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NURS 251 Pharmacology Module 6 Exam Actual
Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Endocrine Pharmacology (Diabetes, Thyroid, Adrenal) (Questions 1-15)
Q1: A nurse is teaching a patient how to mix Regular Insulin (100 U/mL) and NPH Insulin (100
U/mL) in the same syringe. What is the correct technique?
A. Draw up NPH first, then Regular.
B. Draw up Regular (clear) first, then NPH (cloudy).
C. Mix vigorously to ensure they are compatible.
D. Inject immediately after mixing.
C. B. Draw up Regular (clear) first, then NPH (cloudy). [CORRECT]
Correct Answer: B
Rationale: When mixing insulins, the clear insulin (Regular) is drawn up first to prevent
contamination of the NPH bottle with Regular insulin. NPH is cloudy (suspension) and Regular
is clear.
Q2. Which instruction regarding storage of Unopened Insulin vials is correct?
A. Store in the freezer to extend shelf life.
B. Store at room temperature for up to 28 days only if opened.
C. Unopened vials should be refrigerated between 2-8°C (36-46°F).
D. Keep vials in a warm, humid environment.
C. C. Unopened vials should be refrigerated between 2-8°C (36-46°F). [CONRRECT]
Correct Answer: C
Rationale: Unopened insulin vials should be stored in the refrigerator to maintain potency until
the expiration date. Freezing destroys the protein structure.
,2
Q3. A patient with Type 1 diabetes has a blood glucose of 55 mg/dL and is unconscious. What is
the first action?
A. Give 4 oz of orange juice and a sandwich.
B. Administer 1 mg of Glucagon IM.
C. Administer 50% Dextrose IV bolus.
D. Wait 15 minutes and recheck glucose.
C. B. Administer 1 mg of Glucagon IM. [CORRECT]
Correct Answer: B
Rationale: If a patient with diabetes is unconscious, oral carbohydrates are contraindicated due to
aspiration risk. Glucagon IM is the appropriate rescue medication for severe hypoglycemia with
altered mental status.
Q4: A patient with Type 2 diabetes is starting Metformin. The nurse teaches the patient about the
potential for Lactic Acidosis. Which patient condition increases this risk?
A. Hypertension.
B. Renal impairment (eGFR <30 mL/min).
C. Asthma.
D. Hyperlipidemia.
C: B. Renal impairment (eGFR <30 mL/min). [CORRECT]
Correct Answer: B
Rationale: Metformin is contraindicated in severe renal impairment (eGFR <30 mL/min) because
the drug accumulates, increasing the risk of lactic acidosis.
5. A patient is prescribed Glipizide (Sulfonylurea). The nurse explains that this medication works
by:
A. Increasing insulin sensitivity in the liver.
B. Blocking the reabsorption of glucose in the kidneys.
C. Stimulating the pancreas to release insulin.
D. Decreasing hepatic glucose production.
, 3
C: C. Stimulating the pancreas to release insulin. [CORRECT]
Correct Answer: C
Rationale: Sulfonylureas bind to the SUR1 receptor on pancreatic beta cells, causing
depolarization and release of insulin.
Q6: A patient taking SGLT2 inhibitors (e.g., Empagliflozin) reports abdominal pain and nausea.
The nurse should be concerned about:
A. Hypoglycemia.
B. Eosinophilic Esophagitis.
C. Ketoacidosis with normal glucose.
D. Hyperkalemia.
C: C. Ketoacidosis with normal glucose. [Correct]
Correct Answer: C
Rationale: SGLT2 inhibitors can lead to Euglycemic Diabetic Ketoacidosis (euDKA), where the
patient has ketosis/acidosis but blood glucose is normal or only mildly elevated. This can be life-
threatening.
Q7. A patient is prescribed a GLP-1 agonist (e.g., Liraglutide). Which injection site is preferred?
A. Abdomen (2 inches from umbilicus).
B. Deltoid.
C. Vastus lateralis.
D. Dorsogluteal.
C: A. Abdomen (2 inches from umbilicus). [CORRECT]
Correct Answer: A
Rationale: The abdomen provides the most consistent absorption rate for injectable GLP-1
agonists. It should be injected into the anterior abdominal wall, avoiding the 2-inch radius around
the navel.
NURS 251 Pharmacology Module 6 Exam Actual
Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100%
Verified – Pass Guaranteed – A+ Graded
Section 1: Endocrine Pharmacology (Diabetes, Thyroid, Adrenal) (Questions 1-15)
Q1: A nurse is teaching a patient how to mix Regular Insulin (100 U/mL) and NPH Insulin (100
U/mL) in the same syringe. What is the correct technique?
A. Draw up NPH first, then Regular.
B. Draw up Regular (clear) first, then NPH (cloudy).
C. Mix vigorously to ensure they are compatible.
D. Inject immediately after mixing.
C. B. Draw up Regular (clear) first, then NPH (cloudy). [CORRECT]
Correct Answer: B
Rationale: When mixing insulins, the clear insulin (Regular) is drawn up first to prevent
contamination of the NPH bottle with Regular insulin. NPH is cloudy (suspension) and Regular
is clear.
Q2. Which instruction regarding storage of Unopened Insulin vials is correct?
A. Store in the freezer to extend shelf life.
B. Store at room temperature for up to 28 days only if opened.
C. Unopened vials should be refrigerated between 2-8°C (36-46°F).
D. Keep vials in a warm, humid environment.
C. C. Unopened vials should be refrigerated between 2-8°C (36-46°F). [CONRRECT]
Correct Answer: C
Rationale: Unopened insulin vials should be stored in the refrigerator to maintain potency until
the expiration date. Freezing destroys the protein structure.
,2
Q3. A patient with Type 1 diabetes has a blood glucose of 55 mg/dL and is unconscious. What is
the first action?
A. Give 4 oz of orange juice and a sandwich.
B. Administer 1 mg of Glucagon IM.
C. Administer 50% Dextrose IV bolus.
D. Wait 15 minutes and recheck glucose.
C. B. Administer 1 mg of Glucagon IM. [CORRECT]
Correct Answer: B
Rationale: If a patient with diabetes is unconscious, oral carbohydrates are contraindicated due to
aspiration risk. Glucagon IM is the appropriate rescue medication for severe hypoglycemia with
altered mental status.
Q4: A patient with Type 2 diabetes is starting Metformin. The nurse teaches the patient about the
potential for Lactic Acidosis. Which patient condition increases this risk?
A. Hypertension.
B. Renal impairment (eGFR <30 mL/min).
C. Asthma.
D. Hyperlipidemia.
C: B. Renal impairment (eGFR <30 mL/min). [CORRECT]
Correct Answer: B
Rationale: Metformin is contraindicated in severe renal impairment (eGFR <30 mL/min) because
the drug accumulates, increasing the risk of lactic acidosis.
5. A patient is prescribed Glipizide (Sulfonylurea). The nurse explains that this medication works
by:
A. Increasing insulin sensitivity in the liver.
B. Blocking the reabsorption of glucose in the kidneys.
C. Stimulating the pancreas to release insulin.
D. Decreasing hepatic glucose production.
, 3
C: C. Stimulating the pancreas to release insulin. [CORRECT]
Correct Answer: C
Rationale: Sulfonylureas bind to the SUR1 receptor on pancreatic beta cells, causing
depolarization and release of insulin.
Q6: A patient taking SGLT2 inhibitors (e.g., Empagliflozin) reports abdominal pain and nausea.
The nurse should be concerned about:
A. Hypoglycemia.
B. Eosinophilic Esophagitis.
C. Ketoacidosis with normal glucose.
D. Hyperkalemia.
C: C. Ketoacidosis with normal glucose. [Correct]
Correct Answer: C
Rationale: SGLT2 inhibitors can lead to Euglycemic Diabetic Ketoacidosis (euDKA), where the
patient has ketosis/acidosis but blood glucose is normal or only mildly elevated. This can be life-
threatening.
Q7. A patient is prescribed a GLP-1 agonist (e.g., Liraglutide). Which injection site is preferred?
A. Abdomen (2 inches from umbilicus).
B. Deltoid.
C. Vastus lateralis.
D. Dorsogluteal.
C: A. Abdomen (2 inches from umbilicus). [CORRECT]
Correct Answer: A
Rationale: The abdomen provides the most consistent absorption rate for injectable GLP-1
agonists. It should be injected into the anterior abdominal wall, avoiding the 2-inch radius around
the navel.
