NUR 210 | NUR210 Exam 4 V1 – Updated and Latest Questions and
Correct Answers with Rationale – Galen College of Nursing
1. A nurse is providing discharge instructions to a patient prescribed levothyroxine for
hypothyroidism. Which statement by the patient indicates a need for further teaching?
A. If I feel like I have too much energy, I will skip a few doses.
B. I should wait at least 30 to 60 minutes before eating breakfast.
C. I will take this medication every morning on an empty stomach.
D. It may take several weeks before I start feeling the full effects.
Answer: A
Rationale: Levothyroxine is a lifelong replacement therapy and should never be skipped
without provider consultation; ‘feeling like too much energy’ could indicate
hyperthyroidism, requiring a dose adjustment, not self-discontinuation. Taking it on an
empty stomach is correct to ensure absorption.
2. A patient with Type 1 Diabetes Mellitus is prescribed Lispro insulin. When should the nurse
administer this medication?
A. 30 to 45 minutes before a meal.
B. Only when the blood glucose is above 200 mg/dL.
C. Immediately before or within 15 minutes of eating.
D. One hour after the patient finishes their meal.
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes; it must be
administered in close proximity to a meal to prevent hypoglycemia. Traditional regular
insulin is given 30 minutes before meals.
3. A nurse is caring for a patient receiving IV hydrocortisone for an acute adrenal crisis. Which
laboratory value is most important for the nurse to monitor?
A. Serum sodium levels.
B. Serum potassium levels.
C. White blood cell count.
D. Serum glucose levels.
Answer: D
,Rationale: Glucocorticoids like hydrocortisone significantly increase blood glucose levels
via gluconeogenesis; while electrolytes are important in adrenal crisis, monitoring for
steroid-induced hyperglycemia is a primary nursing responsibility.
4. Which medication is considered the first-line treatment for a patient newly diagnosed with
Type 2 Diabetes Mellitus, assuming no contraindications?
A. Glipizide
B. Liraglutide
C. Pioglitazone
D. Metformin
Answer: D
Rationale: Metformin is the preferred initial pharmacological agent for Type 2 Diabetes
because it is effective, does not cause hypoglycemia when used alone, and may assist with
modest weight loss.
5. A patient is scheduled for a CT scan with IV contrast. The nurse notes the patient is taking
Metformin. What action should the nurse take?
A. Administer the Metformin as scheduled before the procedure.
B. Hold the Metformin for 48 hours before and after the procedure.
C. Ensure the patient receives a double dose of Metformin after the scan.
D. Switch the patient to insulin for the duration of the hospital stay.
Answer: B
Rationale: Metformin must be held 48 hours before and after procedures involving
contrast dye to prevent the risk of lactic acidosis and acute renal failure, as both the dye
and the drug are cleared by the kidneys.
6. A patient is prescribed Albuterol and Beclomethasone inhalers for asthma. What is the
correct sequence for administration?
A. Administer beclomethasone, wait 5 minutes, then administer albuterol.
B. Administer albuterol, wait 5 minutes, then administer beclomethasone.
C. Mix both medications in a nebulizer for simultaneous delivery.
D. Administer them in any order as long as the patient rinses their mouth.
Answer: B
Rationale: Albuterol, a bronchodilator, should be administered first to open the airways,
allowing the corticosteroid (beclomethasone) to penetrate deeper into the lung tissue. A 5-
minute wait between different inhalers is standard.
, 7. A patient taking Theophylline for chronic COPD reports nausea, insomnia, and palpitations.
The nurse should suspect which condition?
A. Normal therapeutic effects of the drug.
B. Theophylline toxicity.
C. A looming respiratory infection.
D. Inadequate dosage of the medication.
Answer: B
Rationale: Theophylline has a narrow therapeutic index (10-20 mcg/mL). Nausea,
vomiting, insomnia, and tachycardia/palpitations are early signs of toxicity; severe toxicity
can lead to seizures and dysrhythmias.
8. Which instruction is essential for a patient starting a course of inhaled Budesonide?
A. Take a deep breath and hold it for 2 seconds only.
B. Expect a frequent cough as a normal side effect.
C. Use this medication only when you feel an asthma attack starting.
D. Rinse your mouth with water after each use.
Answer: D
Rationale: Inhaled corticosteroids increase the risk of oral candidiasis (thrush). Rinsing
the mouth and spitting after administration helps prevent this fungal infection.
9. A patient with a history of peptic ulcer disease is prescribed Misoprostol. The nurse must
ensure the patient is NOT:
A. Taking a proton pump inhibitor.
B. Pregnant.
C. Allergic to aspirin.
D. Over the age of 65.
Answer: B
Rationale: Misoprostol is a prostaglandin E1 analog used for ulcer prevention but is
strictly contraindicated in pregnancy as it can cause uterine contractions and miscarriage
(Category X).
10. A patient is prescribed Sucralfate for a duodenal ulcer. When should the nurse schedule
the administration of this medication?
A. With meals and at bedtime.
B. One hour before meals and at bedtime.
Correct Answers with Rationale – Galen College of Nursing
1. A nurse is providing discharge instructions to a patient prescribed levothyroxine for
hypothyroidism. Which statement by the patient indicates a need for further teaching?
A. If I feel like I have too much energy, I will skip a few doses.
B. I should wait at least 30 to 60 minutes before eating breakfast.
C. I will take this medication every morning on an empty stomach.
D. It may take several weeks before I start feeling the full effects.
Answer: A
Rationale: Levothyroxine is a lifelong replacement therapy and should never be skipped
without provider consultation; ‘feeling like too much energy’ could indicate
hyperthyroidism, requiring a dose adjustment, not self-discontinuation. Taking it on an
empty stomach is correct to ensure absorption.
2. A patient with Type 1 Diabetes Mellitus is prescribed Lispro insulin. When should the nurse
administer this medication?
A. 30 to 45 minutes before a meal.
B. Only when the blood glucose is above 200 mg/dL.
C. Immediately before or within 15 minutes of eating.
D. One hour after the patient finishes their meal.
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes; it must be
administered in close proximity to a meal to prevent hypoglycemia. Traditional regular
insulin is given 30 minutes before meals.
3. A nurse is caring for a patient receiving IV hydrocortisone for an acute adrenal crisis. Which
laboratory value is most important for the nurse to monitor?
A. Serum sodium levels.
B. Serum potassium levels.
C. White blood cell count.
D. Serum glucose levels.
Answer: D
,Rationale: Glucocorticoids like hydrocortisone significantly increase blood glucose levels
via gluconeogenesis; while electrolytes are important in adrenal crisis, monitoring for
steroid-induced hyperglycemia is a primary nursing responsibility.
4. Which medication is considered the first-line treatment for a patient newly diagnosed with
Type 2 Diabetes Mellitus, assuming no contraindications?
A. Glipizide
B. Liraglutide
C. Pioglitazone
D. Metformin
Answer: D
Rationale: Metformin is the preferred initial pharmacological agent for Type 2 Diabetes
because it is effective, does not cause hypoglycemia when used alone, and may assist with
modest weight loss.
5. A patient is scheduled for a CT scan with IV contrast. The nurse notes the patient is taking
Metformin. What action should the nurse take?
A. Administer the Metformin as scheduled before the procedure.
B. Hold the Metformin for 48 hours before and after the procedure.
C. Ensure the patient receives a double dose of Metformin after the scan.
D. Switch the patient to insulin for the duration of the hospital stay.
Answer: B
Rationale: Metformin must be held 48 hours before and after procedures involving
contrast dye to prevent the risk of lactic acidosis and acute renal failure, as both the dye
and the drug are cleared by the kidneys.
6. A patient is prescribed Albuterol and Beclomethasone inhalers for asthma. What is the
correct sequence for administration?
A. Administer beclomethasone, wait 5 minutes, then administer albuterol.
B. Administer albuterol, wait 5 minutes, then administer beclomethasone.
C. Mix both medications in a nebulizer for simultaneous delivery.
D. Administer them in any order as long as the patient rinses their mouth.
Answer: B
Rationale: Albuterol, a bronchodilator, should be administered first to open the airways,
allowing the corticosteroid (beclomethasone) to penetrate deeper into the lung tissue. A 5-
minute wait between different inhalers is standard.
, 7. A patient taking Theophylline for chronic COPD reports nausea, insomnia, and palpitations.
The nurse should suspect which condition?
A. Normal therapeutic effects of the drug.
B. Theophylline toxicity.
C. A looming respiratory infection.
D. Inadequate dosage of the medication.
Answer: B
Rationale: Theophylline has a narrow therapeutic index (10-20 mcg/mL). Nausea,
vomiting, insomnia, and tachycardia/palpitations are early signs of toxicity; severe toxicity
can lead to seizures and dysrhythmias.
8. Which instruction is essential for a patient starting a course of inhaled Budesonide?
A. Take a deep breath and hold it for 2 seconds only.
B. Expect a frequent cough as a normal side effect.
C. Use this medication only when you feel an asthma attack starting.
D. Rinse your mouth with water after each use.
Answer: D
Rationale: Inhaled corticosteroids increase the risk of oral candidiasis (thrush). Rinsing
the mouth and spitting after administration helps prevent this fungal infection.
9. A patient with a history of peptic ulcer disease is prescribed Misoprostol. The nurse must
ensure the patient is NOT:
A. Taking a proton pump inhibitor.
B. Pregnant.
C. Allergic to aspirin.
D. Over the age of 65.
Answer: B
Rationale: Misoprostol is a prostaglandin E1 analog used for ulcer prevention but is
strictly contraindicated in pregnancy as it can cause uterine contractions and miscarriage
(Category X).
10. A patient is prescribed Sucralfate for a duodenal ulcer. When should the nurse schedule
the administration of this medication?
A. With meals and at bedtime.
B. One hour before meals and at bedtime.
