NUR 210 Exam 4 V2 | NUR 210 Pharmacology | Actual Q&A with
Rationale (NUR 210 Exam 4) | Galen
1. A nurse is preparing to administer insulin lispro to a patient with type 1 diabetes. Which
action should the nurse take to ensure patient safety?
A. Administer the dose 30 to 60 minutes before the meal arrives.
B. Give the injection only after the patient has finished the entire meal.
C. Ensure the patient’s meal tray is present before administration.
D. Monitor blood glucose levels 4 hours after the injection for the peak effect.
Answer: C
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 15 minutes. The nurse
must ensure that the patient has food immediately available to prevent a rapid drop in
blood glucose. Administering it too early without food can lead to severe hypoglycemia.
2. A patient is scheduled for a CT scan with intravenous iodinated contrast media. Which
medication must the nurse instruct the patient to withhold for 48 hours after the procedure?
A. Metformin
B. Pioglitazone
C. Glyburide
D. Sitagliptin
Answer: A
Rationale: Metformin must be discontinued 24 to 48 hours before and 48 hours after
procedures involving iodine contrast. The combination of contrast media and metformin
significantly increases the risk of lactic acidosis and acute renal failure. The nurse must
verify renal function before the patient resumes metformin therapy.
3. A nurse provides discharge teaching for a patient prescribed levothyroxine for
hypothyroidism. Which statement by the patient indicates a need for further instruction?
A. “I should take this medication on an empty stomach in the morning.”
B. “I will wait at least 30 to 60 minutes after taking it before eating breakfast.”
C. “I need to have my blood levels checked regularly by my doctor.”
D. “If I feel my heart racing, I will know the medication is working well.”
Answer: D
,Rationale: Palpitations, tachycardia, and chest pain are signs of thyrotoxicosis and must be
reported to the provider immediately. Levothyroxine should be taken once daily in the
morning on an empty stomach to enhance absorption. It is a lifelong therapy that requires
periodic monitoring of TSH levels.
4. A patient who has been taking high-dose prednisone for several weeks is being prepared
for discharge. What is the most important instruction regarding this medication?
A. “Take the medication with an antacid to prevent stomach upset.”
B. “Do not stop taking this medication abruptly; it must be tapered.”
C. “Stop the medication immediately if you notice any facial swelling.”
D. “Limit your intake of potassium-rich foods while on this drug.”
Answer: B
Rationale: Abrupt withdrawal of corticosteroids can lead to acute adrenal insufficiency,
which is a life-threatening crisis. The dose must be tapered slowly to allow the adrenal
glands to resume normal endogenous cortisol production. Patients should also be taught to
avoid crowds as the medication suppresses the immune system.
5. A patient experiencing an acute asthma attack arrives at the emergency department.
Which medication should the nurse anticipate administering first?
A. Salmeterol
B. Montelukast
C. Albuterol
D. Beclomethasone
Answer: C
Rationale: Albuterol is a short-acting beta2-agonist (SABA) used as a rescue medication
for acute bronchospasm. It provides rapid relief by relaxing the smooth muscles of the
airway. Other medications like salmeterol and beclomethasone are used for long-term
maintenance and are not effective in an emergency.
6. A nurse is teaching a patient about the use of an ipratropium inhaler. Which allergy should
the nurse screen for before the patient uses this medication?
A. Shellfish
B. Peanuts or soy
C. Penicillin
D. Eggs
Answer: B
, Rationale: Ipratropium bromide metered-dose inhalers often contain soy lecithin as a
propellant, which is contraindicated in patients with peanut or soy allergies. The nurse
must assess for these allergies to prevent an anaphylactic reaction. If a patient has a severe
peanut allergy, alternative formulations must be used.
7. A patient is receiving an intravenous infusion of theophylline. The nurse notes the most
recent serum theophylline level is 24 mcg/mL. Which action is the priority?
A. Increase the infusion rate as the level is below therapeutic range.
B. Stop the infusion and notify the healthcare provider immediately.
C. Continue the infusion at the current rate as the level is normal.
D. Document the finding as a normal expected therapeutic level.
Answer: B
Rationale: The therapeutic range for serum theophylline is 10 to 20 mcg/mL. A level of 24
mcg/mL indicates toxicity, which can lead to serious side effects such as seizures and
dysrhythmias. The nurse must stop the infusion to prevent further toxicity and contact the
physician.
8. A nurse is providing education to a patient prescribed beclomethasone dipropionate by
inhalation. What is the most important instruction to prevent oral candidiasis?
A. “Use a spacer with the inhaler to increase drug delivery.”
B. “Only use the inhaler when you feel short of breath.”
C. “Take a deep breath and hold it for at least 30 seconds.”
D. “Rinse your mouth with water and spit it out after each use.”
Answer: D
Rationale: Inhaled corticosteroids can suppress the local immune response in the mouth,
leading to fungal infections like thrush. Rinsing the mouth and spitting after administration
removes residual medication from the oral mucosa. Using a spacer also helps reduce the
amount of medication that stays in the mouth.
9. A patient with a history of peptic ulcer disease is prescribed omeprazole. The nurse
explains that this medication works by:
A. Neutralizing gastric acid currently present in the stomach.
B. Forming a protective barrier over the ulcer crater.
C. Blocking H2 receptors on the parietal cells.
D. Inhibiting the enzyme that produces gastric acid.
Answer: D
Rationale (NUR 210 Exam 4) | Galen
1. A nurse is preparing to administer insulin lispro to a patient with type 1 diabetes. Which
action should the nurse take to ensure patient safety?
A. Administer the dose 30 to 60 minutes before the meal arrives.
B. Give the injection only after the patient has finished the entire meal.
C. Ensure the patient’s meal tray is present before administration.
D. Monitor blood glucose levels 4 hours after the injection for the peak effect.
Answer: C
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 15 minutes. The nurse
must ensure that the patient has food immediately available to prevent a rapid drop in
blood glucose. Administering it too early without food can lead to severe hypoglycemia.
2. A patient is scheduled for a CT scan with intravenous iodinated contrast media. Which
medication must the nurse instruct the patient to withhold for 48 hours after the procedure?
A. Metformin
B. Pioglitazone
C. Glyburide
D. Sitagliptin
Answer: A
Rationale: Metformin must be discontinued 24 to 48 hours before and 48 hours after
procedures involving iodine contrast. The combination of contrast media and metformin
significantly increases the risk of lactic acidosis and acute renal failure. The nurse must
verify renal function before the patient resumes metformin therapy.
3. A nurse provides discharge teaching for a patient prescribed levothyroxine for
hypothyroidism. Which statement by the patient indicates a need for further instruction?
A. “I should take this medication on an empty stomach in the morning.”
B. “I will wait at least 30 to 60 minutes after taking it before eating breakfast.”
C. “I need to have my blood levels checked regularly by my doctor.”
D. “If I feel my heart racing, I will know the medication is working well.”
Answer: D
,Rationale: Palpitations, tachycardia, and chest pain are signs of thyrotoxicosis and must be
reported to the provider immediately. Levothyroxine should be taken once daily in the
morning on an empty stomach to enhance absorption. It is a lifelong therapy that requires
periodic monitoring of TSH levels.
4. A patient who has been taking high-dose prednisone for several weeks is being prepared
for discharge. What is the most important instruction regarding this medication?
A. “Take the medication with an antacid to prevent stomach upset.”
B. “Do not stop taking this medication abruptly; it must be tapered.”
C. “Stop the medication immediately if you notice any facial swelling.”
D. “Limit your intake of potassium-rich foods while on this drug.”
Answer: B
Rationale: Abrupt withdrawal of corticosteroids can lead to acute adrenal insufficiency,
which is a life-threatening crisis. The dose must be tapered slowly to allow the adrenal
glands to resume normal endogenous cortisol production. Patients should also be taught to
avoid crowds as the medication suppresses the immune system.
5. A patient experiencing an acute asthma attack arrives at the emergency department.
Which medication should the nurse anticipate administering first?
A. Salmeterol
B. Montelukast
C. Albuterol
D. Beclomethasone
Answer: C
Rationale: Albuterol is a short-acting beta2-agonist (SABA) used as a rescue medication
for acute bronchospasm. It provides rapid relief by relaxing the smooth muscles of the
airway. Other medications like salmeterol and beclomethasone are used for long-term
maintenance and are not effective in an emergency.
6. A nurse is teaching a patient about the use of an ipratropium inhaler. Which allergy should
the nurse screen for before the patient uses this medication?
A. Shellfish
B. Peanuts or soy
C. Penicillin
D. Eggs
Answer: B
, Rationale: Ipratropium bromide metered-dose inhalers often contain soy lecithin as a
propellant, which is contraindicated in patients with peanut or soy allergies. The nurse
must assess for these allergies to prevent an anaphylactic reaction. If a patient has a severe
peanut allergy, alternative formulations must be used.
7. A patient is receiving an intravenous infusion of theophylline. The nurse notes the most
recent serum theophylline level is 24 mcg/mL. Which action is the priority?
A. Increase the infusion rate as the level is below therapeutic range.
B. Stop the infusion and notify the healthcare provider immediately.
C. Continue the infusion at the current rate as the level is normal.
D. Document the finding as a normal expected therapeutic level.
Answer: B
Rationale: The therapeutic range for serum theophylline is 10 to 20 mcg/mL. A level of 24
mcg/mL indicates toxicity, which can lead to serious side effects such as seizures and
dysrhythmias. The nurse must stop the infusion to prevent further toxicity and contact the
physician.
8. A nurse is providing education to a patient prescribed beclomethasone dipropionate by
inhalation. What is the most important instruction to prevent oral candidiasis?
A. “Use a spacer with the inhaler to increase drug delivery.”
B. “Only use the inhaler when you feel short of breath.”
C. “Take a deep breath and hold it for at least 30 seconds.”
D. “Rinse your mouth with water and spit it out after each use.”
Answer: D
Rationale: Inhaled corticosteroids can suppress the local immune response in the mouth,
leading to fungal infections like thrush. Rinsing the mouth and spitting after administration
removes residual medication from the oral mucosa. Using a spacer also helps reduce the
amount of medication that stays in the mouth.
9. A patient with a history of peptic ulcer disease is prescribed omeprazole. The nurse
explains that this medication works by:
A. Neutralizing gastric acid currently present in the stomach.
B. Forming a protective barrier over the ulcer crater.
C. Blocking H2 receptors on the parietal cells.
D. Inhibiting the enzyme that produces gastric acid.
Answer: D
