NUR 210: Principles of Pharmacology - Exam 4 Preparation 2026
|Galen College
1. A patient is prescribed Insulin Lispro (Humalog). Which instruction should the
nurse provide regarding the timing of administration?
A. Inject immediately before or within 15 minutes of eating.
B. Inject 30 to 60 minutes before a meal.
C. Inject only at bedtime.
D. Inject once daily in the morning regardless of food.
Answer: A
Rationale: Insulin Lispro is a rapid-acting insulin with an onset of 15 minutes; it must be
administered close to mealtime to prevent hypoglycemia.
2. Which medication is the first-line treatment for Type 2 Diabetes and works by
decreasing hepatic glucose production?
A. Glyburide
B. Metformin
C. Pioglitazone
D. Repaglinide
Answer: B
Rationale: Metformin (a biguanide) decreases glucose production by the liver and
increases insulin sensitivity.
,3. A patient taking Metformin is scheduled for a CT scan with IV contrast. What
is the priority nursing action?
A. Increase the Metformin dose the morning of the procedure.
B. Administer Metformin as scheduled.
C. Hold Metformin 48 hours before and after the procedure.
D. Ensure the patient remains NPO for 24 hours.
Answer: C
Rationale: Metformin combined with iodine-contrast media can cause acute renal failure
and lactic acidosis. It is typically held 48 hours before/after.
4. What is the peak action time for NPH insulin?
A. 4 to 12 hours
B. 1 to 3 hours
C. 18 to 24 hours
D. 30 to 60 minutes
Answer: A
Rationale: NPH is an intermediate-acting insulin with a peak effect typically occurring
between 4 and 12 hours after injection.
5. A patient is prescribed Levothyroxine for hypothyroidism. When should they
be instructed to take this medication?
A. With a high-fiber breakfast.
B. In the morning on an empty stomach, 30-60 minutes before food.
C. At bedtime with a snack.
D. Immediately after the largest meal of the day.
Answer: B
Rationale: Levothyroxine absorption is best on an empty stomach to avoid interference
from food and other medications.
, 6. Which finding indicates that a patient is experiencing a side effect of
excessive Levothyroxine?
A. Bradycardia
B. Insomnia and tremors
C. Weight gain
D. Cold intolerance
Answer: B
Rationale: Excessive thyroid hormone (hyperthyroidism symptoms) causes tachycardia,
tremors, heat intolerance, and insomnia.
7. Propylthiouracil (PTU) is prescribed for a patient with Graves’ disease. The
nurse should monitor for which serious adverse effect?
A. Agranulocytosis
B. Hypertension
C. Hyperglycemia
D. Polyuria
Answer: A
Rationale: Agranulocytosis (dangerously low white blood cell count) is a rare but life-
threatening side effect of antithyroid drugs.
8. A patient is receiving Hydrocortisone for Addison’s disease. Which education
is most important?
A. Stop the medication immediately if you feel better.
B. Take the medication on an empty stomach.
C. Doses may need to be increased during times of high stress or illness.
D. Restrict fluid intake while on this medication.
Answer: C
Rationale: Patients with adrenal insufficiency require ‘stress dosing’ of glucocorticoids to
mimic the body’s natural response to illness or injury.
|Galen College
1. A patient is prescribed Insulin Lispro (Humalog). Which instruction should the
nurse provide regarding the timing of administration?
A. Inject immediately before or within 15 minutes of eating.
B. Inject 30 to 60 minutes before a meal.
C. Inject only at bedtime.
D. Inject once daily in the morning regardless of food.
Answer: A
Rationale: Insulin Lispro is a rapid-acting insulin with an onset of 15 minutes; it must be
administered close to mealtime to prevent hypoglycemia.
2. Which medication is the first-line treatment for Type 2 Diabetes and works by
decreasing hepatic glucose production?
A. Glyburide
B. Metformin
C. Pioglitazone
D. Repaglinide
Answer: B
Rationale: Metformin (a biguanide) decreases glucose production by the liver and
increases insulin sensitivity.
,3. A patient taking Metformin is scheduled for a CT scan with IV contrast. What
is the priority nursing action?
A. Increase the Metformin dose the morning of the procedure.
B. Administer Metformin as scheduled.
C. Hold Metformin 48 hours before and after the procedure.
D. Ensure the patient remains NPO for 24 hours.
Answer: C
Rationale: Metformin combined with iodine-contrast media can cause acute renal failure
and lactic acidosis. It is typically held 48 hours before/after.
4. What is the peak action time for NPH insulin?
A. 4 to 12 hours
B. 1 to 3 hours
C. 18 to 24 hours
D. 30 to 60 minutes
Answer: A
Rationale: NPH is an intermediate-acting insulin with a peak effect typically occurring
between 4 and 12 hours after injection.
5. A patient is prescribed Levothyroxine for hypothyroidism. When should they
be instructed to take this medication?
A. With a high-fiber breakfast.
B. In the morning on an empty stomach, 30-60 minutes before food.
C. At bedtime with a snack.
D. Immediately after the largest meal of the day.
Answer: B
Rationale: Levothyroxine absorption is best on an empty stomach to avoid interference
from food and other medications.
, 6. Which finding indicates that a patient is experiencing a side effect of
excessive Levothyroxine?
A. Bradycardia
B. Insomnia and tremors
C. Weight gain
D. Cold intolerance
Answer: B
Rationale: Excessive thyroid hormone (hyperthyroidism symptoms) causes tachycardia,
tremors, heat intolerance, and insomnia.
7. Propylthiouracil (PTU) is prescribed for a patient with Graves’ disease. The
nurse should monitor for which serious adverse effect?
A. Agranulocytosis
B. Hypertension
C. Hyperglycemia
D. Polyuria
Answer: A
Rationale: Agranulocytosis (dangerously low white blood cell count) is a rare but life-
threatening side effect of antithyroid drugs.
8. A patient is receiving Hydrocortisone for Addison’s disease. Which education
is most important?
A. Stop the medication immediately if you feel better.
B. Take the medication on an empty stomach.
C. Doses may need to be increased during times of high stress or illness.
D. Restrict fluid intake while on this medication.
Answer: C
Rationale: Patients with adrenal insufficiency require ‘stress dosing’ of glucocorticoids to
mimic the body’s natural response to illness or injury.
