NURS 6531 FINAL EXAM REVISION HANDBOOK
2026 MEDICATION CLASSES AND EVIDENCE
BASED PRESCRIBING
◉ A patient recently diagnosed with type 1 diabetes mellitus is in
clinic for a follow-up evaluation. The provider notes that the patient
appears confused and irritable and is sweating and shaking. What
intervention will the provider expect to perform once the point of
care blood glucose level is known?
a. Dipstick urinalysis for ketones
b. Giving a rapid-acting carbohydrate
c. Injection of rapid-acting insulin
d. Performing a hemoglobin A1C.
Answer: ANS: B
This patient has signs of hypoglycemia, so a rapid-acting
carbohydrate should be given once this is confirmed. Assessing for
ketones is done if the patient is hyperglycemic, as is insulin
administration. Hemoglobin A1C gives information about long-term
and not immediate glucose control.
◉ An obese adolescent female patient reports irregular periods and
excessive acne. The provider notes an increased amount of hair on
her upper back, shoulders, and upper abdomen. What will the
provider do, based on these findings?
,a. Consider treatment with oral contraceptive pills (OCPs)
b. Counsel her about diet, exercise, and weight loss
c. Recommend cosmetic laser hair removal
d. Refer to an endocrinologist for evaluation.
Answer: ANS: D
All patients with suspected hirsutism should be referred to a
specialist to determine the cause. OCPs, lifestyle changes, and
cosmetic treatments may be part of the treatment, but the
underlying causes must be determined first to ensure that a life-
threatening condition is not present.
◉ A young adult woman is unable to conceive after trying to get
pregnant for over 6 months. The woman reports having had
irregular periods since the onset of menarche. The provider notes
that the woman is overweight, has acanthosis nigricans, and an
excess hair distribution. What does the provider suspect as the most
likely primary cause of these symptoms?
a. Congenital adrenal hyperplasia
b. Cushing's syndrome
c. Polycystic ovary syndrome (PCOS)
d. Type 2 diabetes.
Answer: ANS: C
PCOS is the most likely cause of oligo- or amenorrhea, so this is the
most likely cause. The other conditions are possible, but less likely.
,◉ A woman who has hirsutism with acne, and oligomenorrhea will
most likely be treated with which medication to control these
symptoms?
a. Finasteride
b. Levonorgestrel
c. Norgestimate
d. Spironolactone.
Answer: ANS: C
Norgestimate is a progestin with low androgenic activity and is used
to suppress testosterone and control symptoms. Finasteride, which
decreases the peripheral conversion of testosterone to
dihydrotestosterone (DHT), is not approved for this use.
Levonorgestrel is an androgenic oral contraceptive pill (OCP) and
should be avoided. Spironolactone is a second-line medication
approved for this purpose.
◉ A patient has a serum potassium level of 3 mEq/L and a normal
blood pressure. Which test should be performed initially to assist
with the differential diagnosis?
a. Plasma aldosterone
b. Plasma renin activity
c. Serum bicarbonate
d. Serum magnesium.
, Answer: ANS: D
Hypomagnesemia often accompanies hypokalemia indicating the
importance of also obtaining a serum magnesium level. Sodium
bicarbonate is occasionally used in the treatment of hyperkalemia
and is most effective when hyperkalemia is a result of metabolic
acidosis. Plasma aldosterone and renin activity are assessed in
patients with hypokalemia who are
hypertensive.
◉ A patient with normal renal function has a potassium level of 6.0
mEq/L. Which underlying cause is possible in this patient?
a. Adrenocortical deficiency
b. Alcoholism
c. Hypertension
d. Malabsorption syndrome.
Answer: ANS: A
Hyperkalemia without underlying renal disorder may be caused by
Addison's disease, which is an adrenocortical deficiency. Alcoholism,
hypertension, and malabsorption syndromes all contribute to
hypokalemia.
◉ A hospitalized patient with renal failure is accidentally given
parenteral potassium and has a potassium level of 7.0 mEq/L. An
ECG reveals a normal QRS interval. What is the initial
recommended treatment for this patient?
2026 MEDICATION CLASSES AND EVIDENCE
BASED PRESCRIBING
◉ A patient recently diagnosed with type 1 diabetes mellitus is in
clinic for a follow-up evaluation. The provider notes that the patient
appears confused and irritable and is sweating and shaking. What
intervention will the provider expect to perform once the point of
care blood glucose level is known?
a. Dipstick urinalysis for ketones
b. Giving a rapid-acting carbohydrate
c. Injection of rapid-acting insulin
d. Performing a hemoglobin A1C.
Answer: ANS: B
This patient has signs of hypoglycemia, so a rapid-acting
carbohydrate should be given once this is confirmed. Assessing for
ketones is done if the patient is hyperglycemic, as is insulin
administration. Hemoglobin A1C gives information about long-term
and not immediate glucose control.
◉ An obese adolescent female patient reports irregular periods and
excessive acne. The provider notes an increased amount of hair on
her upper back, shoulders, and upper abdomen. What will the
provider do, based on these findings?
,a. Consider treatment with oral contraceptive pills (OCPs)
b. Counsel her about diet, exercise, and weight loss
c. Recommend cosmetic laser hair removal
d. Refer to an endocrinologist for evaluation.
Answer: ANS: D
All patients with suspected hirsutism should be referred to a
specialist to determine the cause. OCPs, lifestyle changes, and
cosmetic treatments may be part of the treatment, but the
underlying causes must be determined first to ensure that a life-
threatening condition is not present.
◉ A young adult woman is unable to conceive after trying to get
pregnant for over 6 months. The woman reports having had
irregular periods since the onset of menarche. The provider notes
that the woman is overweight, has acanthosis nigricans, and an
excess hair distribution. What does the provider suspect as the most
likely primary cause of these symptoms?
a. Congenital adrenal hyperplasia
b. Cushing's syndrome
c. Polycystic ovary syndrome (PCOS)
d. Type 2 diabetes.
Answer: ANS: C
PCOS is the most likely cause of oligo- or amenorrhea, so this is the
most likely cause. The other conditions are possible, but less likely.
,◉ A woman who has hirsutism with acne, and oligomenorrhea will
most likely be treated with which medication to control these
symptoms?
a. Finasteride
b. Levonorgestrel
c. Norgestimate
d. Spironolactone.
Answer: ANS: C
Norgestimate is a progestin with low androgenic activity and is used
to suppress testosterone and control symptoms. Finasteride, which
decreases the peripheral conversion of testosterone to
dihydrotestosterone (DHT), is not approved for this use.
Levonorgestrel is an androgenic oral contraceptive pill (OCP) and
should be avoided. Spironolactone is a second-line medication
approved for this purpose.
◉ A patient has a serum potassium level of 3 mEq/L and a normal
blood pressure. Which test should be performed initially to assist
with the differential diagnosis?
a. Plasma aldosterone
b. Plasma renin activity
c. Serum bicarbonate
d. Serum magnesium.
, Answer: ANS: D
Hypomagnesemia often accompanies hypokalemia indicating the
importance of also obtaining a serum magnesium level. Sodium
bicarbonate is occasionally used in the treatment of hyperkalemia
and is most effective when hyperkalemia is a result of metabolic
acidosis. Plasma aldosterone and renin activity are assessed in
patients with hypokalemia who are
hypertensive.
◉ A patient with normal renal function has a potassium level of 6.0
mEq/L. Which underlying cause is possible in this patient?
a. Adrenocortical deficiency
b. Alcoholism
c. Hypertension
d. Malabsorption syndrome.
Answer: ANS: A
Hyperkalemia without underlying renal disorder may be caused by
Addison's disease, which is an adrenocortical deficiency. Alcoholism,
hypertension, and malabsorption syndromes all contribute to
hypokalemia.
◉ A hospitalized patient with renal failure is accidentally given
parenteral potassium and has a potassium level of 7.0 mEq/L. An
ECG reveals a normal QRS interval. What is the initial
recommended treatment for this patient?
