,NURS 6521 Week 5 Quiz | Advanced Pharmacology (2026)
Q&A | Walden University
1. Which of the following best describes the primary mechanism of action of
metformin in treating type 2 diabetes?
A) Stimulating insulin secretion from pancreatic beta cells
B) Decreasing hepatic glucose production and improving insulin sensitivity
C) Inhibiting glucose absorption in the small intestine
D) Increasing renal glucose excretion
Correct Answer: Decreasing hepatic glucose production and improving insulin
sensitivity
Rationale: Metformin is a biguanide that decreases hepatic glucose production,
improves insulin sensitivity in peripheral tissues, and reduces intestinal glucose
absorption. Sulfonylureas stimulate insulin secretion, and SGLT2 inhibitors increase
renal glucose excretion. Metformin does not directly stimulate insulin release.
2. What is the primary mechanism of action of sulfonylureas in treating type 2
diabetes?
A) Decreasing hepatic glucose production
B) Stimulating insulin secretion from pancreatic beta cells
C) Inhibiting glucose absorption
D) Increasing renal glucose excretion
Correct Answer: Stimulating insulin secretion from pancreatic beta cells
,Rationale: Sulfonylureas stimulate insulin secretion from pancreatic beta cells by
closing ATP-sensitive potassium channels. They are used for type 2 diabetes but can
cause hypoglycemia and weight gain. Metformin decreases hepatic glucose
production, and SGLT2 inhibitors increase renal glucose excretion.
3. Which of the following is a rare but serious adverse effect of metformin?
A) Hypoglycemia
B) Lactic acidosis
C) Hypertension
D) Bradycardia
Correct Answer: Lactic acidosis
Rationale: Lactic acidosis is a rare but serious adverse effect of metformin,
particularly in patients with renal impairment, liver disease, or alcohol abuse.
Metformin should be held before contrast studies. Hypoglycemia is more common
with sulfonylureas and insulin.
4. A patient with type 2 diabetes on metformin and glipizide has an HbA1c of 8.5%.
Adding which agent would provide the most pronounced reduction in cardiovascular
mortality?
A) Sitagliptin
B) Empagliflozin
C) Pioglitazone
D) Insulin glargine
, Correct Answer: Empagliflozin
Rationale: Empagliflozin, an SGLT2 inhibitor, has demonstrated significant reductions
in cardiovascular death and heart failure hospitalization in patients with type 2
diabetes and established cardiovascular disease. Sitagliptin is neutral, pioglitazone
may increase heart failure risk, and insulin does not reduce cardiovascular mortality.
5. What is the primary mechanism of action of SGLT2 inhibitors?
A) Inhibiting sodium-glucose cotransporter 2 in the proximal tubule
B) Stimulating insulin secretion
C) Decreasing hepatic glucose production
D) Inhibiting glucose absorption
Correct Answer: Inhibiting sodium-glucose cotransporter 2 in the proximal tubule
Rationale: SGLT2 inhibitors block sodium-glucose cotransporter 2 in the proximal
renal tubule, increasing urinary glucose excretion and lowering blood glucose. They
also have cardiorenal benefits. They do not stimulate insulin secretion or decrease
hepatic glucose production.
6. Which of the following is a common adverse effect of SGLT2 inhibitors?
A) Genital mycotic infections
B) Hypoglycemia
C) Hypertension
D) Bradycardia
Q&A | Walden University
1. Which of the following best describes the primary mechanism of action of
metformin in treating type 2 diabetes?
A) Stimulating insulin secretion from pancreatic beta cells
B) Decreasing hepatic glucose production and improving insulin sensitivity
C) Inhibiting glucose absorption in the small intestine
D) Increasing renal glucose excretion
Correct Answer: Decreasing hepatic glucose production and improving insulin
sensitivity
Rationale: Metformin is a biguanide that decreases hepatic glucose production,
improves insulin sensitivity in peripheral tissues, and reduces intestinal glucose
absorption. Sulfonylureas stimulate insulin secretion, and SGLT2 inhibitors increase
renal glucose excretion. Metformin does not directly stimulate insulin release.
2. What is the primary mechanism of action of sulfonylureas in treating type 2
diabetes?
A) Decreasing hepatic glucose production
B) Stimulating insulin secretion from pancreatic beta cells
C) Inhibiting glucose absorption
D) Increasing renal glucose excretion
Correct Answer: Stimulating insulin secretion from pancreatic beta cells
,Rationale: Sulfonylureas stimulate insulin secretion from pancreatic beta cells by
closing ATP-sensitive potassium channels. They are used for type 2 diabetes but can
cause hypoglycemia and weight gain. Metformin decreases hepatic glucose
production, and SGLT2 inhibitors increase renal glucose excretion.
3. Which of the following is a rare but serious adverse effect of metformin?
A) Hypoglycemia
B) Lactic acidosis
C) Hypertension
D) Bradycardia
Correct Answer: Lactic acidosis
Rationale: Lactic acidosis is a rare but serious adverse effect of metformin,
particularly in patients with renal impairment, liver disease, or alcohol abuse.
Metformin should be held before contrast studies. Hypoglycemia is more common
with sulfonylureas and insulin.
4. A patient with type 2 diabetes on metformin and glipizide has an HbA1c of 8.5%.
Adding which agent would provide the most pronounced reduction in cardiovascular
mortality?
A) Sitagliptin
B) Empagliflozin
C) Pioglitazone
D) Insulin glargine
, Correct Answer: Empagliflozin
Rationale: Empagliflozin, an SGLT2 inhibitor, has demonstrated significant reductions
in cardiovascular death and heart failure hospitalization in patients with type 2
diabetes and established cardiovascular disease. Sitagliptin is neutral, pioglitazone
may increase heart failure risk, and insulin does not reduce cardiovascular mortality.
5. What is the primary mechanism of action of SGLT2 inhibitors?
A) Inhibiting sodium-glucose cotransporter 2 in the proximal tubule
B) Stimulating insulin secretion
C) Decreasing hepatic glucose production
D) Inhibiting glucose absorption
Correct Answer: Inhibiting sodium-glucose cotransporter 2 in the proximal tubule
Rationale: SGLT2 inhibitors block sodium-glucose cotransporter 2 in the proximal
renal tubule, increasing urinary glucose excretion and lowering blood glucose. They
also have cardiorenal benefits. They do not stimulate insulin secretion or decrease
hepatic glucose production.
6. Which of the following is a common adverse effect of SGLT2 inhibitors?
A) Genital mycotic infections
B) Hypoglycemia
C) Hypertension
D) Bradycardia
