D441 Pharmacology: Endocrine Drugs Practice Pack 2026/2027 WGU
1. A patient is prescribed Insulin Lispro (Humalog). Which of the following is the
most appropriate time for the nurse to administer this medication?
A. 30 to 60 minutes before a meal
B. Only at bedtime with a snack
C. Immediately before or within 15 minutes of eating
D. Two hours after the patient has finished their meal
Answer: C
Rationale: Insulin Lispro is a rapid-acting insulin with an onset of 15 minutes; it should be
given immediately before or shortly after a meal to prevent hypoglycemia.
2. Which instruction should the nurse include when teaching a patient about
taking Levothyroxine for hypothyroidism?
A. Take the medication with a full meal to increase absorption
B. Take the medication on an empty stomach, 30-60 minutes before breakfast
C. Take the medication at night before bed with a glass of milk
D. Take the medication only when symptoms of fatigue are present
Answer: B
Rationale: Levothyroxine is best absorbed on an empty stomach and should be taken in
the morning to prevent insomnia and ensure consistent absorption.
,3. A patient on long-term Prednisone therapy is at risk for which of the
following electrolyte imbalances?
A. Hyperkalemia and hyponatremia
B. Hypercalcemia and hypernatremia
C. Hypocalcemia and hypomagnesemia
D. Hypokalemia and hypernatremia
Answer: D
Rationale: Glucocorticoids like Prednisone can cause sodium retention (hypernatremia)
and potassium excretion (hypokalemia).
4. A patient is scheduled for a CT scan with intravenous contrast. Which
medication must be held for 48 hours after the procedure?
A. Glyburide
B. Sitagliptin
C. Pioglitazone
D. Metformin
Answer: D
Rationale: Metformin must be held before and for 48 hours after contrast dye
administration to prevent the risk of lactic acidosis if renal impairment occurs.
5. Which of the following is a common side effect of Propylthiouracil (PTU) used
in the treatment of hyperthyroidism?
A. Weight loss and tachycardia
B. Hyperglycemia
C. Agranulocytosis
D. Peripheral edema
Answer: C
Rationale: Agranulocytosis (a severe drop in white blood cell count) is a rare but serious
side effect of antithyroid drugs like PTU; patients should report any signs of infection.
, 6. Which type of insulin should never be mixed with any other insulin in the
same syringe?
A. Insulin NPH
B. Insulin Glargine
C. Insulin Regular
D. Insulin Aspart
Answer: B
Rationale: Long-acting insulins like Glargine (Lantus) have a low pH and can precipitate if
mixed with other insulins; they must be given as a separate injection.
7. A patient is diagnosed with adrenal insufficiency (Addison’s disease). Which
medication is typically used for maintenance therapy?
A. Dexamethasone
B. Methimazole
C. Hydrocortisone
D. Glipizide
Answer: C
Rationale: Hydrocortisone is the drug of choice for Addison’s disease because it provides
both glucocorticoid and some mineralocorticoid activity to mimic natural cortisol.
8. When should a nurse expect the peak effect of NPH insulin to occur?
A. 1 to 2 hours after administration
B. 30 to 60 minutes after administration
C. 18 to 24 hours after administration
D. 4 to 12 hours after administration
Answer: D
Rationale: NPH is an intermediate-acting insulin with a peak effect occurring between 4
and 12 hours after subcutaneous injection.
1. A patient is prescribed Insulin Lispro (Humalog). Which of the following is the
most appropriate time for the nurse to administer this medication?
A. 30 to 60 minutes before a meal
B. Only at bedtime with a snack
C. Immediately before or within 15 minutes of eating
D. Two hours after the patient has finished their meal
Answer: C
Rationale: Insulin Lispro is a rapid-acting insulin with an onset of 15 minutes; it should be
given immediately before or shortly after a meal to prevent hypoglycemia.
2. Which instruction should the nurse include when teaching a patient about
taking Levothyroxine for hypothyroidism?
A. Take the medication with a full meal to increase absorption
B. Take the medication on an empty stomach, 30-60 minutes before breakfast
C. Take the medication at night before bed with a glass of milk
D. Take the medication only when symptoms of fatigue are present
Answer: B
Rationale: Levothyroxine is best absorbed on an empty stomach and should be taken in
the morning to prevent insomnia and ensure consistent absorption.
,3. A patient on long-term Prednisone therapy is at risk for which of the
following electrolyte imbalances?
A. Hyperkalemia and hyponatremia
B. Hypercalcemia and hypernatremia
C. Hypocalcemia and hypomagnesemia
D. Hypokalemia and hypernatremia
Answer: D
Rationale: Glucocorticoids like Prednisone can cause sodium retention (hypernatremia)
and potassium excretion (hypokalemia).
4. A patient is scheduled for a CT scan with intravenous contrast. Which
medication must be held for 48 hours after the procedure?
A. Glyburide
B. Sitagliptin
C. Pioglitazone
D. Metformin
Answer: D
Rationale: Metformin must be held before and for 48 hours after contrast dye
administration to prevent the risk of lactic acidosis if renal impairment occurs.
5. Which of the following is a common side effect of Propylthiouracil (PTU) used
in the treatment of hyperthyroidism?
A. Weight loss and tachycardia
B. Hyperglycemia
C. Agranulocytosis
D. Peripheral edema
Answer: C
Rationale: Agranulocytosis (a severe drop in white blood cell count) is a rare but serious
side effect of antithyroid drugs like PTU; patients should report any signs of infection.
, 6. Which type of insulin should never be mixed with any other insulin in the
same syringe?
A. Insulin NPH
B. Insulin Glargine
C. Insulin Regular
D. Insulin Aspart
Answer: B
Rationale: Long-acting insulins like Glargine (Lantus) have a low pH and can precipitate if
mixed with other insulins; they must be given as a separate injection.
7. A patient is diagnosed with adrenal insufficiency (Addison’s disease). Which
medication is typically used for maintenance therapy?
A. Dexamethasone
B. Methimazole
C. Hydrocortisone
D. Glipizide
Answer: C
Rationale: Hydrocortisone is the drug of choice for Addison’s disease because it provides
both glucocorticoid and some mineralocorticoid activity to mimic natural cortisol.
8. When should a nurse expect the peak effect of NPH insulin to occur?
A. 1 to 2 hours after administration
B. 30 to 60 minutes after administration
C. 18 to 24 hours after administration
D. 4 to 12 hours after administration
Answer: D
Rationale: NPH is an intermediate-acting insulin with a peak effect occurring between 4
and 12 hours after subcutaneous injection.
