NR 293 Pharmacology Week 8 - Endocrine, Reproduction, and
Immune Review 2026 |Chamberlain College
1. A nurse is teaching a client about a new prescription for levothyroxine. Which
statement by the client indicates understanding of the administration timing?
A. I will take it right before bedtime with a glass of milk.
B. I will take it 30 to 60 minutes before breakfast on an empty stomach.
C. I will take it with my morning meal to avoid stomach upset.
D. I will take it only when I feel sluggish or tired.
Answer: B
Rationale: Levothyroxine should be taken on an empty stomach, 30-60 minutes before
breakfast, to ensure optimal absorption and prevent interference from food.
2. Which of the following insulins should the nurse expect to reach its peak
effect in 1 to 5 hours?
A. Insulin Lispro
B. Insulin Glargine
C. Regular Insulin
D. NPH Insulin
Answer: C
Rationale: Regular insulin (Short-acting) has an onset of 30-60 minutes and a peak of 1-5
hours. Lispro is rapid-acting (peak 0.5-2.5h), and NPH is intermediate (peak 6-14h).
,3. A client is prescribed metformin for type 2 diabetes. What is a critical
teaching point regarding medical imaging procedures?
A. Double the dose on the day of the procedure to manage stress hyperglycemia.
B. Stop metformin 48 hours before and after any procedure involving iodine contrast dye.
C. Take metformin as usual regardless of the procedure.
D. Switch to insulin for one week before the procedure.
Answer: B
Rationale: Metformin must be held before and for 48 hours after procedures using iodine-
based contrast media to prevent renal failure and lactic acidosis.
4. A client with hyperthyroidism is prescribed Propylthiouracil (PTU). The nurse
should monitor for which serious adverse effect?
A. Hyperglycemia
B. Agranulocytosis
C. Weight loss
D. Tachycardia
Answer: B
Rationale: Agranulocytosis (dangerously low white blood cell count) is a severe adverse
effect of PTU; patients should report sore throat or fever immediately.
5. Which medication is the treatment of choice for a client experiencing a severe
hypoglycemic reaction who is unconscious and has no IV access?
A. Glucagon IM or SQ
B. Regular insulin subcutaneously
C. Oral glucose gel
D. Dextrose 5% in water IV
Answer: A
Rationale: If a patient is unconscious and lacks IV access, Glucagon is administered IM or
SQ to stimulate the liver to release glucose.
, 6. A patient taking long-term glucocorticoids (Prednisone) for an autoimmune
disorder is at risk for which condition?
A. Hypoglycemia
B. Weight loss and dehydration
C. Osteoporosis
D. Hypotension
Answer: C
Rationale: Long-term glucocorticoid use causes bone loss by inhibiting osteoblast activity
and reducing calcium absorption, leading to osteoporosis.
7. When mixing NPH and Regular insulin in the same syringe, which insulin
should be drawn up first?
A. The Regular (clear) insulin
B. The NPH (cloudy) insulin
C. It does not matter which is first
D. They should never be mixed
Answer: A
Rationale: Always draw ‘clear before cloudy’ (Regular before NPH) to prevent
contaminating the short-acting insulin vial with the intermediate-acting NPH.
8. A client with Diabetes Insipidus is receiving Desmopressin. Which finding
indicates the medication is effective?
A. Increased urinary output
B. Decreased urine specific gravity
C. Weight loss of 2 lbs in 24 hours
D. Decreased thirst and urine output
Answer: D
Rationale: Desmopressin is a synthetic ADH; effectiveness is demonstrated by decreased
urine output and increased urine specific gravity (more concentrated urine).
Immune Review 2026 |Chamberlain College
1. A nurse is teaching a client about a new prescription for levothyroxine. Which
statement by the client indicates understanding of the administration timing?
A. I will take it right before bedtime with a glass of milk.
B. I will take it 30 to 60 minutes before breakfast on an empty stomach.
C. I will take it with my morning meal to avoid stomach upset.
D. I will take it only when I feel sluggish or tired.
Answer: B
Rationale: Levothyroxine should be taken on an empty stomach, 30-60 minutes before
breakfast, to ensure optimal absorption and prevent interference from food.
2. Which of the following insulins should the nurse expect to reach its peak
effect in 1 to 5 hours?
A. Insulin Lispro
B. Insulin Glargine
C. Regular Insulin
D. NPH Insulin
Answer: C
Rationale: Regular insulin (Short-acting) has an onset of 30-60 minutes and a peak of 1-5
hours. Lispro is rapid-acting (peak 0.5-2.5h), and NPH is intermediate (peak 6-14h).
,3. A client is prescribed metformin for type 2 diabetes. What is a critical
teaching point regarding medical imaging procedures?
A. Double the dose on the day of the procedure to manage stress hyperglycemia.
B. Stop metformin 48 hours before and after any procedure involving iodine contrast dye.
C. Take metformin as usual regardless of the procedure.
D. Switch to insulin for one week before the procedure.
Answer: B
Rationale: Metformin must be held before and for 48 hours after procedures using iodine-
based contrast media to prevent renal failure and lactic acidosis.
4. A client with hyperthyroidism is prescribed Propylthiouracil (PTU). The nurse
should monitor for which serious adverse effect?
A. Hyperglycemia
B. Agranulocytosis
C. Weight loss
D. Tachycardia
Answer: B
Rationale: Agranulocytosis (dangerously low white blood cell count) is a severe adverse
effect of PTU; patients should report sore throat or fever immediately.
5. Which medication is the treatment of choice for a client experiencing a severe
hypoglycemic reaction who is unconscious and has no IV access?
A. Glucagon IM or SQ
B. Regular insulin subcutaneously
C. Oral glucose gel
D. Dextrose 5% in water IV
Answer: A
Rationale: If a patient is unconscious and lacks IV access, Glucagon is administered IM or
SQ to stimulate the liver to release glucose.
, 6. A patient taking long-term glucocorticoids (Prednisone) for an autoimmune
disorder is at risk for which condition?
A. Hypoglycemia
B. Weight loss and dehydration
C. Osteoporosis
D. Hypotension
Answer: C
Rationale: Long-term glucocorticoid use causes bone loss by inhibiting osteoblast activity
and reducing calcium absorption, leading to osteoporosis.
7. When mixing NPH and Regular insulin in the same syringe, which insulin
should be drawn up first?
A. The Regular (clear) insulin
B. The NPH (cloudy) insulin
C. It does not matter which is first
D. They should never be mixed
Answer: A
Rationale: Always draw ‘clear before cloudy’ (Regular before NPH) to prevent
contaminating the short-acting insulin vial with the intermediate-acting NPH.
8. A client with Diabetes Insipidus is receiving Desmopressin. Which finding
indicates the medication is effective?
A. Increased urinary output
B. Decreased urine specific gravity
C. Weight loss of 2 lbs in 24 hours
D. Decreased thirst and urine output
Answer: D
Rationale: Desmopressin is a synthetic ADH; effectiveness is demonstrated by decreased
urine output and increased urine specific gravity (more concentrated urine).
