NU 578 EXAM /ACTUAL NU 578 EXAM 4 LATEST 2026/2027 UNIVERSITY OF SOUTH
ALABAMA PRACTICE QUESTIONS AND A NEW UPDATED STUDY GUIDE COMPLETE
ACCURATE EXAM REAL QUESTIONS WITH WELL ELABORATED ANSWERS AND
RATIONALES (100% CORRECT VERIFIED SOLUTIONS) NEWEST UPDATED VERSION
2026 EDITION |GUARANTEED PASS A+ (BRAND NEW!) FULL REVISED NU 578
APPROVED EXAM 4 |GUARANTEED PASS A+ |JUST RELEASED
Question 1
A patient with type 2 diabetes is prescribed metformin. The NP should educate the
patient to monitor for which of the following signs of lactic acidosis?
A. Weight gain
B. Hyperglycemia
C. Muscle pain and malaise
D. Polyuria
Correct Answer: C. Muscle pain and malaise
Rationale: Lactic acidosis is a rare but serious complication of metformin therapy.
Early signs include muscle pain, malaise, weakness, and respiratory distress. Risk
factors include renal impairment, liver disease, and conditions that increase lactate
production (sepsis, dehydration). Metformin should be held in patients with acute
illness or before contrast procedures.
Question 2
A patient with type 2 diabetes is prescribed a GLP-1 receptor agonist. Which of the
following is the most common side effect?
A. Hypoglycemia
B. Weight gain
C. Nausea
D. Pancreatitis
Correct Answer: C. Nausea
Rationale: Nausea is the most common side effect of GLP-1 receptor agonists,
especially during dose initiation or titration. It often improves over time. Patients
,should be started on a low dose and titrated slowly to minimize GI side effects.
Weight loss is a beneficial effect.
Question 3
A patient with type 2 diabetes is prescribed insulin glargine. The NP should
educate the patient that this insulin:
A. Has a rapid onset and is taken before meals
B. Is a basal insulin that provides steady glucose control over 24 hours
C. Is a mixture of rapid and intermediate-acting insulin
D. Is taken only when blood glucose is high
Correct Answer: B. Is a basal insulin that provides steady glucose control over
24 hours
Rationale: Insulin glargine is a long-acting basal insulin that provides a steady,
peakless effect over approximately 24 hours. It is typically given once daily at the
same time each day. It does not cover mealtime glucose spikes and should be
combined with prandial insulin if needed.
Question 4
A patient with type 2 diabetes and chronic kidney disease (eGFR 25 mL/min)
needs glycemic control. Which of the following agents is safest?
A. Metformin
B. Glyburide
C. Sitagliptin
D. Insulin
Correct Answer: D. Insulin
Rationale: Insulin is the safest option in advanced CKD because it does not
require renal metabolism and can be titrated based on glucose levels. Metformin is
contraindicated when eGFR <30. Glyburide is contraindicated in CKD due to
,prolonged hypoglycemia. Sitagliptin requires dose adjustment but can be used with
caution.
Question 5
A patient with type 1 diabetes is brought to the emergency department with DKA.
The NP should expect which of the following laboratory findings?
A. Normal glucose and bicarbonate
B. Elevated glucose, low bicarbonate, and low pH
C. Elevated glucose, elevated bicarbonate, and high pH
D. Low glucose and high bicarbonate
Correct Answer: B. Elevated glucose, low bicarbonate, and low pH
Rationale: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia
(glucose >250 mg/dL), metabolic acidosis (low pH, low bicarbonate), and
ketonemia/ketonuria. Anion gap is typically elevated. Treatment includes IV
fluids, IV insulin, and electrolyte replacement.
Question 6
A patient is prescribed a sulfonylurea. Which of the following is a contraindication
to the use of sulfonylureas?
A. Type 1 diabetes
B. Type 2 diabetes
C. Obesity
D. Heart failure
Correct Answer: A. Type 1 diabetes
Rationale: Sulfonylureas (e.g., glipizide, glyburide) require functioning pancreatic
beta cells to stimulate insulin secretion. They are contraindicated in type 1 diabetes
where beta cells are destroyed. They are used in type 2 diabetes. Hypoglycemia is
a significant risk.
, Question 7
A patient is prescribed a DPP-4 inhibitor. Which of the following is a characteristic
of this class?
A. Weight gain
B. Weight loss
C. Weight neutral or modest weight loss
D. Significant weight gain
Correct Answer: C. Weight neutral or modest weight loss
Rationale: DPP-4 inhibitors (sitagliptin, linagliptin, saxagliptin, alogliptin) are
generally weight neutral or associated with modest weight loss. They have a low
risk of hypoglycemia and are well-tolerated. They are less potent than GLP-1
agonists.
Question 8
A patient with type 2 diabetes is prescribed empagliflozin. The NP should monitor
for which of the following adverse effects?
A. Weight gain
B. Hypoglycemia
C. Genital yeast infections
D. Hyperglycemia
Correct Answer: C. Genital yeast infections
Rationale: Empagliflozin is an SGLT2 inhibitor that increases urinary glucose
excretion, creating a favorable environment for yeast growth. Genital yeast
infections (vulvovaginal candidiasis) are a common side effect. Patients should be
educated on symptoms and management. SGLT2 inhibitors are also associated
with UTIs.
ALABAMA PRACTICE QUESTIONS AND A NEW UPDATED STUDY GUIDE COMPLETE
ACCURATE EXAM REAL QUESTIONS WITH WELL ELABORATED ANSWERS AND
RATIONALES (100% CORRECT VERIFIED SOLUTIONS) NEWEST UPDATED VERSION
2026 EDITION |GUARANTEED PASS A+ (BRAND NEW!) FULL REVISED NU 578
APPROVED EXAM 4 |GUARANTEED PASS A+ |JUST RELEASED
Question 1
A patient with type 2 diabetes is prescribed metformin. The NP should educate the
patient to monitor for which of the following signs of lactic acidosis?
A. Weight gain
B. Hyperglycemia
C. Muscle pain and malaise
D. Polyuria
Correct Answer: C. Muscle pain and malaise
Rationale: Lactic acidosis is a rare but serious complication of metformin therapy.
Early signs include muscle pain, malaise, weakness, and respiratory distress. Risk
factors include renal impairment, liver disease, and conditions that increase lactate
production (sepsis, dehydration). Metformin should be held in patients with acute
illness or before contrast procedures.
Question 2
A patient with type 2 diabetes is prescribed a GLP-1 receptor agonist. Which of the
following is the most common side effect?
A. Hypoglycemia
B. Weight gain
C. Nausea
D. Pancreatitis
Correct Answer: C. Nausea
Rationale: Nausea is the most common side effect of GLP-1 receptor agonists,
especially during dose initiation or titration. It often improves over time. Patients
,should be started on a low dose and titrated slowly to minimize GI side effects.
Weight loss is a beneficial effect.
Question 3
A patient with type 2 diabetes is prescribed insulin glargine. The NP should
educate the patient that this insulin:
A. Has a rapid onset and is taken before meals
B. Is a basal insulin that provides steady glucose control over 24 hours
C. Is a mixture of rapid and intermediate-acting insulin
D. Is taken only when blood glucose is high
Correct Answer: B. Is a basal insulin that provides steady glucose control over
24 hours
Rationale: Insulin glargine is a long-acting basal insulin that provides a steady,
peakless effect over approximately 24 hours. It is typically given once daily at the
same time each day. It does not cover mealtime glucose spikes and should be
combined with prandial insulin if needed.
Question 4
A patient with type 2 diabetes and chronic kidney disease (eGFR 25 mL/min)
needs glycemic control. Which of the following agents is safest?
A. Metformin
B. Glyburide
C. Sitagliptin
D. Insulin
Correct Answer: D. Insulin
Rationale: Insulin is the safest option in advanced CKD because it does not
require renal metabolism and can be titrated based on glucose levels. Metformin is
contraindicated when eGFR <30. Glyburide is contraindicated in CKD due to
,prolonged hypoglycemia. Sitagliptin requires dose adjustment but can be used with
caution.
Question 5
A patient with type 1 diabetes is brought to the emergency department with DKA.
The NP should expect which of the following laboratory findings?
A. Normal glucose and bicarbonate
B. Elevated glucose, low bicarbonate, and low pH
C. Elevated glucose, elevated bicarbonate, and high pH
D. Low glucose and high bicarbonate
Correct Answer: B. Elevated glucose, low bicarbonate, and low pH
Rationale: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia
(glucose >250 mg/dL), metabolic acidosis (low pH, low bicarbonate), and
ketonemia/ketonuria. Anion gap is typically elevated. Treatment includes IV
fluids, IV insulin, and electrolyte replacement.
Question 6
A patient is prescribed a sulfonylurea. Which of the following is a contraindication
to the use of sulfonylureas?
A. Type 1 diabetes
B. Type 2 diabetes
C. Obesity
D. Heart failure
Correct Answer: A. Type 1 diabetes
Rationale: Sulfonylureas (e.g., glipizide, glyburide) require functioning pancreatic
beta cells to stimulate insulin secretion. They are contraindicated in type 1 diabetes
where beta cells are destroyed. They are used in type 2 diabetes. Hypoglycemia is
a significant risk.
, Question 7
A patient is prescribed a DPP-4 inhibitor. Which of the following is a characteristic
of this class?
A. Weight gain
B. Weight loss
C. Weight neutral or modest weight loss
D. Significant weight gain
Correct Answer: C. Weight neutral or modest weight loss
Rationale: DPP-4 inhibitors (sitagliptin, linagliptin, saxagliptin, alogliptin) are
generally weight neutral or associated with modest weight loss. They have a low
risk of hypoglycemia and are well-tolerated. They are less potent than GLP-1
agonists.
Question 8
A patient with type 2 diabetes is prescribed empagliflozin. The NP should monitor
for which of the following adverse effects?
A. Weight gain
B. Hypoglycemia
C. Genital yeast infections
D. Hyperglycemia
Correct Answer: C. Genital yeast infections
Rationale: Empagliflozin is an SGLT2 inhibitor that increases urinary glucose
excretion, creating a favorable environment for yeast growth. Genital yeast
infections (vulvovaginal candidiasis) are a common side effect. Patients should be
educated on symptoms and management. SGLT2 inhibitors are also associated
with UTIs.
