NCLEX-RN Pharmacology Exam Questions
& Rationales |
Endocrine System Practice Test |
20 Original NCLEX Next Gen (NGN) MCQs |
Nursing Exam Prep Study Guide
Question 1
Clinical Scenario
A 56-year-old woman with newly diagnosed type 2 diabetes
mellitus is prescribed metformin. Her medical history
includes hypertension and obesity. Laboratory results
reveal: serum creatinine 0.9 mg/dL, estimated glomerular
filtration rate (eGFR) 72 mL/min/1.73 m², and hemoglobin
A1C 8.7%. She asks the nurse how to take the medication to
minimize side effects.
Question Stem
Which instruction should the nurse provide?
,A. Take the medication on an empty stomach first thing every
morning.
B. Take the medication with meals to reduce gastrointestinal
discomfort.
C. Stop taking the medication if mild diarrhea occurs after
the first dose.
D. Increase dietary sugar intake if appetite decreases.
Correct Answer
B. Take the medication with meals to reduce
gastrointestinal discomfort.
Detailed Rationale
Metformin is the recommended first-line medication for
many adults with type 2 diabetes because it primarily
decreases hepatic glucose production and improves insulin
sensitivity without usually causing hypoglycemia when used
alone. The most common adverse effects are
gastrointestinal, including nausea, abdominal discomfort,
and diarrhea. Taking the medication with meals or
immediately after eating significantly reduces these effects
and improves adherence.
Option A is incorrect because taking metformin on an empty
stomach often worsens gastrointestinal irritation. Option C
is incorrect because mild gastrointestinal effects are
,common during initiation and frequently improve over
several days or weeks. Patients should not discontinue
therapy without consulting their healthcare provider unless
severe symptoms occur. Option D is incorrect because
decreased appetite does not require increased sugar intake.
Instead, patients should maintain a balanced diabetic diet
and monitor blood glucose as directed.
Nurses should also educate patients about rare but serious
lactic acidosis, emphasize informing providers before
iodinated contrast procedures, encourage routine renal
function monitoring, and reinforce lifestyle modifications
including nutrition, exercise, and weight management to
optimize glycemic control.
Learning Objectives
After completing this question, the learner should be able
to:
• Explain the mechanism and therapeutic role of
metformin.
• Teach patients strategies to minimize common adverse
effects.
• Identify appropriate nursing education regarding
medication administration.
, • Recognize the importance of renal function monitoring
during metformin therapy.
Medication Safety Focus
Patient Education
Question 2
Clinical Scenario
A 29-year-old woman with type 1 diabetes mellitus is
admitted with nausea after viral gastroenteritis. She receives
insulin glargine every evening and rapid-acting insulin
before meals. She states, "I haven't been eating, so I skipped
all my insulin today." Her blood glucose is 314 mg/dL, heart
rate is 112 beats/min, and urine ketones are positive.
Question Stem
Which nursing response is most appropriate?
A. Continue withholding all insulin until the client resumes
normal meals.
B. Explain that basal insulin should usually be continued
even during illness unless otherwise instructed.
C. Recommend doubling the next rapid-acting insulin dose.
D. Advise stopping insulin whenever nausea develops.
& Rationales |
Endocrine System Practice Test |
20 Original NCLEX Next Gen (NGN) MCQs |
Nursing Exam Prep Study Guide
Question 1
Clinical Scenario
A 56-year-old woman with newly diagnosed type 2 diabetes
mellitus is prescribed metformin. Her medical history
includes hypertension and obesity. Laboratory results
reveal: serum creatinine 0.9 mg/dL, estimated glomerular
filtration rate (eGFR) 72 mL/min/1.73 m², and hemoglobin
A1C 8.7%. She asks the nurse how to take the medication to
minimize side effects.
Question Stem
Which instruction should the nurse provide?
,A. Take the medication on an empty stomach first thing every
morning.
B. Take the medication with meals to reduce gastrointestinal
discomfort.
C. Stop taking the medication if mild diarrhea occurs after
the first dose.
D. Increase dietary sugar intake if appetite decreases.
Correct Answer
B. Take the medication with meals to reduce
gastrointestinal discomfort.
Detailed Rationale
Metformin is the recommended first-line medication for
many adults with type 2 diabetes because it primarily
decreases hepatic glucose production and improves insulin
sensitivity without usually causing hypoglycemia when used
alone. The most common adverse effects are
gastrointestinal, including nausea, abdominal discomfort,
and diarrhea. Taking the medication with meals or
immediately after eating significantly reduces these effects
and improves adherence.
Option A is incorrect because taking metformin on an empty
stomach often worsens gastrointestinal irritation. Option C
is incorrect because mild gastrointestinal effects are
,common during initiation and frequently improve over
several days or weeks. Patients should not discontinue
therapy without consulting their healthcare provider unless
severe symptoms occur. Option D is incorrect because
decreased appetite does not require increased sugar intake.
Instead, patients should maintain a balanced diabetic diet
and monitor blood glucose as directed.
Nurses should also educate patients about rare but serious
lactic acidosis, emphasize informing providers before
iodinated contrast procedures, encourage routine renal
function monitoring, and reinforce lifestyle modifications
including nutrition, exercise, and weight management to
optimize glycemic control.
Learning Objectives
After completing this question, the learner should be able
to:
• Explain the mechanism and therapeutic role of
metformin.
• Teach patients strategies to minimize common adverse
effects.
• Identify appropriate nursing education regarding
medication administration.
, • Recognize the importance of renal function monitoring
during metformin therapy.
Medication Safety Focus
Patient Education
Question 2
Clinical Scenario
A 29-year-old woman with type 1 diabetes mellitus is
admitted with nausea after viral gastroenteritis. She receives
insulin glargine every evening and rapid-acting insulin
before meals. She states, "I haven't been eating, so I skipped
all my insulin today." Her blood glucose is 314 mg/dL, heart
rate is 112 beats/min, and urine ketones are positive.
Question Stem
Which nursing response is most appropriate?
A. Continue withholding all insulin until the client resumes
normal meals.
B. Explain that basal insulin should usually be continued
even during illness unless otherwise instructed.
C. Recommend doubling the next rapid-acting insulin dose.
D. Advise stopping insulin whenever nausea develops.
