NUR 210 Exam 4 | Principles of Pharmacology (2026) Q&A |
Galen College
1. A nurse is preparing to administer Regular insulin subcutaneously to a patient with type 1
diabetes at 0730. The breakfast trays arrive at 0800. At what time is this patient at the highest
risk for developing hypoglycemia?
A) 0745 to 0800
B) 0930 to 1130
C) 1330 to 1530
D) 1930 to 2030
Correct Answer: 0930 to 1130
Rationale: Regular insulin is a short-acting insulin with an onset of 30-60 minutes, a peak of 2-4
hours, and a duration of 5-8 hours. The risk for hypoglycemia is highest during the peak action
time, which occurs 2 to 4 hours post-administration (0930 to 1130). The other time frames do
not correspond to the peak action of regular insulin.
2. A patient with type 2 diabetes is scheduled for a diagnostic CT scan with IV iodinated contrast
dye at 1400. Which daily medication must the nurse verify has been held prior to the
procedure?
A) Glipizide
B) Metformin
C) Pioglitazone
D) Sitagliptin
Correct Answer: Metformin
,Rationale: Metformin must be held on the day of IV contrast administration and withheld for 48
hours post-procedure. Combining iodinated contrast dye with metformin significantly increases
the risk of contrast-induced nephrotoxicity and fatal severe lactic acidosis. Glipizide,
pioglitazone, and sitagliptin do not carry this same risk.
3. A patient is prescribed Levothyroxine 88 mcg PO daily for primary hypothyroidism. What
instruction must the nurse include in the medication teaching plan?
A) "Take the medication at bedtime with a full glass of warm milk."
B) "Take the medication in the morning on an empty stomach with water, 30 to 60 minutes
before breakfast."
C) "Take the tablet with your morning coffee and breakfast."
D) "Crush the tablet and mix it into calcium-fortified orange juice."
Correct Answer: "Take the medication in the morning on an empty stomach with water, 30 to 60
minutes before breakfast."
Rationale: Levothyroxine absorption is optimal when taken early in the morning on an empty
stomach with a full glass of water, at least 30 to 60 minutes before consuming food or other
medications. Calcium, iron, and foods decrease its bioavailability. Taking it with milk, coffee, or
crushing it would reduce absorption.
4. A nurse monitors a patient receiving long-term oral Prednisone therapy for Addison's disease.
Which assessment finding indicates an adverse effect of systemic corticosteroid therapy?
A) Serum glucose level of 68 mg/dL
B) Serum potassium level of 5.8 mEq/L
C) Delayed wound healing and hyperglycemia
D) Weight loss and muscle atrophy
Correct Answer: Delayed wound healing and hyperglycemia
,Rationale: Long-term corticosteroid therapy can cause hyperglycemia, delayed wound healing,
immunosuppression, and other adverse effects. A serum glucose of 68 mg/dL indicates
hypoglycemia, which is not typical of corticosteroid therapy. Serum potassium of 5.8 mEq/L
indicates hyperkalemia, but corticosteroids typically cause hypokalemia.
5. A patient prescribed an oral hypoglycemic agent asks the nurse how the medication works.
Which response by the nurse is correct for a sulfonylurea such as glipizide?
A) "It decreases glucose production in the liver."
B) "It increases insulin secretion from the pancreas."
C) "It slows the absorption of carbohydrates in the intestine."
D) "It increases the sensitivity of peripheral tissues to insulin."
Correct Answer: "It increases insulin secretion from the pancreas."
Rationale: Sulfonylureas such as glipizide work by stimulating the pancreas to release more
insulin. Metformin decreases hepatic glucose production, alpha-glucosidase inhibitors slow
carbohydrate absorption, and thiazolidinediones increase insulin sensitivity.
6. A patient with type 2 diabetes is prescribed pioglitazone. Which adverse effect should the
nurse monitor for?
A) Weight loss
B) Fluid retention and heart failure
C) Hypoglycemia
D) Lactic acidosis
Correct Answer: Fluid retention and heart failure
, Rationale: Thiazolidinediones like pioglitazone can cause fluid retention, which may lead to or
exacerbate heart failure. Patients should be monitored for signs of fluid overload, including
weight gain, edema, and shortness of breath. Pioglitazone is generally weight-neutral or may
cause weight gain, not weight loss.
7. A patient is prescribed a GLP-1 receptor agonist for type 2 diabetes. Which medication is an
example of a GLP-1 receptor agonist?
A) Sitagliptin
B) Exenatide
C) Pioglitazone
D) Metformin
Correct Answer: Exenatide
Rationale: Exenatide is a GLP-1 receptor agonist that enhances insulin secretion, slows gastric
emptying, and promotes satiety. Sitagliptin is a DPP-4 inhibitor, pioglitazone is a
thiazolidinedione, and metformin is a biguanide.
8. A patient is prescribed an SGLT-2 inhibitor for type 2 diabetes. Which medication belongs to
this class?
A) Glipizide
B) Canagliflozin
C) Pioglitazone
D) Sitagliptin
Correct Answer: Canagliflozin
Galen College
1. A nurse is preparing to administer Regular insulin subcutaneously to a patient with type 1
diabetes at 0730. The breakfast trays arrive at 0800. At what time is this patient at the highest
risk for developing hypoglycemia?
A) 0745 to 0800
B) 0930 to 1130
C) 1330 to 1530
D) 1930 to 2030
Correct Answer: 0930 to 1130
Rationale: Regular insulin is a short-acting insulin with an onset of 30-60 minutes, a peak of 2-4
hours, and a duration of 5-8 hours. The risk for hypoglycemia is highest during the peak action
time, which occurs 2 to 4 hours post-administration (0930 to 1130). The other time frames do
not correspond to the peak action of regular insulin.
2. A patient with type 2 diabetes is scheduled for a diagnostic CT scan with IV iodinated contrast
dye at 1400. Which daily medication must the nurse verify has been held prior to the
procedure?
A) Glipizide
B) Metformin
C) Pioglitazone
D) Sitagliptin
Correct Answer: Metformin
,Rationale: Metformin must be held on the day of IV contrast administration and withheld for 48
hours post-procedure. Combining iodinated contrast dye with metformin significantly increases
the risk of contrast-induced nephrotoxicity and fatal severe lactic acidosis. Glipizide,
pioglitazone, and sitagliptin do not carry this same risk.
3. A patient is prescribed Levothyroxine 88 mcg PO daily for primary hypothyroidism. What
instruction must the nurse include in the medication teaching plan?
A) "Take the medication at bedtime with a full glass of warm milk."
B) "Take the medication in the morning on an empty stomach with water, 30 to 60 minutes
before breakfast."
C) "Take the tablet with your morning coffee and breakfast."
D) "Crush the tablet and mix it into calcium-fortified orange juice."
Correct Answer: "Take the medication in the morning on an empty stomach with water, 30 to 60
minutes before breakfast."
Rationale: Levothyroxine absorption is optimal when taken early in the morning on an empty
stomach with a full glass of water, at least 30 to 60 minutes before consuming food or other
medications. Calcium, iron, and foods decrease its bioavailability. Taking it with milk, coffee, or
crushing it would reduce absorption.
4. A nurse monitors a patient receiving long-term oral Prednisone therapy for Addison's disease.
Which assessment finding indicates an adverse effect of systemic corticosteroid therapy?
A) Serum glucose level of 68 mg/dL
B) Serum potassium level of 5.8 mEq/L
C) Delayed wound healing and hyperglycemia
D) Weight loss and muscle atrophy
Correct Answer: Delayed wound healing and hyperglycemia
,Rationale: Long-term corticosteroid therapy can cause hyperglycemia, delayed wound healing,
immunosuppression, and other adverse effects. A serum glucose of 68 mg/dL indicates
hypoglycemia, which is not typical of corticosteroid therapy. Serum potassium of 5.8 mEq/L
indicates hyperkalemia, but corticosteroids typically cause hypokalemia.
5. A patient prescribed an oral hypoglycemic agent asks the nurse how the medication works.
Which response by the nurse is correct for a sulfonylurea such as glipizide?
A) "It decreases glucose production in the liver."
B) "It increases insulin secretion from the pancreas."
C) "It slows the absorption of carbohydrates in the intestine."
D) "It increases the sensitivity of peripheral tissues to insulin."
Correct Answer: "It increases insulin secretion from the pancreas."
Rationale: Sulfonylureas such as glipizide work by stimulating the pancreas to release more
insulin. Metformin decreases hepatic glucose production, alpha-glucosidase inhibitors slow
carbohydrate absorption, and thiazolidinediones increase insulin sensitivity.
6. A patient with type 2 diabetes is prescribed pioglitazone. Which adverse effect should the
nurse monitor for?
A) Weight loss
B) Fluid retention and heart failure
C) Hypoglycemia
D) Lactic acidosis
Correct Answer: Fluid retention and heart failure
, Rationale: Thiazolidinediones like pioglitazone can cause fluid retention, which may lead to or
exacerbate heart failure. Patients should be monitored for signs of fluid overload, including
weight gain, edema, and shortness of breath. Pioglitazone is generally weight-neutral or may
cause weight gain, not weight loss.
7. A patient is prescribed a GLP-1 receptor agonist for type 2 diabetes. Which medication is an
example of a GLP-1 receptor agonist?
A) Sitagliptin
B) Exenatide
C) Pioglitazone
D) Metformin
Correct Answer: Exenatide
Rationale: Exenatide is a GLP-1 receptor agonist that enhances insulin secretion, slows gastric
emptying, and promotes satiety. Sitagliptin is a DPP-4 inhibitor, pioglitazone is a
thiazolidinedione, and metformin is a biguanide.
8. A patient is prescribed an SGLT-2 inhibitor for type 2 diabetes. Which medication belongs to
this class?
A) Glipizide
B) Canagliflozin
C) Pioglitazone
D) Sitagliptin
Correct Answer: Canagliflozin
