, NUR 353 NURsiNg PhaRmacology – academic yeaR
2026/2027 – examiNatioN 4 comPReheNsive QUestioNs ||
veRiFied By exPeRts .
EXAM OVERVIEW
NUR 353 Nursing Pharmacology Exam 4 typically covers endocrine pharmacology,
autonomic nervous system drugs, corticosteroids, and related therapeutic agents. Based
on the course curriculum, Exam 4 focuses on:
Domain Key Topics
Endocrine Pharmacology Insulin, oral hypoglycemics, thyroid hormones, corticosteroids
Autonomic Nervous System Adrenergic agonists/antagonists, cholinergic agonists/antagonis
Cardiovascular Pharmacology Antihypertensives, antiarrhythmics, heart failure medications
Neurological & Psychiatric Medications Antidepressants, antipsychotics, anticonvulsants, Parkinson's dr
Antimicrobials Antibiotics, antivirals, antifungals
SECTION 1: ENDOCRINE PHARMACOLOGY
Question 1:
A patient with type 1 diabetes is prescribed rapid-acting insulin. Which of the following is a rapid-
acting insulin?
A) Regular insulin
B) NPH insulin
C) Insulin lispro
D) Insulin glargine
coRRect aNsweR: C) Insulin lispro
RatioNale: Insulin lispro (Humalog) is a rapid-acting insulin with an onset of 15-30 minutes,
peak of 30-90 minutes, and duration of 3-5 hours. It should be administered 15-15 minutes
,before a meal. Regular insulin is short-acting, NPH is intermediate-acting, and insulin glargine
is long-acting.
Question 2:
A patient with type 2 diabetes is prescribed metformin. Which of the following is a major adverse
effect that the nurse should monitor for?
A) Weight gain
B) Hypoglycemia
C) Lactic acidosis
D) Pancreatitis
coRRect aNsweR: C) Lactic acidosis
RatioNale: Metformin can cause lactic acidosis, a rare but serious adverse effect. Risk
factors include renal impairment, liver disease, and conditions that cause hypoxia. Patients
should hold metformin before and for 48 hours after contrast studies.
Question 3:
A patient prescribed levothyroxine should be instructed to take the medication:
A) With food
B) At bedtime
C) On an empty stomach, 30-60 minutes before breakfast
D) With antacids
coRRect aNsweR: C) On an empty stomach, 30-60 minutes before breakfast
RatioNale: Levothyroxine absorption is significantly reduced by food, calcium, iron
supplements, and antacids. It should be taken on an empty stomach, 30-60 minutes before
breakfast, with a full glass of water.
Question 4:
A patient with hyperthyroidism is prescribed methimazole. Which adverse effect requires
immediate nursing intervention?
A) Weight gain
B) Agranulocytosis
C) Bradycardia
D) Hypocalcemia
coRRect aNsweR: B) Agranulocytosis
RatioNale: Methimazole can cause agranulocytosis (severe neutropenia). Patients should
be educated to report signs of infection (fever, sore throat, malaise). Regular CBC monitoring is
recommended.
, Question 5:
A patient with type 2 diabetes is prescribed a GLP-1 receptor agonist. Which of the following is
an example of this class?
A) Metformin
B) Glipizide
C) Liraglutide
D) Pioglitazone
coRRect aNsweR: C) Liraglutide
RatioNale: Liraglutide (Victoza) is a GLP-1 receptor agonist that increases insulin secretion,
suppresses glucagon, and slows gastric emptying. It is associated with weight loss and has
cardiovascular benefits.
Question 6:
A patient is prescribed NPH insulin. When should the nurse anticipate the peak effect?
A) 15-30 minutes
B) 30-60 minutes
C) 2-4 hours
D) 4-12 hours
coRRect aNsweR: D) 4-12 hours
RatioNale: NPH insulin is an intermediate-acting insulin with an onset of 1-2 hours, peak of
4-12 hours, and duration of 18-24 hours. The peak time is when the patient is at greatest risk for
hypoglycemia.
Question 7:
A patient with Cushing's syndrome is taking long-term corticosteroids. The nurse should monitor
for which complication?
A) Hyperglycemia
B) Hypokalemia
C) Weight loss
D) Hypotension
coRRect aNsweR: A) Hyperglycemia
RatioNale: Corticosteroids increase hepatic glucose production and decrease peripheral
glucose uptake, leading to hyperglycemia. Long-term use is also associated with osteoporosis,
weight gain, hypertension, and immunosuppression.
2026/2027 – examiNatioN 4 comPReheNsive QUestioNs ||
veRiFied By exPeRts .
EXAM OVERVIEW
NUR 353 Nursing Pharmacology Exam 4 typically covers endocrine pharmacology,
autonomic nervous system drugs, corticosteroids, and related therapeutic agents. Based
on the course curriculum, Exam 4 focuses on:
Domain Key Topics
Endocrine Pharmacology Insulin, oral hypoglycemics, thyroid hormones, corticosteroids
Autonomic Nervous System Adrenergic agonists/antagonists, cholinergic agonists/antagonis
Cardiovascular Pharmacology Antihypertensives, antiarrhythmics, heart failure medications
Neurological & Psychiatric Medications Antidepressants, antipsychotics, anticonvulsants, Parkinson's dr
Antimicrobials Antibiotics, antivirals, antifungals
SECTION 1: ENDOCRINE PHARMACOLOGY
Question 1:
A patient with type 1 diabetes is prescribed rapid-acting insulin. Which of the following is a rapid-
acting insulin?
A) Regular insulin
B) NPH insulin
C) Insulin lispro
D) Insulin glargine
coRRect aNsweR: C) Insulin lispro
RatioNale: Insulin lispro (Humalog) is a rapid-acting insulin with an onset of 15-30 minutes,
peak of 30-90 minutes, and duration of 3-5 hours. It should be administered 15-15 minutes
,before a meal. Regular insulin is short-acting, NPH is intermediate-acting, and insulin glargine
is long-acting.
Question 2:
A patient with type 2 diabetes is prescribed metformin. Which of the following is a major adverse
effect that the nurse should monitor for?
A) Weight gain
B) Hypoglycemia
C) Lactic acidosis
D) Pancreatitis
coRRect aNsweR: C) Lactic acidosis
RatioNale: Metformin can cause lactic acidosis, a rare but serious adverse effect. Risk
factors include renal impairment, liver disease, and conditions that cause hypoxia. Patients
should hold metformin before and for 48 hours after contrast studies.
Question 3:
A patient prescribed levothyroxine should be instructed to take the medication:
A) With food
B) At bedtime
C) On an empty stomach, 30-60 minutes before breakfast
D) With antacids
coRRect aNsweR: C) On an empty stomach, 30-60 minutes before breakfast
RatioNale: Levothyroxine absorption is significantly reduced by food, calcium, iron
supplements, and antacids. It should be taken on an empty stomach, 30-60 minutes before
breakfast, with a full glass of water.
Question 4:
A patient with hyperthyroidism is prescribed methimazole. Which adverse effect requires
immediate nursing intervention?
A) Weight gain
B) Agranulocytosis
C) Bradycardia
D) Hypocalcemia
coRRect aNsweR: B) Agranulocytosis
RatioNale: Methimazole can cause agranulocytosis (severe neutropenia). Patients should
be educated to report signs of infection (fever, sore throat, malaise). Regular CBC monitoring is
recommended.
, Question 5:
A patient with type 2 diabetes is prescribed a GLP-1 receptor agonist. Which of the following is
an example of this class?
A) Metformin
B) Glipizide
C) Liraglutide
D) Pioglitazone
coRRect aNsweR: C) Liraglutide
RatioNale: Liraglutide (Victoza) is a GLP-1 receptor agonist that increases insulin secretion,
suppresses glucagon, and slows gastric emptying. It is associated with weight loss and has
cardiovascular benefits.
Question 6:
A patient is prescribed NPH insulin. When should the nurse anticipate the peak effect?
A) 15-30 minutes
B) 30-60 minutes
C) 2-4 hours
D) 4-12 hours
coRRect aNsweR: D) 4-12 hours
RatioNale: NPH insulin is an intermediate-acting insulin with an onset of 1-2 hours, peak of
4-12 hours, and duration of 18-24 hours. The peak time is when the patient is at greatest risk for
hypoglycemia.
Question 7:
A patient with Cushing's syndrome is taking long-term corticosteroids. The nurse should monitor
for which complication?
A) Hyperglycemia
B) Hypokalemia
C) Weight loss
D) Hypotension
coRRect aNsweR: A) Hyperglycemia
RatioNale: Corticosteroids increase hepatic glucose production and decrease peripheral
glucose uptake, leading to hyperglycemia. Long-term use is also associated with osteoporosis,
weight gain, hypertension, and immunosuppression.
