NU 578 Unit 4 Exam: Advanced Pharmacology – 2026/2027
Actual Questions with Answers & Explanations | Diabetes,
Endocrine, Steroids, Gout, Rheumatoid Arthritis | University
of South Alabama
COVERAGE BY TOPIC
Topic Questions
Diabetes Pharmacotherapy (Insulin, Metformin, 1–40
Sulfonylureas, DPP-4, SGLT-2, GLP-1, Acarbose)
Thyroid Disorders (Hyperthyroidism, Hypothyroidism, 41–50
Methimazole, PTU, Levothyroxine)
Steroids & Glucocorticoids (Prednisone, Dexamethasone, 51–60
Tapering, SE)
Gout Treatment (Allopurinol, Febuxostat, Colchicine, 61–70
NSAIDs)
Rheumatoid Arthritis & Immunosuppressants 71–80
(Methotrexate, Cyclosporine, Biologics)
Reproductive & Bone Health (PCOS, Birth Control, 81–90
Bisphosphonates, Teriparatide)
CNS & Neurotransmitters (Blood-Brain Barrier, Tolerance, 91–100
Neurotransmitters)
Total Questions: 100 | Passing Score: 90% | Course: NU 578 – Advanced
Nursing | Institution: University of South Alabama
Section 1: Diabetes Pharmacotherapy (Questions 1–40)
,1. Insulin is used to treat which types of diabetes?
a) Type 2 diabetes only
b) Gestational diabetes only
c) Type 1 diabetes only
d) Type 1 diabetes and many patients with type 2 diabetes
Insulin is used to treat all patients with type 1 diabetes and many with type 2 diabetes. It
consists of two amino acid chains linked by two disulfide bridges and is synthesized in the
pancreas by beta cells within the islets of Langerhans. Insulin is released by a rise in blood
sugar from eating a meal. Insulin promotes an anabolic reaction, conserving energy and
building up energy stores.
2. What are the metabolic actions of insulin?
a) Glycogen into glucose, proteins into amino acids, fats into glycerol
b) Glucose into glycogen, amino acids into proteins, fatty acids into triglycerides
c) Glucose into fatty acids, proteins into glucose, fats into proteins
d) Glycogen into proteins, glucose into fats, amino acids into glucose
Insulin promotes the conversion of glucose into glycogen, amino acids into proteins, and
fatty acids into triglycerides. In contrast, insulin deficiency promotes the breakdown of
glycogen into glucose, proteins into amino acids, and fats into glycerol.
3. What is the primary mechanism of action of metformin?
a) Stimulates insulin release from the pancreas
b) Increases glucose absorption in the gut
c) Inhibits breakdown of oligosaccharides into monosaccharides
d) Reduces glucose production in the liver and increases glucose uptake in
peripheral tissues
Metformin is a biguanide used for type 2 diabetes. It reduces GI absorbance of glucose and
hepatic production of glucose. It does NOT stimulate insulin release from the pancreas. It
also increases HDL, decreases blood pressure, and promotes weight loss. It can be used
for prevention of type 2 diabetes, GDM, and PCOS.
4. What is the most common side effect of metformin?
a) GI upset
,b) Hypoglycemia
c) Weight gain
d) Lactic acidosis
The most common side effects of metformin are gastrointestinal disturbances, including
nausea, diarrhea, and abdominal discomfort. Lactic acidosis is a rare but potentially fatal
adverse effect (black box warning) that is highest risk in patients with renal disease.
5. Metformin should be discontinued before and after administration of which
diagnostic agent?
a) MRI contrast (gadolinium)
b) Iodinated radio contrast media
c) Barium sulfate
d) Radioactive iodine
Metformin should be discontinued before using iodinated radio contrast media and withheld
for 48 hours after the procedure to prevent lactic acidosis. Renal function should be
evaluated before restarting metformin.
6. Which class of oral antidiabetic drugs stimulates the pancreas to release more
insulin?
a) Biguanides (metformin)
b) DPP-4 inhibitors (gliptins)
c) SGLT-2 inhibitors (gliflozins)
d) Sulfonylureas
*Sulfonylureas stimulate the pancreas to release more insulin. They range in onset,
duration, and potency and are only used for type 2 diabetes. Second-generation
sulfonylureas are more potent, have lower doses, and have fewer drug-drug interactions.
The primary adverse effect is hypoglycemia.*
7. Which DPP-4 inhibitor is commonly prescribed for type 2 diabetes?
a) Empagliflozin
b) Sitagliptin
c) Exenatide
d) Pioglitazone
, *Sitagliptin is a DPP-4 inhibitor (gliptin) that goes to the pancreas and increases insulin
release. It stimulates glucose-dependent release of insulin and suppresses postprandial
release of glycogen, helping to keep blood glucose from climbing too high. Adverse effects
include URI, headache, nasal/throat inflammation, pancreatitis, and hypersensitivity
reactions.*
8. What is the mechanism of action of SGLT-2 inhibitors (gliflozins)?
a) Stimulate insulin release from the pancreas
b) Delay absorption of dietary carbohydrates
c) Reduce glucose production in the liver
d) Block reabsorption of glucose in the kidneys, increasing urinary glucose excretion
*SGLT-2 inhibitors (canagliflozin, empagliflozin) block the reabsorption of filtered glucose in
the kidneys, causing glucosuria. They are very helpful for diabetes, heart failure, and renal
dysfunction. Adverse effects include female genital fungal infections, UTIs, and increased
urination.*
9. Which SGLT-2 inhibitor reduces cardiovascular risk in patients with type 2
diabetes?
a) Canagliflozin
b) Empagliflozin
c) Dapagliflozin
d) Ertugliflozin
Empagliflozin increases urinary excretion of glucose, is taken orally, and reduces
cardiovascular risk in patients with type 2 diabetes. Adverse effects include yeast infections
and, rarely, genital gangrene (Fournier's gangrene).
10. What is the mechanism of action of GLP-1 receptor agonists (incretin mimetics)?
a) Stimulate insulin release regardless of glucose level
b) Inhibit glucose production in the liver
c) Slow gastric emptying, inhibit glucagon, suppress appetite, and stimulate glucose-
dependent insulin release
d) Block reabsorption of glucose in the kidneys
Actual Questions with Answers & Explanations | Diabetes,
Endocrine, Steroids, Gout, Rheumatoid Arthritis | University
of South Alabama
COVERAGE BY TOPIC
Topic Questions
Diabetes Pharmacotherapy (Insulin, Metformin, 1–40
Sulfonylureas, DPP-4, SGLT-2, GLP-1, Acarbose)
Thyroid Disorders (Hyperthyroidism, Hypothyroidism, 41–50
Methimazole, PTU, Levothyroxine)
Steroids & Glucocorticoids (Prednisone, Dexamethasone, 51–60
Tapering, SE)
Gout Treatment (Allopurinol, Febuxostat, Colchicine, 61–70
NSAIDs)
Rheumatoid Arthritis & Immunosuppressants 71–80
(Methotrexate, Cyclosporine, Biologics)
Reproductive & Bone Health (PCOS, Birth Control, 81–90
Bisphosphonates, Teriparatide)
CNS & Neurotransmitters (Blood-Brain Barrier, Tolerance, 91–100
Neurotransmitters)
Total Questions: 100 | Passing Score: 90% | Course: NU 578 – Advanced
Nursing | Institution: University of South Alabama
Section 1: Diabetes Pharmacotherapy (Questions 1–40)
,1. Insulin is used to treat which types of diabetes?
a) Type 2 diabetes only
b) Gestational diabetes only
c) Type 1 diabetes only
d) Type 1 diabetes and many patients with type 2 diabetes
Insulin is used to treat all patients with type 1 diabetes and many with type 2 diabetes. It
consists of two amino acid chains linked by two disulfide bridges and is synthesized in the
pancreas by beta cells within the islets of Langerhans. Insulin is released by a rise in blood
sugar from eating a meal. Insulin promotes an anabolic reaction, conserving energy and
building up energy stores.
2. What are the metabolic actions of insulin?
a) Glycogen into glucose, proteins into amino acids, fats into glycerol
b) Glucose into glycogen, amino acids into proteins, fatty acids into triglycerides
c) Glucose into fatty acids, proteins into glucose, fats into proteins
d) Glycogen into proteins, glucose into fats, amino acids into glucose
Insulin promotes the conversion of glucose into glycogen, amino acids into proteins, and
fatty acids into triglycerides. In contrast, insulin deficiency promotes the breakdown of
glycogen into glucose, proteins into amino acids, and fats into glycerol.
3. What is the primary mechanism of action of metformin?
a) Stimulates insulin release from the pancreas
b) Increases glucose absorption in the gut
c) Inhibits breakdown of oligosaccharides into monosaccharides
d) Reduces glucose production in the liver and increases glucose uptake in
peripheral tissues
Metformin is a biguanide used for type 2 diabetes. It reduces GI absorbance of glucose and
hepatic production of glucose. It does NOT stimulate insulin release from the pancreas. It
also increases HDL, decreases blood pressure, and promotes weight loss. It can be used
for prevention of type 2 diabetes, GDM, and PCOS.
4. What is the most common side effect of metformin?
a) GI upset
,b) Hypoglycemia
c) Weight gain
d) Lactic acidosis
The most common side effects of metformin are gastrointestinal disturbances, including
nausea, diarrhea, and abdominal discomfort. Lactic acidosis is a rare but potentially fatal
adverse effect (black box warning) that is highest risk in patients with renal disease.
5. Metformin should be discontinued before and after administration of which
diagnostic agent?
a) MRI contrast (gadolinium)
b) Iodinated radio contrast media
c) Barium sulfate
d) Radioactive iodine
Metformin should be discontinued before using iodinated radio contrast media and withheld
for 48 hours after the procedure to prevent lactic acidosis. Renal function should be
evaluated before restarting metformin.
6. Which class of oral antidiabetic drugs stimulates the pancreas to release more
insulin?
a) Biguanides (metformin)
b) DPP-4 inhibitors (gliptins)
c) SGLT-2 inhibitors (gliflozins)
d) Sulfonylureas
*Sulfonylureas stimulate the pancreas to release more insulin. They range in onset,
duration, and potency and are only used for type 2 diabetes. Second-generation
sulfonylureas are more potent, have lower doses, and have fewer drug-drug interactions.
The primary adverse effect is hypoglycemia.*
7. Which DPP-4 inhibitor is commonly prescribed for type 2 diabetes?
a) Empagliflozin
b) Sitagliptin
c) Exenatide
d) Pioglitazone
, *Sitagliptin is a DPP-4 inhibitor (gliptin) that goes to the pancreas and increases insulin
release. It stimulates glucose-dependent release of insulin and suppresses postprandial
release of glycogen, helping to keep blood glucose from climbing too high. Adverse effects
include URI, headache, nasal/throat inflammation, pancreatitis, and hypersensitivity
reactions.*
8. What is the mechanism of action of SGLT-2 inhibitors (gliflozins)?
a) Stimulate insulin release from the pancreas
b) Delay absorption of dietary carbohydrates
c) Reduce glucose production in the liver
d) Block reabsorption of glucose in the kidneys, increasing urinary glucose excretion
*SGLT-2 inhibitors (canagliflozin, empagliflozin) block the reabsorption of filtered glucose in
the kidneys, causing glucosuria. They are very helpful for diabetes, heart failure, and renal
dysfunction. Adverse effects include female genital fungal infections, UTIs, and increased
urination.*
9. Which SGLT-2 inhibitor reduces cardiovascular risk in patients with type 2
diabetes?
a) Canagliflozin
b) Empagliflozin
c) Dapagliflozin
d) Ertugliflozin
Empagliflozin increases urinary excretion of glucose, is taken orally, and reduces
cardiovascular risk in patients with type 2 diabetes. Adverse effects include yeast infections
and, rarely, genital gangrene (Fournier's gangrene).
10. What is the mechanism of action of GLP-1 receptor agonists (incretin mimetics)?
a) Stimulate insulin release regardless of glucose level
b) Inhibit glucose production in the liver
c) Slow gastric emptying, inhibit glucagon, suppress appetite, and stimulate glucose-
dependent insulin release
d) Block reabsorption of glucose in the kidneys
