NCLEX-RN Endocrine Pharmacology
Practice Exam |
20 NGN-Style Questions with Rationales |
ATI Pharmacology Made Easy Nursing
Study Guide
Question 1
Clinical Scenario
A 48-year-old woman with newly diagnosed primary
hypothyroidism is prescribed levothyroxine 75 mcg orally
once daily. During discharge teaching, the nurse reviews
medication administration instructions.
Question Stem
Which statement by the client indicates an understanding of
how to take this medication?
A. "I will take the medication with breakfast each morning."
B. "I will take the medication at bedtime with a snack."
,C. "I will take the medication on an empty stomach 30 to 60
minutes before breakfast."
D. "I will stop taking the medication once my symptoms
improve."
Correct Answer
Correct Answer: C. "I will take the medication on an
empty stomach 30 to 60 minutes before breakfast."
Detailed Rationale
Levothyroxine is best absorbed when taken on an empty
stomach, ideally 30 to 60 minutes before breakfast. Food,
calcium supplements, iron products, and some medications
can significantly reduce absorption. Consistent
administration is essential because thyroid hormone
replacement is usually lifelong.
Option A is incorrect because taking levothyroxine with
breakfast decreases absorption and may lead to inadequate
therapeutic response. Option B is incorrect because
bedtime dosing can be acceptable only if consistently taken
several hours after eating, not with a snack. Option D is
incorrect because hypothyroidism generally requires lifelong
treatment; discontinuation can result in recurrence of
symptoms and metabolic complications.
,Nurses should educate patients that symptom improvement
may take several weeks. Monitoring of thyroid-stimulating
hormone (TSH) levels is necessary to evaluate effectiveness
and guide dose adjustments. Patients should also report
symptoms of overreplacement such as palpitations,
nervousness, insomnia, or unexplained weight loss.
Learning Objective
After completing this question, the learner should be able
to:
• Explain proper administration of levothyroxine.
• Identify factors that interfere with thyroid hormone
absorption.
• Describe the importance of long-term adherence.
• Recognize the need for TSH monitoring.
Medication Safety Focus
Medication administration
Question 2
Clinical Scenario
A 67-year-old client with type 2 diabetes mellitus receives
insulin glargine 24 units subcutaneously nightly. The nurse
, reviews the medication administration record before
administering the dose.
Question Stem
Which action is appropriate when administering insulin
glargine?
A. Mix it with regular insulin in the same syringe.
B. Administer it intravenously for rapid effect.
C. Dilute it with sterile water before injection.
D. Administer it as a separate injection without mixing.
Correct Answer
Correct Answer: D. Administer it as a separate injection
without mixing.
Detailed Rationale
Insulin glargine is a long-acting basal insulin formulated to
provide a relatively steady release over approximately 24
hours. It should never be mixed with other insulins because
mixing alters its pharmacokinetic properties and may result
in unpredictable glucose control.
Option A is incorrect because glargine must not be mixed
with other insulin products. Option B is incorrect because
glargine is not intended for IV administration. Option C is
Practice Exam |
20 NGN-Style Questions with Rationales |
ATI Pharmacology Made Easy Nursing
Study Guide
Question 1
Clinical Scenario
A 48-year-old woman with newly diagnosed primary
hypothyroidism is prescribed levothyroxine 75 mcg orally
once daily. During discharge teaching, the nurse reviews
medication administration instructions.
Question Stem
Which statement by the client indicates an understanding of
how to take this medication?
A. "I will take the medication with breakfast each morning."
B. "I will take the medication at bedtime with a snack."
,C. "I will take the medication on an empty stomach 30 to 60
minutes before breakfast."
D. "I will stop taking the medication once my symptoms
improve."
Correct Answer
Correct Answer: C. "I will take the medication on an
empty stomach 30 to 60 minutes before breakfast."
Detailed Rationale
Levothyroxine is best absorbed when taken on an empty
stomach, ideally 30 to 60 minutes before breakfast. Food,
calcium supplements, iron products, and some medications
can significantly reduce absorption. Consistent
administration is essential because thyroid hormone
replacement is usually lifelong.
Option A is incorrect because taking levothyroxine with
breakfast decreases absorption and may lead to inadequate
therapeutic response. Option B is incorrect because
bedtime dosing can be acceptable only if consistently taken
several hours after eating, not with a snack. Option D is
incorrect because hypothyroidism generally requires lifelong
treatment; discontinuation can result in recurrence of
symptoms and metabolic complications.
,Nurses should educate patients that symptom improvement
may take several weeks. Monitoring of thyroid-stimulating
hormone (TSH) levels is necessary to evaluate effectiveness
and guide dose adjustments. Patients should also report
symptoms of overreplacement such as palpitations,
nervousness, insomnia, or unexplained weight loss.
Learning Objective
After completing this question, the learner should be able
to:
• Explain proper administration of levothyroxine.
• Identify factors that interfere with thyroid hormone
absorption.
• Describe the importance of long-term adherence.
• Recognize the need for TSH monitoring.
Medication Safety Focus
Medication administration
Question 2
Clinical Scenario
A 67-year-old client with type 2 diabetes mellitus receives
insulin glargine 24 units subcutaneously nightly. The nurse
, reviews the medication administration record before
administering the dose.
Question Stem
Which action is appropriate when administering insulin
glargine?
A. Mix it with regular insulin in the same syringe.
B. Administer it intravenously for rapid effect.
C. Dilute it with sterile water before injection.
D. Administer it as a separate injection without mixing.
Correct Answer
Correct Answer: D. Administer it as a separate injection
without mixing.
Detailed Rationale
Insulin glargine is a long-acting basal insulin formulated to
provide a relatively steady release over approximately 24
hours. It should never be mixed with other insulins because
mixing alters its pharmacokinetic properties and may result
in unpredictable glucose control.
Option A is incorrect because glargine must not be mixed
with other insulin products. Option B is incorrect because
glargine is not intended for IV administration. Option C is
