ASU NUR 354 Pharmacology II Exam 4 | Comprehensive
Questions and Correct Answers plus Rationales | Already
Graded A+ | New 2026-2027 Update
1. Which of the following best describes the primary purpose of administering
regular insulin via the intravenous route?
A) To provide rapid glucose control in acute settings such as DKA
B) To provide long-acting basal insulin coverage
C) To replace intermediate-acting insulin for mealtime coverage
D) To administer insulin orally for better absorption
Correct Answer: To provide rapid glucose control in acute settings such as DKA
Rationale: Regular insulin is the only insulin that can be administered
intravenously. It has a rapid onset and is used in acute settings such as diabetic
ketoacidosis, where rapid glucose control is essential. Long-acting insulins like
glargine cannot be given IV, and insulin is not administered orally due to
degradation by gastric enzymes.
2. What is the primary mechanism of action of propylthiouracil (PTU) in
treating hyperthyroidism?
A) Inhibiting thyroid hormone synthesis and peripheral conversion of T4 to
T3
B) Replacing deficient thyroid hormones
C) Increasing thyroid hormone secretion
D) Suppressing the immune system
Correct Answer: Inhibiting thyroid hormone synthesis and peripheral conversion
of T4 to T3
Rationale: PTU inhibits the synthesis of thyroid hormones by blocking iodine
organification and also inhibits the peripheral conversion of T4 to T3. It is used to
treat hyperthyroidism and thyroid storm. It does not replace deficient hormones
or increase secretion.
, 3. According to the NUR 354 Exam 4 study guide, which insulin can be
administered via the IV route?
A) Short-acting regular insulin
B) NPH insulin
C) Glargine insulin
D) Detemir insulin
Correct Answer: Short-acting regular insulin
Rationale: The study guide explicitly states that short-acting regular insulin
(Humulin R) is the correct answer for insulins that can be given via the IV route.
NPH, glargine, and detemir are not administered intravenously. This distinction is
critical for safe medication administration in acute care settings.
4. A nurse is teaching a patient about mixing regular and NPH insulin. Which
sequence is correct?
A) Inject air into NPH, inject air into regular, withdraw regular, then
withdraw NPH
B) Inject air into regular, withdraw regular, inject air into NPH, withdraw
NPH
C) Withdraw NPH first, then withdraw regular
D) Inject air into both vials, then withdraw NPH first
Correct Answer: Inject air into NPH, inject air into regular, withdraw regular, then
withdraw NPH
Rationale: The correct sequence is to inject air into the intermediate-acting (NPH)
vial first, then inject air into the regular vial, withdraw the regular insulin, and
finally withdraw the NPH insulin. This prevents contamination of the regular
insulin with the intermediate-acting insulin. This is a critical patient teaching point.
5. What is the most important laboratory value to monitor for assessing long-
term glucose control in a diabetic patient?
A) Hemoglobin A1C
B) Fasting blood glucose
C) Random blood glucose
D) Urine ketones
Correct Answer: Hemoglobin A1C
,Rationale: Hemoglobin A1C reflects average blood glucose levels over the past 2–
3 months and is the most important lab value for assessing long-term glucose
control. The study guide specifies that A1C should be less than 6.5%. Fasting and
random glucose provide only snapshots of current glucose levels.
6. Which adverse effect is most commonly associated with propylthiouracil
(PTU) therapy?
A) Agranulocytosis
B) Hyperkalemia
C) Bradycardia
D) Constipation
Correct Answer: Agranulocytosis
Rationale: Agranulocytosis is a serious adverse effect of PTU therapy,
characterized by a severe decrease in white blood cells. Patients should be
instructed to report fever, sore throat, or other signs of infection immediately.
Other adverse effects include liver damage and hypothyroidism from
overmedication.
7. What is the primary purpose of administering levothyroxine in a patient
with hypothyroidism?
A) To replace deficient thyroid hormones
B) To inhibit thyroid hormone synthesis
C) To increase thyroid hormone secretion
D) To suppress the immune system
Correct Answer: To replace deficient thyroid hormones
Rationale: Levothyroxine is a synthetic form of thyroxine (T4) used as hormone
replacement therapy in hypothyroidism. It restores normal metabolic function.
Thyroid function should be monitored every 6–8 weeks after initiating therapy or
adjusting the dose, as noted in the study guide.
8. Which finding indicates that thyroid replacement therapy with
levothyroxine is effective?
A) TSH level returns to normal range
B) Blood glucose level decreases
, C) Heart rate increases above 100 beats per minute
D) Weight gain continues
Correct Answer: TSH level returns to normal range
Rationale: TSH is the most sensitive indicator of thyroid function and is used to
monitor the effectiveness of thyroid replacement therapy. When levothyroxine is
adequately dosed, TSH levels should return to normal. Persistent elevation of TSH
indicates inadequate replacement.
9. What is the primary mechanism of action of ACE inhibitors such as
lisinopril?
A) Inhibiting the conversion of angiotensin I to angiotensin II
B) Blocking beta-1 receptors in the heart
C) Blocking calcium channels in vascular smooth muscle
D) Directly dilating arterioles
Correct Answer: Inhibiting the conversion of angiotensin I to angiotensin II
Rationale: Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I
to angiotensin II. This reduces vasoconstriction and aldosterone secretion,
lowering blood pressure and reducing afterload. ACE inhibitors also decrease the
degradation of bradykinin, which can cause a dry cough.
10.Which laboratory value should be monitored closely in a patient taking
lisinopril?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum chloride
Correct Answer: Serum potassium
Rationale: ACE inhibitors decrease aldosterone secretion, which leads to
potassium retention and an increased risk of hyperkalemia. The study guide and
sample questions emphasize monitoring for hyperkalemia in patients taking
lisinopril, especially those with renal impairment or taking potassium
supplements.
Questions and Correct Answers plus Rationales | Already
Graded A+ | New 2026-2027 Update
1. Which of the following best describes the primary purpose of administering
regular insulin via the intravenous route?
A) To provide rapid glucose control in acute settings such as DKA
B) To provide long-acting basal insulin coverage
C) To replace intermediate-acting insulin for mealtime coverage
D) To administer insulin orally for better absorption
Correct Answer: To provide rapid glucose control in acute settings such as DKA
Rationale: Regular insulin is the only insulin that can be administered
intravenously. It has a rapid onset and is used in acute settings such as diabetic
ketoacidosis, where rapid glucose control is essential. Long-acting insulins like
glargine cannot be given IV, and insulin is not administered orally due to
degradation by gastric enzymes.
2. What is the primary mechanism of action of propylthiouracil (PTU) in
treating hyperthyroidism?
A) Inhibiting thyroid hormone synthesis and peripheral conversion of T4 to
T3
B) Replacing deficient thyroid hormones
C) Increasing thyroid hormone secretion
D) Suppressing the immune system
Correct Answer: Inhibiting thyroid hormone synthesis and peripheral conversion
of T4 to T3
Rationale: PTU inhibits the synthesis of thyroid hormones by blocking iodine
organification and also inhibits the peripheral conversion of T4 to T3. It is used to
treat hyperthyroidism and thyroid storm. It does not replace deficient hormones
or increase secretion.
, 3. According to the NUR 354 Exam 4 study guide, which insulin can be
administered via the IV route?
A) Short-acting regular insulin
B) NPH insulin
C) Glargine insulin
D) Detemir insulin
Correct Answer: Short-acting regular insulin
Rationale: The study guide explicitly states that short-acting regular insulin
(Humulin R) is the correct answer for insulins that can be given via the IV route.
NPH, glargine, and detemir are not administered intravenously. This distinction is
critical for safe medication administration in acute care settings.
4. A nurse is teaching a patient about mixing regular and NPH insulin. Which
sequence is correct?
A) Inject air into NPH, inject air into regular, withdraw regular, then
withdraw NPH
B) Inject air into regular, withdraw regular, inject air into NPH, withdraw
NPH
C) Withdraw NPH first, then withdraw regular
D) Inject air into both vials, then withdraw NPH first
Correct Answer: Inject air into NPH, inject air into regular, withdraw regular, then
withdraw NPH
Rationale: The correct sequence is to inject air into the intermediate-acting (NPH)
vial first, then inject air into the regular vial, withdraw the regular insulin, and
finally withdraw the NPH insulin. This prevents contamination of the regular
insulin with the intermediate-acting insulin. This is a critical patient teaching point.
5. What is the most important laboratory value to monitor for assessing long-
term glucose control in a diabetic patient?
A) Hemoglobin A1C
B) Fasting blood glucose
C) Random blood glucose
D) Urine ketones
Correct Answer: Hemoglobin A1C
,Rationale: Hemoglobin A1C reflects average blood glucose levels over the past 2–
3 months and is the most important lab value for assessing long-term glucose
control. The study guide specifies that A1C should be less than 6.5%. Fasting and
random glucose provide only snapshots of current glucose levels.
6. Which adverse effect is most commonly associated with propylthiouracil
(PTU) therapy?
A) Agranulocytosis
B) Hyperkalemia
C) Bradycardia
D) Constipation
Correct Answer: Agranulocytosis
Rationale: Agranulocytosis is a serious adverse effect of PTU therapy,
characterized by a severe decrease in white blood cells. Patients should be
instructed to report fever, sore throat, or other signs of infection immediately.
Other adverse effects include liver damage and hypothyroidism from
overmedication.
7. What is the primary purpose of administering levothyroxine in a patient
with hypothyroidism?
A) To replace deficient thyroid hormones
B) To inhibit thyroid hormone synthesis
C) To increase thyroid hormone secretion
D) To suppress the immune system
Correct Answer: To replace deficient thyroid hormones
Rationale: Levothyroxine is a synthetic form of thyroxine (T4) used as hormone
replacement therapy in hypothyroidism. It restores normal metabolic function.
Thyroid function should be monitored every 6–8 weeks after initiating therapy or
adjusting the dose, as noted in the study guide.
8. Which finding indicates that thyroid replacement therapy with
levothyroxine is effective?
A) TSH level returns to normal range
B) Blood glucose level decreases
, C) Heart rate increases above 100 beats per minute
D) Weight gain continues
Correct Answer: TSH level returns to normal range
Rationale: TSH is the most sensitive indicator of thyroid function and is used to
monitor the effectiveness of thyroid replacement therapy. When levothyroxine is
adequately dosed, TSH levels should return to normal. Persistent elevation of TSH
indicates inadequate replacement.
9. What is the primary mechanism of action of ACE inhibitors such as
lisinopril?
A) Inhibiting the conversion of angiotensin I to angiotensin II
B) Blocking beta-1 receptors in the heart
C) Blocking calcium channels in vascular smooth muscle
D) Directly dilating arterioles
Correct Answer: Inhibiting the conversion of angiotensin I to angiotensin II
Rationale: Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I
to angiotensin II. This reduces vasoconstriction and aldosterone secretion,
lowering blood pressure and reducing afterload. ACE inhibitors also decrease the
degradation of bradykinin, which can cause a dry cough.
10.Which laboratory value should be monitored closely in a patient taking
lisinopril?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum chloride
Correct Answer: Serum potassium
Rationale: ACE inhibitors decrease aldosterone secretion, which leads to
potassium retention and an increased risk of hyperkalemia. The study guide and
sample questions emphasize monitoring for hyperkalemia in patients taking
lisinopril, especially those with renal impairment or taking potassium
supplements.
