NUR 210 Exam 3 V3 | NUR 210 Pharmacology | Actual Q&A with
Rationale (NUR 210 Exam 3) | Galen
1. A patient is prescribed insulin lispro (Humalog) for mealtime coverage. At what time should
the nurse ensure the patient’s meal is available to prevent hypoglycemia?
A. Immediately before the bedtime snack
B. 30 to 45 minutes after administration
C. 1 hour after administration
D. Within 15 minutes of administration
Answer: D
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 10 to 30 minutes.
Therefore, the nurse must ensure that the patient eats within 15 minutes of receiving the
dose to avoid a rapid drop in blood glucose. Administering this medication without
immediate food intake significantly increases the risk of a hypoglycemic event.
2. The nurse is caring for a patient taking metformin (Glucophage) for type 2 diabetes. Which
laboratory value should the nurse prioritize prior to a scheduled CT scan with contrast?
A. Blood Urea Nitrogen (BUN)
B. Glycosylated Hemoglobin (A1c)
C. Alanine Aminotransferase (ALT)
D. Serum Creatinine
Answer: D
Rationale: Metformin must be withheld for 48 hours after a procedure involving contrast
dye to prevent lactic acidosis. Serum creatinine is the most specific indicator of renal
function, which is critical because contrast dye can cause acute renal failure. If renal
function is impaired, metformin can accumulate to toxic levels in the body.
3. A patient with hypothyroidism is starting levothyroxine (Synthroid). What information is
most important for the nurse to include in the discharge teaching?
A. Take the medication with a full meal to avoid GI upset
B. Take the medication on an empty stomach in the morning
C. Stop the medication immediately if you feel heart palpitations
D. The medication should only be taken when you feel tired
Answer: B
,Rationale: Levothyroxine absorption is optimized when taken on an empty stomach, at
least 30 to 60 minutes before breakfast. Patients should be taught that this is a lifelong
therapy and should not be discontinued abruptly. It is also important to wait several hours
before taking any calcium or iron supplements as they interfere with absorption.
4. Which assessment finding should the nurse report immediately for a patient receiving
propylthiouracil (PTU)?
A. Weight gain of 2 pounds
B. Increased appetite
C. Sore throat and fever
D. Constipation
Answer: C
Rationale: Propylthiouracil can cause agranulocytosis, which is a dangerous decrease in
white blood cell counts. A sore throat and fever are early signs of infection that may
indicate this life-threatening adverse effect. The nurse must notify the provider
immediately to obtain a complete blood count.
5. A nurse is preparing to administer glargine (Lantus) insulin. Which action by the nurse is
correct?
A. Draw it up in the same syringe as Regular insulin
B. Administer it intravenously for rapid effect
C. Administer it at the same time every day, usually at bedtime
D. Vigorously shake the vial to mix the suspension
Answer: C
Rationale: Glargine is a long-acting insulin that provides a steady basal rate over 24 hours.
It must never be mixed in the same syringe with any other insulin because the pH balance
will be altered. Because it has no peak, it is typically given once daily at a consistent time to
maintain stable blood glucose levels.
6. A patient is prescribed prednisone for an acute asthma exacerbation. Which side effect
should the nurse monitor for during therapy?
A. Hypoglycemia
B. Weight loss
C. Hypokalemia
D. Hypotension
Answer: C
, Rationale: Glucocorticoids like prednisone cause the body to retain sodium and water
while excreting potassium. This can lead to hypokalemia, which increases the risk of
cardiac arrhythmias. Nurses should also monitor for hyperglycemia and signs of fluid
volume excess during treatment.
7. The nurse is teaching a patient about using a fluticasone (Flovent) inhaler. Which
instruction is essential for preventing oral candidiasis?
A. Rinse the mouth with water after each use
B. Use a spacer with the inhaler
C. Take a deep breath before puffing
D. Clean the inhaler mouthpiece once a week
Answer: A
Rationale: Inhaled corticosteroids can suppress the local immune response in the
oropharynx, leading to fungal infections like thrush. Rinsing the mouth and spitting after
each use removes residual medication from the oral mucosa. This simple hygiene measure
is the most effective way to prevent oral candidiasis.
8. Which medication should the nurse identify as the priority ‘rescue’ treatment for a patient
experiencing acute bronchospasm?
A. Albuterol
B. Salmeterol
C. Montelukast
D. Tiotropium
Answer: A
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
bronchodilation during an acute asthma attack. Long-acting medications like salmeterol or
maintenance drugs like montelukast are not effective for emergency symptom relief. The
nurse should always ensure the patient has immediate access to their rescue inhaler.
9. A patient with a history of heart failure is prescribed pioglitazone (Actos). What
assessment finding is most concerning?
A. Mild muscle aches
B. A fasting blood glucose of 110 mg/dL
C. Occasional flatulence
D. Bilateral 2+ pitting edema in the lower extremities
Answer: D
Rationale (NUR 210 Exam 3) | Galen
1. A patient is prescribed insulin lispro (Humalog) for mealtime coverage. At what time should
the nurse ensure the patient’s meal is available to prevent hypoglycemia?
A. Immediately before the bedtime snack
B. 30 to 45 minutes after administration
C. 1 hour after administration
D. Within 15 minutes of administration
Answer: D
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 10 to 30 minutes.
Therefore, the nurse must ensure that the patient eats within 15 minutes of receiving the
dose to avoid a rapid drop in blood glucose. Administering this medication without
immediate food intake significantly increases the risk of a hypoglycemic event.
2. The nurse is caring for a patient taking metformin (Glucophage) for type 2 diabetes. Which
laboratory value should the nurse prioritize prior to a scheduled CT scan with contrast?
A. Blood Urea Nitrogen (BUN)
B. Glycosylated Hemoglobin (A1c)
C. Alanine Aminotransferase (ALT)
D. Serum Creatinine
Answer: D
Rationale: Metformin must be withheld for 48 hours after a procedure involving contrast
dye to prevent lactic acidosis. Serum creatinine is the most specific indicator of renal
function, which is critical because contrast dye can cause acute renal failure. If renal
function is impaired, metformin can accumulate to toxic levels in the body.
3. A patient with hypothyroidism is starting levothyroxine (Synthroid). What information is
most important for the nurse to include in the discharge teaching?
A. Take the medication with a full meal to avoid GI upset
B. Take the medication on an empty stomach in the morning
C. Stop the medication immediately if you feel heart palpitations
D. The medication should only be taken when you feel tired
Answer: B
,Rationale: Levothyroxine absorption is optimized when taken on an empty stomach, at
least 30 to 60 minutes before breakfast. Patients should be taught that this is a lifelong
therapy and should not be discontinued abruptly. It is also important to wait several hours
before taking any calcium or iron supplements as they interfere with absorption.
4. Which assessment finding should the nurse report immediately for a patient receiving
propylthiouracil (PTU)?
A. Weight gain of 2 pounds
B. Increased appetite
C. Sore throat and fever
D. Constipation
Answer: C
Rationale: Propylthiouracil can cause agranulocytosis, which is a dangerous decrease in
white blood cell counts. A sore throat and fever are early signs of infection that may
indicate this life-threatening adverse effect. The nurse must notify the provider
immediately to obtain a complete blood count.
5. A nurse is preparing to administer glargine (Lantus) insulin. Which action by the nurse is
correct?
A. Draw it up in the same syringe as Regular insulin
B. Administer it intravenously for rapid effect
C. Administer it at the same time every day, usually at bedtime
D. Vigorously shake the vial to mix the suspension
Answer: C
Rationale: Glargine is a long-acting insulin that provides a steady basal rate over 24 hours.
It must never be mixed in the same syringe with any other insulin because the pH balance
will be altered. Because it has no peak, it is typically given once daily at a consistent time to
maintain stable blood glucose levels.
6. A patient is prescribed prednisone for an acute asthma exacerbation. Which side effect
should the nurse monitor for during therapy?
A. Hypoglycemia
B. Weight loss
C. Hypokalemia
D. Hypotension
Answer: C
, Rationale: Glucocorticoids like prednisone cause the body to retain sodium and water
while excreting potassium. This can lead to hypokalemia, which increases the risk of
cardiac arrhythmias. Nurses should also monitor for hyperglycemia and signs of fluid
volume excess during treatment.
7. The nurse is teaching a patient about using a fluticasone (Flovent) inhaler. Which
instruction is essential for preventing oral candidiasis?
A. Rinse the mouth with water after each use
B. Use a spacer with the inhaler
C. Take a deep breath before puffing
D. Clean the inhaler mouthpiece once a week
Answer: A
Rationale: Inhaled corticosteroids can suppress the local immune response in the
oropharynx, leading to fungal infections like thrush. Rinsing the mouth and spitting after
each use removes residual medication from the oral mucosa. This simple hygiene measure
is the most effective way to prevent oral candidiasis.
8. Which medication should the nurse identify as the priority ‘rescue’ treatment for a patient
experiencing acute bronchospasm?
A. Albuterol
B. Salmeterol
C. Montelukast
D. Tiotropium
Answer: A
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
bronchodilation during an acute asthma attack. Long-acting medications like salmeterol or
maintenance drugs like montelukast are not effective for emergency symptom relief. The
nurse should always ensure the patient has immediate access to their rescue inhaler.
9. A patient with a history of heart failure is prescribed pioglitazone (Actos). What
assessment finding is most concerning?
A. Mild muscle aches
B. A fasting blood glucose of 110 mg/dL
C. Occasional flatulence
D. Bilateral 2+ pitting edema in the lower extremities
Answer: D
