NURS 305 Exam 3 V3 | NURS 305 Pharmacology | Actual Q&A with
Rationale (NURS305 Exam 3) | Liberty University
1. A patient is prescribed insulin lispro (Humalog). Which instruction should the nurse provide
regarding the timing of administration?
A. Take the insulin 30 to 45 minutes before a meal.
B. Administer the dose exactly at bedtime.
C. Administer only if the blood glucose is above 200 mg/dL.
D. Inject the medication 15 minutes before or immediately after starting a meal.
Answer: D
Explanation: Insulin lispro is a rapid-acting insulin with an onset of 15 to 30 minutes.
Patients must eat immediately to prevent profound hypoglycemia. Administration 30 to 45
minutes before meals is appropriate for regular (short-acting) insulin, not rapid-acting
analogs.
2. When educating a patient on insulin glargine (Lantus), which characteristic of this
medication is most critical for the nurse to emphasize?
A. It should be mixed with NPH insulin to prolong its effect.
B. It has a peak action time of 6 to 8 hours.
C. It should never be mixed in the same syringe with any other insulin.
D. The dose should be adjusted based on the carbohydrate count of the meal.
Answer: C
Explanation: Insulin glargine is a long-acting basal insulin that is formulated at a low pH,
causing it to precipitate upon injection. Mixing it with other insulins can alter its solubility
and absorption rate. It provides a steady blood level over 24 hours without a distinct peak.
3. A patient taking metformin (Glucophage) is scheduled for an intravenous contrast-
enhanced CT scan. What is the priority nursing action?
A. Increase the dose of metformin before the procedure.
B. Administer a bolus of normal saline before the scan.
C. Monitor the patient for symptoms of hyperglycemia.
D. Ensure the metformin is withheld for 48 hours after the procedure.
Answer: D
,Explanation: Metformin must be withheld the day of and for 48 hours after procedures
involving iodine contrast dye. This precaution prevents the development of lactic acidosis
in the event of contrast-induced nephrotoxicity. Renal function should be verified as
normal before resuming the medication.
4. The nurse is caring for a patient receiving glyburide (DiaBeta). Which statement by the
patient indicates a need for further teaching?
A. I will carry a source of fast-acting sugar with me.
B. I should wear sunscreen when I am outdoors.
C. It is safe for me to have a few glasses of wine with dinner.
D. I will report any yellowing of my skin to my doctor.
Answer: C
Explanation: Sulfonylureas like glyburide can cause a disulfiram-like reaction when
consumed with alcohol, leading to flushing, nausea, and palpitations. Furthermore, alcohol
increases the risk of hypoglycemia. Patients should also be aware of photosensitivity and
potential hepatotoxicity associated with this class.
5. A patient with Type 1 diabetes is found unconscious and clammy. The nurse is unable to
obtain intravenous access. Which medication should be administered?
A. Insulin aspart
B. Orange juice with sugar
C. Glucagon IM
D. Acarbose
Answer: C
Explanation: Glucagon is the emergency treatment of choice for severe hypoglycemia in
unconscious patients when IV access is unavailable. It acts by stimulating hepatic
glycogenolysis to increase blood glucose levels. Once the patient regains consciousness,
they should be given oral carbohydrates to replenish glycogen stores.
6. A patient newly prescribed levothyroxine (Synthroid) for hypothyroidism should be
instructed to take the medication at what time?
A. With the largest meal of the day.
B. In the morning on an empty stomach, 30-60 minutes before breakfast.
C. Immediately before bedtime.
D. Whenever the patient remembers, as long as it is daily.
Answer: B
, Explanation: Levothyroxine absorption is optimized when taken on an empty stomach.
Taking it with food, especially those high in fiber or calcium, can significantly decrease its
bioavailability. Consistency in timing is essential to maintain therapeutic hormone levels.
7. Which laboratory value is most important for the nurse to monitor in a patient taking
propylthiouracil (PTU) for Graves’ disease?
A. Complete Blood Count (CBC) with differential
B. Serum potassium
C. Hemoglobin A1c
D. Blood Urea Nitrogen (BUN)
Answer: A
Explanation: Agranulocytosis is a rare but life-threatening side effect of PTU. Patients
must be monitored for a decrease in white blood cell counts and instructed to report any
sore throat or fever immediately. Liver function tests should also be monitored due to the
risk of severe hepatotoxicity.
8. A patient with Diabetes Insipidus is receiving desmopressin (DDAVP). Which finding
indicates that the medication is effective?
A. Blood glucose is 110 mg/dL.
B. Serum sodium is 150 mEq/L.
C. Increased thirst and fluid intake.
D. Decreased urine output and increased urine specific gravity.
Answer: D
Explanation: Desmopressin is a synthetic form of antidiuretic hormone (ADH) that
increases water reabsorption in the kidneys. Success is marked by a reduction in the
polyuria and polydipsia characteristic of Diabetes Insipidus. Urine specific gravity will shift
from dilute (low) to more concentrated (higher) levels.
9. Long-term use of high-dose prednisone can lead to which of the following electrolyte
imbalances?
A. Hypokalemia and hypernatremia.
B. Hyperkalemia and hyponatremia.
C. Hypocalcemia and hypophosphatemia.
D. Hypermagnesemia.
Answer: A
Rationale (NURS305 Exam 3) | Liberty University
1. A patient is prescribed insulin lispro (Humalog). Which instruction should the nurse provide
regarding the timing of administration?
A. Take the insulin 30 to 45 minutes before a meal.
B. Administer the dose exactly at bedtime.
C. Administer only if the blood glucose is above 200 mg/dL.
D. Inject the medication 15 minutes before or immediately after starting a meal.
Answer: D
Explanation: Insulin lispro is a rapid-acting insulin with an onset of 15 to 30 minutes.
Patients must eat immediately to prevent profound hypoglycemia. Administration 30 to 45
minutes before meals is appropriate for regular (short-acting) insulin, not rapid-acting
analogs.
2. When educating a patient on insulin glargine (Lantus), which characteristic of this
medication is most critical for the nurse to emphasize?
A. It should be mixed with NPH insulin to prolong its effect.
B. It has a peak action time of 6 to 8 hours.
C. It should never be mixed in the same syringe with any other insulin.
D. The dose should be adjusted based on the carbohydrate count of the meal.
Answer: C
Explanation: Insulin glargine is a long-acting basal insulin that is formulated at a low pH,
causing it to precipitate upon injection. Mixing it with other insulins can alter its solubility
and absorption rate. It provides a steady blood level over 24 hours without a distinct peak.
3. A patient taking metformin (Glucophage) is scheduled for an intravenous contrast-
enhanced CT scan. What is the priority nursing action?
A. Increase the dose of metformin before the procedure.
B. Administer a bolus of normal saline before the scan.
C. Monitor the patient for symptoms of hyperglycemia.
D. Ensure the metformin is withheld for 48 hours after the procedure.
Answer: D
,Explanation: Metformin must be withheld the day of and for 48 hours after procedures
involving iodine contrast dye. This precaution prevents the development of lactic acidosis
in the event of contrast-induced nephrotoxicity. Renal function should be verified as
normal before resuming the medication.
4. The nurse is caring for a patient receiving glyburide (DiaBeta). Which statement by the
patient indicates a need for further teaching?
A. I will carry a source of fast-acting sugar with me.
B. I should wear sunscreen when I am outdoors.
C. It is safe for me to have a few glasses of wine with dinner.
D. I will report any yellowing of my skin to my doctor.
Answer: C
Explanation: Sulfonylureas like glyburide can cause a disulfiram-like reaction when
consumed with alcohol, leading to flushing, nausea, and palpitations. Furthermore, alcohol
increases the risk of hypoglycemia. Patients should also be aware of photosensitivity and
potential hepatotoxicity associated with this class.
5. A patient with Type 1 diabetes is found unconscious and clammy. The nurse is unable to
obtain intravenous access. Which medication should be administered?
A. Insulin aspart
B. Orange juice with sugar
C. Glucagon IM
D. Acarbose
Answer: C
Explanation: Glucagon is the emergency treatment of choice for severe hypoglycemia in
unconscious patients when IV access is unavailable. It acts by stimulating hepatic
glycogenolysis to increase blood glucose levels. Once the patient regains consciousness,
they should be given oral carbohydrates to replenish glycogen stores.
6. A patient newly prescribed levothyroxine (Synthroid) for hypothyroidism should be
instructed to take the medication at what time?
A. With the largest meal of the day.
B. In the morning on an empty stomach, 30-60 minutes before breakfast.
C. Immediately before bedtime.
D. Whenever the patient remembers, as long as it is daily.
Answer: B
, Explanation: Levothyroxine absorption is optimized when taken on an empty stomach.
Taking it with food, especially those high in fiber or calcium, can significantly decrease its
bioavailability. Consistency in timing is essential to maintain therapeutic hormone levels.
7. Which laboratory value is most important for the nurse to monitor in a patient taking
propylthiouracil (PTU) for Graves’ disease?
A. Complete Blood Count (CBC) with differential
B. Serum potassium
C. Hemoglobin A1c
D. Blood Urea Nitrogen (BUN)
Answer: A
Explanation: Agranulocytosis is a rare but life-threatening side effect of PTU. Patients
must be monitored for a decrease in white blood cell counts and instructed to report any
sore throat or fever immediately. Liver function tests should also be monitored due to the
risk of severe hepatotoxicity.
8. A patient with Diabetes Insipidus is receiving desmopressin (DDAVP). Which finding
indicates that the medication is effective?
A. Blood glucose is 110 mg/dL.
B. Serum sodium is 150 mEq/L.
C. Increased thirst and fluid intake.
D. Decreased urine output and increased urine specific gravity.
Answer: D
Explanation: Desmopressin is a synthetic form of antidiuretic hormone (ADH) that
increases water reabsorption in the kidneys. Success is marked by a reduction in the
polyuria and polydipsia characteristic of Diabetes Insipidus. Urine specific gravity will shift
from dilute (low) to more concentrated (higher) levels.
9. Long-term use of high-dose prednisone can lead to which of the following electrolyte
imbalances?
A. Hypokalemia and hypernatremia.
B. Hyperkalemia and hyponatremia.
C. Hypocalcemia and hypophosphatemia.
D. Hypermagnesemia.
Answer: A
