NUR 2474 Pharm Final Guide 2026/2027
| Most Tested Questions & Verified
Answers | Latest Update | Graded A+
Question 1
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on
a sliding scale and are ordered before a meal and at bedtime. The patient's blood
sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to
administer?
A. No insulin should be administered
B. NPH
C. 70/30 mix
D. Lispro (Humalog)
Correct Answer: D. Lispro (Humalog)
Rationale: Lispro is a rapid-acting insulin with an onset of 10-15 minutes. Given the
blood sugar of 317 mg/dL, rapid-acting insulin is needed to cover mealtime glucose
elevation. It should be given just before or immediately after meals .
Question 2
Insulin glargine (Lantus) is prescribed for a hospitalized patient who is diabetic.
When will the nurse administer this drug?
A. Approximately 15 to 30 minutes before each meal
B. In the morning and at 4 PM
C. Once daily at bedtime
D. After meals and at bedtime
Correct Answer: C. Once daily at bedtime
,Rationale: Insulin glargine is a long-acting insulin with a 24-hour duration, providing
basal coverage. It is typically administered once daily at bedtime. It should never be
mixed with other insulins .
Question 3
A patient with type 1 diabetes who takes insulin reports taking propranolol for
hypertension. Why is the nurse concerned?
A. The beta blocker can cause insulin resistance
B. Using the two agents together increases the risk of ketoacidosis
C. Propranolol increases insulin requirements because of receptor blocking
D. The beta blocker can mask the symptoms of hypoglycemia
Correct Answer: D. The beta blocker can mask the symptoms of hypoglycemia
Rationale: Beta-blockers block adrenaline, which signals the liver to release glucose and
causes symptoms of hypoglycemia (tachycardia, tremors). This can mask the signs of
hypoglycemia, delaying recognition and treatment .
Question 4
An adolescent patient recently attended a health fair and had a serum glucose test.
The patient telephones the nurse and says, "My level was 125 mg/dL. Does that
mean I have diabetes?" What is the nurse's most accurate response?
A. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you
have diabetes."
B. "At this level, you probably have diabetes. You will need an oral glucose tolerance test
this week."
C. "This level is conclusive evidence that you have diabetes."
D. "This level is conclusive evidence that you do not have diabetes."
Correct Answer: A. "Unless you were fasting for longer than 8 hours, this does not
necessarily mean you have diabetes."
,Rationale: A level of 125 mg/dL could be a normal level without fasting and does not
confirm diabetes unless it was high for a fasting blood glucose level. Fasting blood
glucose ≥126 mg/dL is diagnostic for diabetes .
Question 5
The nurse working on a high-acuity medical-surgical unit is prioritizing care for
four patients who were just admitted. Which patient should the nurse assess first?
A. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of
70/30 Novolin insulin
B. The patient with a pulse of 58 beats per minute who is about to receive digoxin
(Lanoxin)
C. The patient with a blood pressure of 136/92 mm Hg who complains of having a
headache
D. The patient with an allergy to penicillin who is receiving an infusion of vancomycin
(Vancocin)
Correct Answer: A. The NPO patient with a blood glucose level of 80 mg/dL who just
received 20 units of 70/30 Novolin insulin
Rationale: An NPO patient with a blood glucose of 80 mg/dL who received 70/30
insulin is at high risk for hypoglycemia. 70/30 insulin contains 70% NPH and 30% regular
insulin, which will continue to drop glucose levels. This is the priority patient .
Question 6
A patient with type 1 diabetes recently became pregnant. The nurse plans a blood
glucose testing schedule for her. What is the recommended monitoring schedule?
A. Before each meal and before bed
B. In the morning for a fasting level and at 4 PM for the peak level
C. Six or seven times a day
D. Three times a day, along with urine glucose testing
Correct Answer: C. Six or seven times a day
, Rationale: Pregnancy affects glucose levels, requiring more frequent monitoring (six or
seven times a day) to maintain tight glycemic control and prevent complications for
both mother and fetus .
Question 7
Which statement is correct about the contrast between acarbose and miglitol?
A. Miglitol has not been associated with hepatic dysfunction
B. With miglitol, sucrose can be used to treat hypoglycemia
C. Miglitol is less effective in African Americans
D. Miglitol has no gastrointestinal side effects
Correct Answer: A. Miglitol has not been associated with hepatic dysfunction
Rationale: Acarbose has been associated with rare cases of hepatic dysfunction,
whereas miglitol has not. Both are alpha-glucosidase inhibitors used to manage
postprandial glucose levels in diabetes .
Question 8
A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for
which adverse reactions? (Select All That Apply)
A. Hypoglycemia
B. Flatulence
C. Elevated iron levels in the blood
D. Fluid retention
E. Diarrhea
Correct Answer: B, E. Flatulence, Diarrhea
Rationale: Alpha-glucosidase inhibitors (acarbose, miglitol) cause gastrointestinal side
effects including flatulence (from undigested carbohydrates reaching the colon) and
diarrhea (osmotic effect). They do not cause hypoglycemia when used alone .
| Most Tested Questions & Verified
Answers | Latest Update | Graded A+
Question 1
A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on
a sliding scale and are ordered before a meal and at bedtime. The patient's blood
sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to
administer?
A. No insulin should be administered
B. NPH
C. 70/30 mix
D. Lispro (Humalog)
Correct Answer: D. Lispro (Humalog)
Rationale: Lispro is a rapid-acting insulin with an onset of 10-15 minutes. Given the
blood sugar of 317 mg/dL, rapid-acting insulin is needed to cover mealtime glucose
elevation. It should be given just before or immediately after meals .
Question 2
Insulin glargine (Lantus) is prescribed for a hospitalized patient who is diabetic.
When will the nurse administer this drug?
A. Approximately 15 to 30 minutes before each meal
B. In the morning and at 4 PM
C. Once daily at bedtime
D. After meals and at bedtime
Correct Answer: C. Once daily at bedtime
,Rationale: Insulin glargine is a long-acting insulin with a 24-hour duration, providing
basal coverage. It is typically administered once daily at bedtime. It should never be
mixed with other insulins .
Question 3
A patient with type 1 diabetes who takes insulin reports taking propranolol for
hypertension. Why is the nurse concerned?
A. The beta blocker can cause insulin resistance
B. Using the two agents together increases the risk of ketoacidosis
C. Propranolol increases insulin requirements because of receptor blocking
D. The beta blocker can mask the symptoms of hypoglycemia
Correct Answer: D. The beta blocker can mask the symptoms of hypoglycemia
Rationale: Beta-blockers block adrenaline, which signals the liver to release glucose and
causes symptoms of hypoglycemia (tachycardia, tremors). This can mask the signs of
hypoglycemia, delaying recognition and treatment .
Question 4
An adolescent patient recently attended a health fair and had a serum glucose test.
The patient telephones the nurse and says, "My level was 125 mg/dL. Does that
mean I have diabetes?" What is the nurse's most accurate response?
A. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you
have diabetes."
B. "At this level, you probably have diabetes. You will need an oral glucose tolerance test
this week."
C. "This level is conclusive evidence that you have diabetes."
D. "This level is conclusive evidence that you do not have diabetes."
Correct Answer: A. "Unless you were fasting for longer than 8 hours, this does not
necessarily mean you have diabetes."
,Rationale: A level of 125 mg/dL could be a normal level without fasting and does not
confirm diabetes unless it was high for a fasting blood glucose level. Fasting blood
glucose ≥126 mg/dL is diagnostic for diabetes .
Question 5
The nurse working on a high-acuity medical-surgical unit is prioritizing care for
four patients who were just admitted. Which patient should the nurse assess first?
A. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of
70/30 Novolin insulin
B. The patient with a pulse of 58 beats per minute who is about to receive digoxin
(Lanoxin)
C. The patient with a blood pressure of 136/92 mm Hg who complains of having a
headache
D. The patient with an allergy to penicillin who is receiving an infusion of vancomycin
(Vancocin)
Correct Answer: A. The NPO patient with a blood glucose level of 80 mg/dL who just
received 20 units of 70/30 Novolin insulin
Rationale: An NPO patient with a blood glucose of 80 mg/dL who received 70/30
insulin is at high risk for hypoglycemia. 70/30 insulin contains 70% NPH and 30% regular
insulin, which will continue to drop glucose levels. This is the priority patient .
Question 6
A patient with type 1 diabetes recently became pregnant. The nurse plans a blood
glucose testing schedule for her. What is the recommended monitoring schedule?
A. Before each meal and before bed
B. In the morning for a fasting level and at 4 PM for the peak level
C. Six or seven times a day
D. Three times a day, along with urine glucose testing
Correct Answer: C. Six or seven times a day
, Rationale: Pregnancy affects glucose levels, requiring more frequent monitoring (six or
seven times a day) to maintain tight glycemic control and prevent complications for
both mother and fetus .
Question 7
Which statement is correct about the contrast between acarbose and miglitol?
A. Miglitol has not been associated with hepatic dysfunction
B. With miglitol, sucrose can be used to treat hypoglycemia
C. Miglitol is less effective in African Americans
D. Miglitol has no gastrointestinal side effects
Correct Answer: A. Miglitol has not been associated with hepatic dysfunction
Rationale: Acarbose has been associated with rare cases of hepatic dysfunction,
whereas miglitol has not. Both are alpha-glucosidase inhibitors used to manage
postprandial glucose levels in diabetes .
Question 8
A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for
which adverse reactions? (Select All That Apply)
A. Hypoglycemia
B. Flatulence
C. Elevated iron levels in the blood
D. Fluid retention
E. Diarrhea
Correct Answer: B, E. Flatulence, Diarrhea
Rationale: Alpha-glucosidase inhibitors (acarbose, miglitol) cause gastrointestinal side
effects including flatulence (from undigested carbohydrates reaching the colon) and
diarrhea (osmotic effect). They do not cause hypoglycemia when used alone .
