NUR 521
Exam 3
High-Yield Qs & Answers with
Rationales
University of Alabama
This Exam Description:
High-Yield Qs
Answers with Rationales
100% Guaranteed Pass
Multiple –Choices (A-D)
1
,Q1
A patient on levothyroxine begins warfarin therapy. What is the priority concern?
A. Reduced anticoagulation
B. Increased bleeding risk
C. Hyperkalemia
D. Decreased thyroid function
Answer: B
Rationale:
Levothyroxine increases metabolic turnover of clotting factors, which potentiates the
anticoagulant effect of warfarin. This pharmacodynamics interaction elevates INR
and significantly increases bleeding risk. Clinically, this requires close INR monitoring
and dose adjustment. From a safety standpoint, bleeding complications (e.g., GI
hemorrhage, intracranial bleeding) represent the highest priority.
Q2
Which mechanism explains metformin’s glucose-lowering effect?
A. Stimulates insulin secretion
B. Decreases hepatic gluconeogenesis
C. Increases glucose absorption
D. Activates glucagon release
Answer: B
Rationale:
Metformin primarily reduces hepatic glucose production (gluconeogenesis) while
improving peripheral insulin sensitivity. Unlike sulfonylureas, it does not stimulate
insulin release, which explains its low hypoglycemia risk. Its mechanism directly
targets the pathophysiology of type 2 diabetes—excess hepatic glucose output.
Q3
A patient with renal impairment is prescribed metformin. What is the most serious risk?
A. Hypoglycemia
B. Lactic acidosis
C. Hypernatremia
D. Weight gain
Answer: B
Rationale:
Metformin accumulation in renal dysfunction increases the risk of lactic acidosis, a
rare but life-threatening condition characterized by metabolic acidosis and elevated
2
,lactate. Kidney function must be assessed prior to initiation and monitored regularly to
prevent this complication.
Q4
Octreotide is most appropriate for which condition?
A. Hypothyroidism
B. Acromegaly
C. Diabetes insipidus
D. Addison’s disease
Answer: B
Rationale:
Octreotide is a somatostatin analog that suppresses growth hormone secretion. In
acromegaly, excess GH leads to tissue overgrowth; octreotide counteracts this by
inhibiting pituitary hormone release, improving symptoms and metabolic
complications.
Q5
Which hormone is used to treat severe hypoglycemia?
A. Insulin
B. Glucagon
C. Cortisol
D. Aldosterone
Answer: B
Rationale:
Glucagon increases blood glucose by stimulating glycogen lysis and gluconeogenesis. It
is used in emergency settings when patients cannot take oral glucose. The rapid
reversal of hypoglycemia prevents neurologic damage, making it a critical rescue
medication.
Q6
Which lab value is essential for monitoring levothyroxine therapy?
A. Potassium
B. TSH
C. Sodium
D. Glucose
Answer: B
Rationale:
3
, TSH is the most sensitive marker for thyroid hormone activity. Levothyroxine dosing is
titrated based on TSH levels to avoid under-treatment (hypothyroidism) or over-
treatment (thyrotoxicosis).
Q7
Which drug is contraindicated in thyroid storm?
A. Propranolol
B. Methimazole
C. Levothyroxine
D. Propylthiouracil
Answer: C
Rationale:
Thyroid storm represents extreme hyperthyroidism. Administering levothyroxine
would exacerbate the condition. Instead, therapy focuses on blocking hormone
synthesis and peripheral effects.
Q8
Insulin promotes which physiologic action?
A. Glycogen breakdown
B. Glucose uptake into cells
C. Lipolysis
D. Protein catabolism
Answer: B
Rationale:
Insulin facilitates cellular glucose uptake, particularly in muscle and adipose tissue,
thereby lowering blood glucose levels and promoting energy storage.
Q9
Abrupt discontinuation of corticosteroids may lead to:
A. Hypertension
B. Adrenal crisis
C. Hyperglycemia
D. Infection
Answer: B
Rationale:
Chronic corticosteroid therapy suppresses the hypothalamic-pituitary-adrenal (HPA)
4
Exam 3
High-Yield Qs & Answers with
Rationales
University of Alabama
This Exam Description:
High-Yield Qs
Answers with Rationales
100% Guaranteed Pass
Multiple –Choices (A-D)
1
,Q1
A patient on levothyroxine begins warfarin therapy. What is the priority concern?
A. Reduced anticoagulation
B. Increased bleeding risk
C. Hyperkalemia
D. Decreased thyroid function
Answer: B
Rationale:
Levothyroxine increases metabolic turnover of clotting factors, which potentiates the
anticoagulant effect of warfarin. This pharmacodynamics interaction elevates INR
and significantly increases bleeding risk. Clinically, this requires close INR monitoring
and dose adjustment. From a safety standpoint, bleeding complications (e.g., GI
hemorrhage, intracranial bleeding) represent the highest priority.
Q2
Which mechanism explains metformin’s glucose-lowering effect?
A. Stimulates insulin secretion
B. Decreases hepatic gluconeogenesis
C. Increases glucose absorption
D. Activates glucagon release
Answer: B
Rationale:
Metformin primarily reduces hepatic glucose production (gluconeogenesis) while
improving peripheral insulin sensitivity. Unlike sulfonylureas, it does not stimulate
insulin release, which explains its low hypoglycemia risk. Its mechanism directly
targets the pathophysiology of type 2 diabetes—excess hepatic glucose output.
Q3
A patient with renal impairment is prescribed metformin. What is the most serious risk?
A. Hypoglycemia
B. Lactic acidosis
C. Hypernatremia
D. Weight gain
Answer: B
Rationale:
Metformin accumulation in renal dysfunction increases the risk of lactic acidosis, a
rare but life-threatening condition characterized by metabolic acidosis and elevated
2
,lactate. Kidney function must be assessed prior to initiation and monitored regularly to
prevent this complication.
Q4
Octreotide is most appropriate for which condition?
A. Hypothyroidism
B. Acromegaly
C. Diabetes insipidus
D. Addison’s disease
Answer: B
Rationale:
Octreotide is a somatostatin analog that suppresses growth hormone secretion. In
acromegaly, excess GH leads to tissue overgrowth; octreotide counteracts this by
inhibiting pituitary hormone release, improving symptoms and metabolic
complications.
Q5
Which hormone is used to treat severe hypoglycemia?
A. Insulin
B. Glucagon
C. Cortisol
D. Aldosterone
Answer: B
Rationale:
Glucagon increases blood glucose by stimulating glycogen lysis and gluconeogenesis. It
is used in emergency settings when patients cannot take oral glucose. The rapid
reversal of hypoglycemia prevents neurologic damage, making it a critical rescue
medication.
Q6
Which lab value is essential for monitoring levothyroxine therapy?
A. Potassium
B. TSH
C. Sodium
D. Glucose
Answer: B
Rationale:
3
, TSH is the most sensitive marker for thyroid hormone activity. Levothyroxine dosing is
titrated based on TSH levels to avoid under-treatment (hypothyroidism) or over-
treatment (thyrotoxicosis).
Q7
Which drug is contraindicated in thyroid storm?
A. Propranolol
B. Methimazole
C. Levothyroxine
D. Propylthiouracil
Answer: C
Rationale:
Thyroid storm represents extreme hyperthyroidism. Administering levothyroxine
would exacerbate the condition. Instead, therapy focuses on blocking hormone
synthesis and peripheral effects.
Q8
Insulin promotes which physiologic action?
A. Glycogen breakdown
B. Glucose uptake into cells
C. Lipolysis
D. Protein catabolism
Answer: B
Rationale:
Insulin facilitates cellular glucose uptake, particularly in muscle and adipose tissue,
thereby lowering blood glucose levels and promoting energy storage.
Q9
Abrupt discontinuation of corticosteroids may lead to:
A. Hypertension
B. Adrenal crisis
C. Hyperglycemia
D. Infection
Answer: B
Rationale:
Chronic corticosteroid therapy suppresses the hypothalamic-pituitary-adrenal (HPA)
4
