NUR 378 Exam 3 V3 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 3) |
Concordia
1. A nurse is preparing to administer Lispro insulin to a client with Type 1 Diabetes. When
should the nurse advise the client to eat their meal?
A. 30 to 60 minutes after administration
B. Exactly 1 hour before administration
C. 2 hours after administration
D. Immediately or within 15 minutes of administration
Correct Answer: D
Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. Administering it too
early without food intake poses a severe risk of hypoglycemia. The nurse must ensure the
meal tray is present or the client is ready to eat immediately to align with the peak action of
the medication.
2. A client is prescribed Metformin for Type 2 Diabetes management. Which diagnostic test
requires the nurse to withhold this medication?
A. Chest X-ray
B. Computed Tomography (CT) scan with IV contrast
,C. Electrocardiogram (ECG)
D. Abdominal Ultrasound
Correct Answer: B
Metformin must be held 48 hours before and after procedures involving iodine-based
contrast media to prevent acute renal failure. The combination of contrast dye and
metformin significantly increases the risk of lactic acidosis. Monitoring creatinine levels
post-procedure is essential before resuming the medication.
3. Which insulin is considered ‘cloudy’ and requires rolling the vial before drawing it into the
syringe?
A. Insulin Glargine
B. NPH Insulin
C. Insulin Lispro
D. Regular Insulin
Correct Answer: B
NPH (Neutral Protamine Hagedorn) is an intermediate-acting insulin that contains a
protamine suspension, giving it a cloudy appearance. It must be gently agitated or rolled
between the palms to ensure the suspension is uniform before administration. Clear
insulins like Regular or Glargine should never be shaken or rolled if they appear cloudy.
,4. A nurse is teaching a client about the peak action of NPH insulin. Which time frame should
the nurse include?
A. 1 to 3 hours
B. 18 to 24 hours
C. 4 to 12 hours
D. 30 to 60 minutes
Correct Answer: C
NPH insulin has an intermediate duration of action with a peak typically occurring
between 4 and 12 hours after injection. This is the period when the client is at the highest
risk for hypoglycemic episodes. Nurses should educate clients to time their snacks to
coincide with this peak period.
5. A client presents with a blood glucose of 45 mg/dL and is unconscious. Which intervention
is the most appropriate for the nurse to perform first?
A. Administer 4 oz of orange juice
B. Recheck the blood glucose in 30 minutes
C. Provide a complex carbohydrate snack
D. Administer 15g of glucose gel
E. Administer subcutaneous Glucagon
Correct Answer: E
, For an unconscious client with hypoglycemia, oral routes are contraindicated due to the
high risk of aspiration. Subcutaneous or intramuscular Glucagon is the emergency
treatment of choice to stimulate the liver to release glucose. Once the client regains
consciousness and can swallow safely, oral carbohydrates should be provided.
6. A client is starting Repaglinide for blood sugar control. What instruction should the nurse
provide regarding its administration?
A. Take the dose once daily at bedtime
B. Take the dose 15 to 30 minutes before each meal
C. Take the dose only when blood sugar is above 200 mg/dL
D. Skip the dose if a meal is missed
Correct Answer: B
Repaglinide belongs to the meglitinide class, which stimulates insulin release from the
pancreas in response to food. It has a short half-life and must be taken shortly before meals
to be effective. If the client skips a meal, they must also skip the dose to avoid
hypoglycemia.
7. When mixing NPH and Regular insulin in a single syringe, which step is performed first after
injecting air into the vials?
A. Withdraw the Regular insulin
B. Withdraw the NPH insulin
C. Shake both vials vigorously
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 3) |
Concordia
1. A nurse is preparing to administer Lispro insulin to a client with Type 1 Diabetes. When
should the nurse advise the client to eat their meal?
A. 30 to 60 minutes after administration
B. Exactly 1 hour before administration
C. 2 hours after administration
D. Immediately or within 15 minutes of administration
Correct Answer: D
Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. Administering it too
early without food intake poses a severe risk of hypoglycemia. The nurse must ensure the
meal tray is present or the client is ready to eat immediately to align with the peak action of
the medication.
2. A client is prescribed Metformin for Type 2 Diabetes management. Which diagnostic test
requires the nurse to withhold this medication?
A. Chest X-ray
B. Computed Tomography (CT) scan with IV contrast
,C. Electrocardiogram (ECG)
D. Abdominal Ultrasound
Correct Answer: B
Metformin must be held 48 hours before and after procedures involving iodine-based
contrast media to prevent acute renal failure. The combination of contrast dye and
metformin significantly increases the risk of lactic acidosis. Monitoring creatinine levels
post-procedure is essential before resuming the medication.
3. Which insulin is considered ‘cloudy’ and requires rolling the vial before drawing it into the
syringe?
A. Insulin Glargine
B. NPH Insulin
C. Insulin Lispro
D. Regular Insulin
Correct Answer: B
NPH (Neutral Protamine Hagedorn) is an intermediate-acting insulin that contains a
protamine suspension, giving it a cloudy appearance. It must be gently agitated or rolled
between the palms to ensure the suspension is uniform before administration. Clear
insulins like Regular or Glargine should never be shaken or rolled if they appear cloudy.
,4. A nurse is teaching a client about the peak action of NPH insulin. Which time frame should
the nurse include?
A. 1 to 3 hours
B. 18 to 24 hours
C. 4 to 12 hours
D. 30 to 60 minutes
Correct Answer: C
NPH insulin has an intermediate duration of action with a peak typically occurring
between 4 and 12 hours after injection. This is the period when the client is at the highest
risk for hypoglycemic episodes. Nurses should educate clients to time their snacks to
coincide with this peak period.
5. A client presents with a blood glucose of 45 mg/dL and is unconscious. Which intervention
is the most appropriate for the nurse to perform first?
A. Administer 4 oz of orange juice
B. Recheck the blood glucose in 30 minutes
C. Provide a complex carbohydrate snack
D. Administer 15g of glucose gel
E. Administer subcutaneous Glucagon
Correct Answer: E
, For an unconscious client with hypoglycemia, oral routes are contraindicated due to the
high risk of aspiration. Subcutaneous or intramuscular Glucagon is the emergency
treatment of choice to stimulate the liver to release glucose. Once the client regains
consciousness and can swallow safely, oral carbohydrates should be provided.
6. A client is starting Repaglinide for blood sugar control. What instruction should the nurse
provide regarding its administration?
A. Take the dose once daily at bedtime
B. Take the dose 15 to 30 minutes before each meal
C. Take the dose only when blood sugar is above 200 mg/dL
D. Skip the dose if a meal is missed
Correct Answer: B
Repaglinide belongs to the meglitinide class, which stimulates insulin release from the
pancreas in response to food. It has a short half-life and must be taken shortly before meals
to be effective. If the client skips a meal, they must also skip the dose to avoid
hypoglycemia.
7. When mixing NPH and Regular insulin in a single syringe, which step is performed first after
injecting air into the vials?
A. Withdraw the Regular insulin
B. Withdraw the NPH insulin
C. Shake both vials vigorously
