NUR 2474|NUR 2474 PHARMACOLOGY FINAL
EXAM|LATEST UPDATE
1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for
four patients who were just admitted. Which patient should the nurse assess
first?
a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20
units of 70/30 Novolin insulin.
b. The patient with a pulse of 58 beats per minute who is about to receive digoxin
(Lanoxin)
c. The patient with a blood pressure of 136/92 mm Hg who complains of having a
headache
d. The patient with an allergy to penicillin who is receiving an infusion of
vancomycin (Vancocin) - (ANSWER)a. The NPO patient with a blood glucose level
of 80 mg/dL who just received 20 units of 70/30 Novolin insulin.
*low/normal BGL and insulin will continue to drop glucose level. At risk for
hypoglycemia.
2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are
on a sliding scale and are ordered before a meal and at bedtime. The patient's
blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse
prepare to administer?
a. No insulin should be administered.
b. NPH
,c. 70/30 mix
d. Lispro (Humalog) - (ANSWER)d. Lispro (Humalog)
*high blood sugar needs rapid acting insulin.
3. A patient with type 1 diabetes recently became pregnant. The nurse plans a
blood glucose testing schedule for her. What is the recommended monitoring
schedule?
a. Before each meal and before bed
b. In the morning for a fasting level and at 4 PM for the peak level
c. Six or seven times a day
d. Three times a day, along with urine glucose testing - (ANSWER)c. Six or seven
times a day
*pregnancy can effect glucose levels. Frequent monitoring required.
4. An adolescent patient recently attended a health fair and had a serum glucose
test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does
that mean I have diabetes?" What is the nurse's most accurate response?
a. "Unless you were fasting for longer than 8 hours, this does not necessarily
mean you have diabetes."
,b. "At this level, you probably have diabetes. You will need an oral glucose
tolerance test this week."
c. "This level is conclusive evidence that you have diabetes."
d. "This level is conclusive evidence that you do not have diabetes." - (ANSWER)a.
"Unless you were fasting for longer than 8 hours, this does not necessarily mean
you have diabetes."
*could be a normal level without fasting and does not mean diabetes unless it
was high for a fasting blood glucose level.
5. Insulin glargine is prescribed for a hospitalized patient who is diabetic. When
will the nurse administer this drug?
a. Approximately 15 to 30 minutes before each meal
b. In the morning and at 4 PM
c. Once daily at bedtime
d. After meals and at bedtime - (ANSWER)c. Once daily at bedtime
*goodnight glargine
6. A patient with type 1 diabetes who takes insulin reports taking propranolol for
hypertension. Why is the nurse concerned?
a. The beta blocker can cause insulin resistance.
, b. Using the two agents together increases the risk of ketoacidosis.
c. Propranolol increases insulin requirements because of receptor blocking.
d. The beta blocker can mask the symptoms of hypoglycemia. - (ANSWER)d. The
beta blocker can mask the symptoms of hypoglycemia.
*beta blockers block adrenaline which signals the liver to release glucose in the
blood when glucose is low to avoid hypoglycemia.
7. Which statement is correct about the contrast between a carbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects. - (ANSWER)a. Miglitol has not
been associated with hepatic dysfunction.
*key difference is that acarbose has been associated with rare cases of hepatic
dysfunction
8. A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for
which adverse reactions? (Select all that apply.)
a. Hypoglycemia
EXAM|LATEST UPDATE
1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for
four patients who were just admitted. Which patient should the nurse assess
first?
a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20
units of 70/30 Novolin insulin.
b. The patient with a pulse of 58 beats per minute who is about to receive digoxin
(Lanoxin)
c. The patient with a blood pressure of 136/92 mm Hg who complains of having a
headache
d. The patient with an allergy to penicillin who is receiving an infusion of
vancomycin (Vancocin) - (ANSWER)a. The NPO patient with a blood glucose level
of 80 mg/dL who just received 20 units of 70/30 Novolin insulin.
*low/normal BGL and insulin will continue to drop glucose level. At risk for
hypoglycemia.
2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are
on a sliding scale and are ordered before a meal and at bedtime. The patient's
blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse
prepare to administer?
a. No insulin should be administered.
b. NPH
,c. 70/30 mix
d. Lispro (Humalog) - (ANSWER)d. Lispro (Humalog)
*high blood sugar needs rapid acting insulin.
3. A patient with type 1 diabetes recently became pregnant. The nurse plans a
blood glucose testing schedule for her. What is the recommended monitoring
schedule?
a. Before each meal and before bed
b. In the morning for a fasting level and at 4 PM for the peak level
c. Six or seven times a day
d. Three times a day, along with urine glucose testing - (ANSWER)c. Six or seven
times a day
*pregnancy can effect glucose levels. Frequent monitoring required.
4. An adolescent patient recently attended a health fair and had a serum glucose
test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does
that mean I have diabetes?" What is the nurse's most accurate response?
a. "Unless you were fasting for longer than 8 hours, this does not necessarily
mean you have diabetes."
,b. "At this level, you probably have diabetes. You will need an oral glucose
tolerance test this week."
c. "This level is conclusive evidence that you have diabetes."
d. "This level is conclusive evidence that you do not have diabetes." - (ANSWER)a.
"Unless you were fasting for longer than 8 hours, this does not necessarily mean
you have diabetes."
*could be a normal level without fasting and does not mean diabetes unless it
was high for a fasting blood glucose level.
5. Insulin glargine is prescribed for a hospitalized patient who is diabetic. When
will the nurse administer this drug?
a. Approximately 15 to 30 minutes before each meal
b. In the morning and at 4 PM
c. Once daily at bedtime
d. After meals and at bedtime - (ANSWER)c. Once daily at bedtime
*goodnight glargine
6. A patient with type 1 diabetes who takes insulin reports taking propranolol for
hypertension. Why is the nurse concerned?
a. The beta blocker can cause insulin resistance.
, b. Using the two agents together increases the risk of ketoacidosis.
c. Propranolol increases insulin requirements because of receptor blocking.
d. The beta blocker can mask the symptoms of hypoglycemia. - (ANSWER)d. The
beta blocker can mask the symptoms of hypoglycemia.
*beta blockers block adrenaline which signals the liver to release glucose in the
blood when glucose is low to avoid hypoglycemia.
7. Which statement is correct about the contrast between a carbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects. - (ANSWER)a. Miglitol has not
been associated with hepatic dysfunction.
*key difference is that acarbose has been associated with rare cases of hepatic
dysfunction
8. A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for
which adverse reactions? (Select all that apply.)
a. Hypoglycemia
