NCLEX-RN Pharmacology Practice
Questions: 20 Endocrine System NCLEX-
Style MCQs with Detailed Rationales |
ATI Pharmacology Made Easy Review |
Nursing Exam Prep
Question 1
Clinical Scenario
A 54-year-old client with type 2 diabetes mellitus is
prescribed metformin. The nurse reviews the client’s
laboratory results: HbA1c 8.5%, creatinine 2.2 mg/dL, eGFR
28 mL/min/1.73 m². The client reports fatigue and decreased
appetite.
Question Stem
Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Administer with food to reduce GI upset
D. Encourage increased fluid intake
,Correct Answer: B. Hold the medication and notify the
provider
Detailed Rationale
Metformin is contraindicated in clients with significantly
reduced renal function (eGFR <30 mL/min/1.73 m²) due to
the risk of lactic acidosis, a rare but life-threatening adverse
effect. This client’s eGFR of 28 places them at high risk. The
nurse must hold the medication and notify the provider
immediately for alternative therapy.
Option A is unsafe because administering metformin in renal
impairment increases toxicity risk.
Option C is appropriate for mild GI upset but does not
address the critical contraindication.
Option D may be beneficial generally but does not mitigate
the immediate risk.
Nursing priorities include assessing renal function before
administration, monitoring for signs of lactic acidosis (e.g.,
malaise, respiratory distress), and ensuring safe medication
use.
Learning Objective
• Identify contraindications to metformin therapy
• Recognize the relationship between renal function and
drug safety
, • Prioritize nursing actions in high-risk medication
situations
Medication Safety Focus: Contraindication
Question 2
Clinical Scenario
A 28-year-old client with type 1 diabetes is prescribed
insulin glargine at bedtime. The nurse is preparing to
administer the medication.
Question Stem
Which action by the nurse is appropriate?
A. Mix insulin glargine with regular insulin
B. Administer insulin glargine intravenously
C. Administer insulin glargine subcutaneously without
mixing
D. Hold the dose if blood glucose is 180 mg/dL
Correct Answer: C. Administer insulin glargine
subcutaneously without mixing
Detailed Rationale
Insulin glargine is a long-acting basal insulin designed for
slow, steady release over 24 hours. It must not be mixed
with other insulins because mixing alters its
pharmacokinetics and can lead to unpredictable glucose
Questions: 20 Endocrine System NCLEX-
Style MCQs with Detailed Rationales |
ATI Pharmacology Made Easy Review |
Nursing Exam Prep
Question 1
Clinical Scenario
A 54-year-old client with type 2 diabetes mellitus is
prescribed metformin. The nurse reviews the client’s
laboratory results: HbA1c 8.5%, creatinine 2.2 mg/dL, eGFR
28 mL/min/1.73 m². The client reports fatigue and decreased
appetite.
Question Stem
Which action should the nurse take?
A. Administer the medication as prescribed
B. Hold the medication and notify the provider
C. Administer with food to reduce GI upset
D. Encourage increased fluid intake
,Correct Answer: B. Hold the medication and notify the
provider
Detailed Rationale
Metformin is contraindicated in clients with significantly
reduced renal function (eGFR <30 mL/min/1.73 m²) due to
the risk of lactic acidosis, a rare but life-threatening adverse
effect. This client’s eGFR of 28 places them at high risk. The
nurse must hold the medication and notify the provider
immediately for alternative therapy.
Option A is unsafe because administering metformin in renal
impairment increases toxicity risk.
Option C is appropriate for mild GI upset but does not
address the critical contraindication.
Option D may be beneficial generally but does not mitigate
the immediate risk.
Nursing priorities include assessing renal function before
administration, monitoring for signs of lactic acidosis (e.g.,
malaise, respiratory distress), and ensuring safe medication
use.
Learning Objective
• Identify contraindications to metformin therapy
• Recognize the relationship between renal function and
drug safety
, • Prioritize nursing actions in high-risk medication
situations
Medication Safety Focus: Contraindication
Question 2
Clinical Scenario
A 28-year-old client with type 1 diabetes is prescribed
insulin glargine at bedtime. The nurse is preparing to
administer the medication.
Question Stem
Which action by the nurse is appropriate?
A. Mix insulin glargine with regular insulin
B. Administer insulin glargine intravenously
C. Administer insulin glargine subcutaneously without
mixing
D. Hold the dose if blood glucose is 180 mg/dL
Correct Answer: C. Administer insulin glargine
subcutaneously without mixing
Detailed Rationale
Insulin glargine is a long-acting basal insulin designed for
slow, steady release over 24 hours. It must not be mixed
with other insulins because mixing alters its
pharmacokinetics and can lead to unpredictable glucose
