NU 150 Exam 3 | NU 150 Pharmacology |
Questions and Answers with Rationales
2026/2027 Update
QUESTION 1
Which medication class is considered first-line oral pharmacotherapy for the
management of type 2 diabetes mellitus due to its efficacy in decreasing hepatic
glucose production?
A. Sulfonylureas
B. Biguanides such as metformin
C. Thiazolidinediones
D. Alpha-glucosidase inhibitors
ANSWER: B
RATIONALE: Metformin is a biguanide and the preferred first-line oral medication
for type 2 diabetes because it decreases hepatic gluconeogenesis, reduces
intestinal glucose absorption, and improves insulin sensitivity without causing
hypoglycemia.
QUESTION 2
Which adverse effect requires temporary discontinuation of metformin prior to
diagnostic imaging procedures utilizing iodinated radiocontrast media?
A. Severe hypoglycemia
B. Lactic acidosis due to contrast-induced acute kidney injury
C. Acute hepatic necrosis
D. Severe allergic anaphylaxis
ANSWER: B
,RATIONALE: If a patient develops contrast-induced acute kidney injury, metformin
can accumulate and lead to fatal lactic acidosis. Metformin is held before and for
48 hours after iodinated contrast administration.
QUESTION 3
What is the primary mechanism of action of sulfonylureas such as glipizide in
managing type 2 diabetes?
A. Increasing peripheral muscle glucose uptake
B. Stimulating pancreatic beta cells to release stored insulin
C. Inhibiting hepatic glycogenolysis directly
D. Delaying carbohydrate digestion in the intestinal tract
ANSWER: B
RATIONALE: Sulfonylureas act as insulin secretagogues by closing ATP-sensitive
potassium channels in pancreatic beta cells, causing depolarization, calcium
influx, and exocytosis of stored insulin.
QUESTION 4
Which insulin preparation has the fastest onset of action, typically administered
fifteen minutes before a meal?
A. Regular insulin
B. Neutral protamine hagedorn insulin
C. Rapid-acting insulin analogs such as lispro, aspart, or glulisine
D. Long-acting insulin glargine
ANSWER: C
RATIONALE: Rapid-acting insulin analogs have an onset of action within ten to
fifteen minutes, allowing patients to inject them immediately before meals to
control postprandial blood glucose spikes.
QUESTION 5
,Which insulin preparation provides a prolonged duration of action lasting up to
twenty-four hours without a pronounced peak effect?
A. Regular insulin
B. Neutral protamine hagedorn insulin
C. Insulin glargine or detemir
D. Insulin lispro
ANSWER: C
RATIONALE: Long-acting insulins like glargine and detemir form microprecipitates
or bind to albumin, releasing slowly over twenty-four hours to provide a steady
basal level of insulin without significant peaks.
QUESTION 6
What is the standard clinical rule when mixing regular insulin and neutral
protamine hagedorn insulin in the same syringe?
A. Draw up cloudy suspension insulin first, then clear regular insulin
B. Draw up clear regular insulin first, then cloudy suspension insulin
C. Never mix any insulin types in the same syringe
D. Mix them in equal proportions only
ANSWER: B
RATIONALE: To avoid contaminating the regular insulin vial with intermediate-
acting suspension particles, nurses follow the clear-to-cloudy rule: draw up
regular insulin first, then neutral protamine hagedorn insulin.
QUESTION 7
Why is regular rotation of subcutaneous insulin injection sites mandatory?
A. To prevent lipodystrophy which impairs insulin absorption
B. To prevent systemic allergic reactions
C. To accelerate the systemic absorption of insulin
, D. To avoid muscle tissue damage
ANSWER: A
RATIONALE: Repeated injections in the exact same spot cause lipodystrophy, an
abnormal thickening or loss of subcutaneous fat that alters blood flow and leads
to erratic, unpredictable insulin absorption.
QUESTION 8
What is the primary pharmacological action of levothyroxine sodium when
prescribed for hypothyroidism?
A. Synthetic replacement of thyroxine hormone to restore normal metabolic rate
and physiological function
B. Destruction of overactive thyroid tissue
C. Suppression of thyroid-stimulating hormone from the pituitary gland
exclusively
D. Stimulation of radioactive iodine uptake
ANSWER: A
RATIONALE: Levothyroxine is a synthetic form of thyroxine used as lifelong
hormone replacement therapy for hypothyroidism to restore normal metabolic
rate and physiological function.
QUESTION 9
When is the optimal time of day for a patient to take their daily dose of
levothyroxine?
A. At bedtime with a high-fat snack
B. In the morning on an empty stomach with a full glass of water, thirty to sixty
minutes before breakfast
C. Immediately after lunch with an antacid
D. With dinner to prevent nocturnal insomnia
ANSWER: B
Questions and Answers with Rationales
2026/2027 Update
QUESTION 1
Which medication class is considered first-line oral pharmacotherapy for the
management of type 2 diabetes mellitus due to its efficacy in decreasing hepatic
glucose production?
A. Sulfonylureas
B. Biguanides such as metformin
C. Thiazolidinediones
D. Alpha-glucosidase inhibitors
ANSWER: B
RATIONALE: Metformin is a biguanide and the preferred first-line oral medication
for type 2 diabetes because it decreases hepatic gluconeogenesis, reduces
intestinal glucose absorption, and improves insulin sensitivity without causing
hypoglycemia.
QUESTION 2
Which adverse effect requires temporary discontinuation of metformin prior to
diagnostic imaging procedures utilizing iodinated radiocontrast media?
A. Severe hypoglycemia
B. Lactic acidosis due to contrast-induced acute kidney injury
C. Acute hepatic necrosis
D. Severe allergic anaphylaxis
ANSWER: B
,RATIONALE: If a patient develops contrast-induced acute kidney injury, metformin
can accumulate and lead to fatal lactic acidosis. Metformin is held before and for
48 hours after iodinated contrast administration.
QUESTION 3
What is the primary mechanism of action of sulfonylureas such as glipizide in
managing type 2 diabetes?
A. Increasing peripheral muscle glucose uptake
B. Stimulating pancreatic beta cells to release stored insulin
C. Inhibiting hepatic glycogenolysis directly
D. Delaying carbohydrate digestion in the intestinal tract
ANSWER: B
RATIONALE: Sulfonylureas act as insulin secretagogues by closing ATP-sensitive
potassium channels in pancreatic beta cells, causing depolarization, calcium
influx, and exocytosis of stored insulin.
QUESTION 4
Which insulin preparation has the fastest onset of action, typically administered
fifteen minutes before a meal?
A. Regular insulin
B. Neutral protamine hagedorn insulin
C. Rapid-acting insulin analogs such as lispro, aspart, or glulisine
D. Long-acting insulin glargine
ANSWER: C
RATIONALE: Rapid-acting insulin analogs have an onset of action within ten to
fifteen minutes, allowing patients to inject them immediately before meals to
control postprandial blood glucose spikes.
QUESTION 5
,Which insulin preparation provides a prolonged duration of action lasting up to
twenty-four hours without a pronounced peak effect?
A. Regular insulin
B. Neutral protamine hagedorn insulin
C. Insulin glargine or detemir
D. Insulin lispro
ANSWER: C
RATIONALE: Long-acting insulins like glargine and detemir form microprecipitates
or bind to albumin, releasing slowly over twenty-four hours to provide a steady
basal level of insulin without significant peaks.
QUESTION 6
What is the standard clinical rule when mixing regular insulin and neutral
protamine hagedorn insulin in the same syringe?
A. Draw up cloudy suspension insulin first, then clear regular insulin
B. Draw up clear regular insulin first, then cloudy suspension insulin
C. Never mix any insulin types in the same syringe
D. Mix them in equal proportions only
ANSWER: B
RATIONALE: To avoid contaminating the regular insulin vial with intermediate-
acting suspension particles, nurses follow the clear-to-cloudy rule: draw up
regular insulin first, then neutral protamine hagedorn insulin.
QUESTION 7
Why is regular rotation of subcutaneous insulin injection sites mandatory?
A. To prevent lipodystrophy which impairs insulin absorption
B. To prevent systemic allergic reactions
C. To accelerate the systemic absorption of insulin
, D. To avoid muscle tissue damage
ANSWER: A
RATIONALE: Repeated injections in the exact same spot cause lipodystrophy, an
abnormal thickening or loss of subcutaneous fat that alters blood flow and leads
to erratic, unpredictable insulin absorption.
QUESTION 8
What is the primary pharmacological action of levothyroxine sodium when
prescribed for hypothyroidism?
A. Synthetic replacement of thyroxine hormone to restore normal metabolic rate
and physiological function
B. Destruction of overactive thyroid tissue
C. Suppression of thyroid-stimulating hormone from the pituitary gland
exclusively
D. Stimulation of radioactive iodine uptake
ANSWER: A
RATIONALE: Levothyroxine is a synthetic form of thyroxine used as lifelong
hormone replacement therapy for hypothyroidism to restore normal metabolic
rate and physiological function.
QUESTION 9
When is the optimal time of day for a patient to take their daily dose of
levothyroxine?
A. At bedtime with a high-fat snack
B. In the morning on an empty stomach with a full glass of water, thirty to sixty
minutes before breakfast
C. Immediately after lunch with an antacid
D. With dinner to prevent nocturnal insomnia
ANSWER: B
