. The risk of lactic
acidosis is increased if Metformin is taken during procedures involving iodinated contrast
media.
4. A patient with Type 1 Diabetes Mellitus is prescribed Lispro (Humalog) insulin. When
should the nurse administer this insulin?
A. 15 minutes before the meal or when the meal is present.
B. Immediately after the patient finishes eating.
C. 30 to 45 minutes before the meal arrives.
D. Only at bedtime to control fasting glucose.
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of approximately 15 minutes.
Administering it too early can lead to severe hypoglycemia if the meal is delayed. The nurse
must ensure that the food is present or will be delivered within 15 minutes of
administration.
5. A patient is receiving Propylthiouracil (PTU) for hyperthyroidism. Which adverse effect
should the nurse instruct the patient to report immediately?
A. Increased appetite
B. Slight weight gain
C. Sore throat and fever
D. Dry skin
Answer: C
Rationale: PTU can cause agranulocytosis, which is a significant decrease in white blood
cell counts that leaves the patient vulnerable to infection. A sore throat and fever are early
clinical manifestations of this potentially life-threatening condition. Patients should be
monitored with regular blood counts while on this medication.
6. Which insulin can be administered intravenously (IV)?
A. NPH (Humulin N)
B. Regular (Humulin R)
C. Glargine (Lantus)
D. Detemir (Levemir)
Answer: B
, Rationale: Regular insulin is a short-acting insulin and is the only type that is typically
administered via the IV route for emergencies like diabetic ketoacidosis (DKA). NPH is an
intermediate-acting insulin that is cloudy and given subcutaneously. Long-acting insulins
like Glargine and Detemir should never be mixed with other insulins or given IV.
7. A patient is prescribed Prednisone for a chronic inflammatory condition. Which teaching
point is essential for this patient?
A. The medication should be stopped abruptly once symptoms improve.
B. The patient should avoid crowds and people who are sick.
C. Take the medication late at night to prevent insomnia.
D. Increase sodium intake to maintain blood pressure.
Answer: B
Rationale: Corticosteroids like Prednisone cause immunosuppression, placing the patient
at a higher risk for infections. These medications should never be stopped abruptly because
of the risk of adrenal crisis. They should be taken in the morning to mimic the body’s
natural circadian rhythm of cortisol release.
8. A patient is taking Glipizide (Glucotrol), a second-generation sulfonylurea. What is the
primary mechanism of action for this drug?
A. It increases the excretion of glucose through the urine.
B. It decreases the absorption of carbohydrates in the intestines.
C. It inhibits the release of glucagon from the liver.
D. It stimulates the beta cells of the pancreas to release insulin.
Answer: D
Rationale: Sulfonylureas such as Glipizide work by stimulating the beta cells of the
pancreas to secrete more insulin. Therefore, they are only effective in patients who have
functioning beta cells, such as those with Type 2 Diabetes. A common side effect is
hypoglycemia, especially if meals are skipped.
9. A patient with Type 2 Diabetes is prescribed Exenatide (Byetta). How is this medication
administered?
A. Subcutaneous injection within 60 minutes before a meal.
B. Orally, once daily in the morning.
C. Intramuscular injection once a week.
D. Intravenous infusion during hospital stays.
Answer: A
Rationale (NUR 210 Exam 4) | Galen
1. A patient is prescribed Levothyroxine (Synthroid) for hypothyroidism. Which instruction
should the nurse include in the teaching plan?
A. Take the medication on an empty stomach 30 to 60 minutes before breakfast.
B. Take the medication with a full meal to avoid gastric upset.
C. If a dose is missed, double the next dose to maintain blood levels.
D. Expect to see full therapeutic effects within 24 to 48 hours.
Answer: A
Rationale: Levothyroxine is best absorbed when taken on an empty stomach, typically 30
to 60 minutes before breakfast. This medication is a lifelong therapy for most patients with
hypothyroidism. It usually takes several weeks for the patient to reach a steady-state
therapeutic level.
2. Which lab value should the nurse monitor most closely for a patient receiving
Desmopressin (DDAVP) for the treatment of Diabetes Insipidus?
A. Serum Potassium
B. Serum Calcium
C. Serum Sodium
D. Blood Urea Nitrogen (BUN)
Answer: C
Rationale: Desmopressin is an antidiuretic hormone that can cause water retention and
subsequent hyponatremia. The nurse must monitor serum sodium levels to prevent water
intoxication and seizures. It is also important to monitor daily weights and intake and
output for these patients.
3. A nurse is teaching a patient about Metformin (Glucophage). Which statement by the
patient indicates a need for further teaching?
A. I will stop taking this medication 48 hours before my scheduled CT scan with contrast.
B. This medication will stimulate my pancreas to produce more insulin.
C. I might experience some abdominal bloating or diarrhea when I first start this.
D. I should not drink excessive amounts of alcohol while on this drug.
Answer: B
,Rationale: Metformin does not stimulate insulin secretion; instead, it decreases glucose
production by the liver and increases insulin sensitivity in the tissues. Medications that
stimulate insulin secretion are secretagogues, such as Sulfonylureas. The risk of lactic
acidosis is increased if Metformin is taken during procedures involving iodinated contrast
media.
4. A patient with Type 1 Diabetes Mellitus is prescribed Lispro (Humalog) insulin. When
should the nurse administer this insulin?
A. 15 minutes before the meal or when the meal is present.
B. Immediately after the patient finishes eating.
C. 30 to 45 minutes before the meal arrives.
D. Only at bedtime to control fasting glucose.
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of approximately 15 minutes.
Administering it too early can lead to severe hypoglycemia if the meal is delayed. The nurse
must ensure that the food is present or will be delivered within 15 minutes of
administration.
5. A patient is receiving Propylthiouracil (PTU) for hyperthyroidism. Which adverse effect
should the nurse instruct the patient to report immediately?
A. Increased appetite
B. Slight weight gain
C. Sore throat and fever
D. Dry skin
Answer: C
Rationale: PTU can cause agranulocytosis, which is a significant decrease in white blood
cell counts that leaves the patient vulnerable to infection. A sore throat and fever are early
clinical manifestations of this potentially life-threatening condition. Patients should be
monitored with regular blood counts while on this medication.
6. Which insulin can be administered intravenously (IV)?
A. NPH (Humulin N)
B. Regular (Humulin R)
C. Glargine (Lantus)
D. Detemir (Levemir)
Answer: B
, Rationale: Regular insulin is a short-acting insulin and is the only type that is typically
administered via the IV route for emergencies like diabetic ketoacidosis (DKA). NPH is an
intermediate-acting insulin that is cloudy and given subcutaneously. Long-acting insulins
like Glargine and Detemir should never be mixed with other insulins or given IV.
7. A patient is prescribed Prednisone for a chronic inflammatory condition. Which teaching
point is essential for this patient?
A. The medication should be stopped abruptly once symptoms improve.
B. The patient should avoid crowds and people who are sick.
C. Take the medication late at night to prevent insomnia.
D. Increase sodium intake to maintain blood pressure.
Answer: B
Rationale: Corticosteroids like Prednisone cause immunosuppression, placing the patient
at a higher risk for infections. These medications should never be stopped abruptly because
of the risk of adrenal crisis. They should be taken in the morning to mimic the body’s
natural circadian rhythm of cortisol release.
8. A patient is taking Glipizide (Glucotrol), a second-generation sulfonylurea. What is the
primary mechanism of action for this drug?
A. It increases the excretion of glucose through the urine.
B. It decreases the absorption of carbohydrates in the intestines.
C. It inhibits the release of glucagon from the liver.
D. It stimulates the beta cells of the pancreas to release insulin.
Answer: D
Rationale: Sulfonylureas such as Glipizide work by stimulating the beta cells of the
pancreas to secrete more insulin. Therefore, they are only effective in patients who have
functioning beta cells, such as those with Type 2 Diabetes. A common side effect is
hypoglycemia, especially if meals are skipped.
9. A patient with Type 2 Diabetes is prescribed Exenatide (Byetta). How is this medication
administered?
A. Subcutaneous injection within 60 minutes before a meal.
B. Orally, once daily in the morning.
C. Intramuscular injection once a week.
D. Intravenous infusion during hospital stays.
Answer: A
