NR 508 WEEK 5 QUESTIONS AND ANSWERS 2025
Both men and women experience bone loss with aging. The bones most likely to demonstrate significant
loss are:
1. Cortical bones
2. Femoral neck bones
3. Cervical vertebrae
4. Pelvic bones - (ANSWER)2. Femoral neck bones
Bisphosphonates treat or prevent osteoporosis by:
1. Inhibiting osteoclastic activity
2. Fostering bone resorption
3. Enhancing calcium uptake in the bone
4. Strengthening the osteoclastic proton pump - (ANSWER)1. Inhibiting osteoclastic activity
Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-
term use of which of the following drugs?
1. Selective estrogen receptor modulators
2. Aspirin
3. Glucocorticoids
4. Calcium supplements - (ANSWER)3. Glucocorticoids
Patients with cystic fibrosis are often prescribed enzyme replacement for pancreatic secretions. Each
replacement drug has lipase, protease, and amylase components, but the drug is prescribed in units of:
1. Lipase
2. Protease
3. Amylase
4. Pancreatin - (ANSWER)1. Lipase
Brands of pancreatic enzyme replacement drugs are:
,NR 508 WEEK 5 QUESTIONS AND ANSWERS 2025
1. Bioequivalent
2. About the same in cost per unit of lipase across brands
3. Able to be interchanged between generic and brand-name products to reduce cost
4. None of the above - (ANSWER)2. About the same in cost per unit of lipase across brands
When given subcutaneously, how long until neutral protamine Hagedorn insulin begins to take effect
(onset of action) after administration?
1. 15 to 30 minutes
2. 60 to 90 minutes
3. 3 to 4 hours
4. 6 to 8 hours - (ANSWER)2. 60 to 90 minutes
Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms
of hypoglycemia include:
1. "Fruity" breath odor and rapid respiration
2. Diarrhea, abdominal pain, weight loss, and hypertension
3. Dizziness, confusion, diaphoresis, and tachycardia
4. Easy bruising, palpitations, cardiac dysrhythmias, and coma - (ANSWER)3. Dizziness, confusion,
diaphoresis, and tachycardia
Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:
1. Increase blood glucose levels
2. Produce unexplained diaphoresis
3. Interfere with the ability of the body to metabolize glucose
4. Mask the signs and symptoms of altered glucose levels - (ANSWER)4. Mask the signs and symptoms of
altered glucose levels
Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following
statements about this form of insulin is NOT true?
, NR 508 WEEK 5 QUESTIONS AND ANSWERS 2025
1. Optimal time of preprandial injection is 15 minutes.
2. Duration of action is increased when the dose is increased.
3. It is compatible with neutral protamine Hagedorn insulin.
4. It has no pronounced peak. - (ANSWER)2. Duration of action is increased when the dose is increased.
The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to
insulin glargine to improve glycemia control throughout the day. If this is done:
1. The initial dose of glargine is reduced by 20% to avoid hypoglycemia.
2. The initial dose of glargine is 2 to 10 units per day.
3. Patients who have been on high doses of NPH will need tests for insulin antibodies.
4. Obese patients may require more than 100 units per day. - (ANSWER)1. The initial dose of glargine is
reduced by 20% to avoid hypoglycemia.
When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may be added
to the treatment regimen to control blood glucose and limit complication risks. Which of the following
statements is accurate based on research?
1. Premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia.
2. Premixed insulin analogues and the newer premixed insulins are associated with more weight gain
than the oral antidiabetic agents.
3. Newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-
acting insulins.
4. Patients who are not controlled on oral agents and have postprandial hyperglycemia can have neutral
protamine Hagedorn insulin added at bedtime. - (ANSWER)3. Newer premixed insulins are better at
lowering HbA1C and postprandial glucose levels than long-acting insulins.
Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:
1. Substitutes for insulin usually secreted by the pancreas
2. Decreases glycogenolysis by the liver
3. Increases the release of insulin from beta cells
4. Decreases peripheral glucose utilization - (ANSWER)2. Decreases glycogenolysis by the liver
Both men and women experience bone loss with aging. The bones most likely to demonstrate significant
loss are:
1. Cortical bones
2. Femoral neck bones
3. Cervical vertebrae
4. Pelvic bones - (ANSWER)2. Femoral neck bones
Bisphosphonates treat or prevent osteoporosis by:
1. Inhibiting osteoclastic activity
2. Fostering bone resorption
3. Enhancing calcium uptake in the bone
4. Strengthening the osteoclastic proton pump - (ANSWER)1. Inhibiting osteoclastic activity
Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-
term use of which of the following drugs?
1. Selective estrogen receptor modulators
2. Aspirin
3. Glucocorticoids
4. Calcium supplements - (ANSWER)3. Glucocorticoids
Patients with cystic fibrosis are often prescribed enzyme replacement for pancreatic secretions. Each
replacement drug has lipase, protease, and amylase components, but the drug is prescribed in units of:
1. Lipase
2. Protease
3. Amylase
4. Pancreatin - (ANSWER)1. Lipase
Brands of pancreatic enzyme replacement drugs are:
,NR 508 WEEK 5 QUESTIONS AND ANSWERS 2025
1. Bioequivalent
2. About the same in cost per unit of lipase across brands
3. Able to be interchanged between generic and brand-name products to reduce cost
4. None of the above - (ANSWER)2. About the same in cost per unit of lipase across brands
When given subcutaneously, how long until neutral protamine Hagedorn insulin begins to take effect
(onset of action) after administration?
1. 15 to 30 minutes
2. 60 to 90 minutes
3. 3 to 4 hours
4. 6 to 8 hours - (ANSWER)2. 60 to 90 minutes
Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs and symptoms
of hypoglycemia include:
1. "Fruity" breath odor and rapid respiration
2. Diarrhea, abdominal pain, weight loss, and hypertension
3. Dizziness, confusion, diaphoresis, and tachycardia
4. Easy bruising, palpitations, cardiac dysrhythmias, and coma - (ANSWER)3. Dizziness, confusion,
diaphoresis, and tachycardia
Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:
1. Increase blood glucose levels
2. Produce unexplained diaphoresis
3. Interfere with the ability of the body to metabolize glucose
4. Mask the signs and symptoms of altered glucose levels - (ANSWER)4. Mask the signs and symptoms of
altered glucose levels
Lispro is an insulin analogue produced by recombinant DNA technology. Which of the following
statements about this form of insulin is NOT true?
, NR 508 WEEK 5 QUESTIONS AND ANSWERS 2025
1. Optimal time of preprandial injection is 15 minutes.
2. Duration of action is increased when the dose is increased.
3. It is compatible with neutral protamine Hagedorn insulin.
4. It has no pronounced peak. - (ANSWER)2. Duration of action is increased when the dose is increased.
The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to
insulin glargine to improve glycemia control throughout the day. If this is done:
1. The initial dose of glargine is reduced by 20% to avoid hypoglycemia.
2. The initial dose of glargine is 2 to 10 units per day.
3. Patients who have been on high doses of NPH will need tests for insulin antibodies.
4. Obese patients may require more than 100 units per day. - (ANSWER)1. The initial dose of glargine is
reduced by 20% to avoid hypoglycemia.
When blood glucose levels are difficult to control in type 2 diabetes some form of insulin may be added
to the treatment regimen to control blood glucose and limit complication risks. Which of the following
statements is accurate based on research?
1. Premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia.
2. Premixed insulin analogues and the newer premixed insulins are associated with more weight gain
than the oral antidiabetic agents.
3. Newer premixed insulins are better at lowering HbA1C and postprandial glucose levels than long-
acting insulins.
4. Patients who are not controlled on oral agents and have postprandial hyperglycemia can have neutral
protamine Hagedorn insulin added at bedtime. - (ANSWER)3. Newer premixed insulins are better at
lowering HbA1C and postprandial glucose levels than long-acting insulins.
Metformin is a primary choice of drug to treat hyperglycemia in type 2 diabetes because it:
1. Substitutes for insulin usually secreted by the pancreas
2. Decreases glycogenolysis by the liver
3. Increases the release of insulin from beta cells
4. Decreases peripheral glucose utilization - (ANSWER)2. Decreases glycogenolysis by the liver
