NUR 334 PHARMACOLOGY EXAM 4 -
ADVANCED NURSING CONCEPTS
QUESTIONS AND DETAILED ANSWERS
2026/2027
1. A patient with Type 1 Diabetes is prescribed Lispro (Humalog) insulin. At what time should
the nurse ensure the patient’s meal tray is present to prevent hypoglycemia?
A. 2 hours after administration
B. 30 to 60 minutes after administration
C. Within 15 minutes of administration
D. Immediately before the bedtime snack
Answer: C
Conceptual Explanation: Lispro is a rapid-acting insulin with an onset of 15 minutes;
therefore, the meal must be available immediately to prevent rapid drops in blood glucose.
2. Which laboratory value is the most critical for the nurse to monitor in a patient receiving
Metformin (Glucophage) who is scheduled for a CT scan with IV contrast?
A. Serum Creatinine
B. Serum Potassium
C. Glycosylated Hemoglobin (A1C)
,D. White Blood Cell Count
Answer: A
Conceptual Explanation: Metformin is excreted by the kidneys. IV contrast can cause
acute renal failure, leading to Metformin accumulation and life-threatening lactic acidosis.
Creatinine monitors renal function.
3. A patient taking Levothyroxine (Synthroid) for hypothyroidism reports insomnia,
palpitations, and tremors. Which action should the nurse take first?
A. Assess the patient’s heart rate and rhythm
B. Explain that these are expected side effects that will subside
C. Advise the patient to take the medication with food
D. Instruct the patient to double the next dose to stabilize levels
Answer: A
Conceptual Explanation: Insomnia, palpitations, and tremors are signs of
hyperthyroidism/thyrotoxicosis, indicating the dose may be too high. Cardiac assessment
is the priority.
4. Which instruction is essential for a patient starting a course of Prednisone for an acute
asthma exacerbation?
A. Stop the medication immediately if you feel better
B. Take the medication on an empty stomach for better absorption
, C. Expect an increase in urinary output
D. Avoid large crowds and people with active infections
Answer: D
Conceptual Explanation: Corticosteroids like Prednisone suppress the immune system,
increasing the risk of infection. They should never be stopped abruptly due to the risk of
adrenal crisis.
5. A patient is prescribed Omeprazole (Prilosec) for GERD. The nurse should monitor for
which long-term complication associated with Proton Pump Inhibitors (PPIs)?
A. Hypermagnesemia
B. Hypertension
C. Osteoporosis and fractures
D. Vitamin C deficiency
Answer: C
Conceptual Explanation: Long-term PPI use is associated with decreased calcium
absorption, leading to increased risk of osteoporosis and hip fractures, as well as
hypomagnesemia.
6. A patient has a new prescription for Cimetidine (Tagamet). The nurse should review the
patient’s record for which medication that interacts significantly with this drug?
A. Docusate Sodium
ADVANCED NURSING CONCEPTS
QUESTIONS AND DETAILED ANSWERS
2026/2027
1. A patient with Type 1 Diabetes is prescribed Lispro (Humalog) insulin. At what time should
the nurse ensure the patient’s meal tray is present to prevent hypoglycemia?
A. 2 hours after administration
B. 30 to 60 minutes after administration
C. Within 15 minutes of administration
D. Immediately before the bedtime snack
Answer: C
Conceptual Explanation: Lispro is a rapid-acting insulin with an onset of 15 minutes;
therefore, the meal must be available immediately to prevent rapid drops in blood glucose.
2. Which laboratory value is the most critical for the nurse to monitor in a patient receiving
Metformin (Glucophage) who is scheduled for a CT scan with IV contrast?
A. Serum Creatinine
B. Serum Potassium
C. Glycosylated Hemoglobin (A1C)
,D. White Blood Cell Count
Answer: A
Conceptual Explanation: Metformin is excreted by the kidneys. IV contrast can cause
acute renal failure, leading to Metformin accumulation and life-threatening lactic acidosis.
Creatinine monitors renal function.
3. A patient taking Levothyroxine (Synthroid) for hypothyroidism reports insomnia,
palpitations, and tremors. Which action should the nurse take first?
A. Assess the patient’s heart rate and rhythm
B. Explain that these are expected side effects that will subside
C. Advise the patient to take the medication with food
D. Instruct the patient to double the next dose to stabilize levels
Answer: A
Conceptual Explanation: Insomnia, palpitations, and tremors are signs of
hyperthyroidism/thyrotoxicosis, indicating the dose may be too high. Cardiac assessment
is the priority.
4. Which instruction is essential for a patient starting a course of Prednisone for an acute
asthma exacerbation?
A. Stop the medication immediately if you feel better
B. Take the medication on an empty stomach for better absorption
, C. Expect an increase in urinary output
D. Avoid large crowds and people with active infections
Answer: D
Conceptual Explanation: Corticosteroids like Prednisone suppress the immune system,
increasing the risk of infection. They should never be stopped abruptly due to the risk of
adrenal crisis.
5. A patient is prescribed Omeprazole (Prilosec) for GERD. The nurse should monitor for
which long-term complication associated with Proton Pump Inhibitors (PPIs)?
A. Hypermagnesemia
B. Hypertension
C. Osteoporosis and fractures
D. Vitamin C deficiency
Answer: C
Conceptual Explanation: Long-term PPI use is associated with decreased calcium
absorption, leading to increased risk of osteoporosis and hip fractures, as well as
hypomagnesemia.
6. A patient has a new prescription for Cimetidine (Tagamet). The nurse should review the
patient’s record for which medication that interacts significantly with this drug?
A. Docusate Sodium
