NUR 378 Exam 4 V2 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 4) |
Concordia
1. A nurse is preparing to administer insulin aspart to a patient with Type 1 diabetes. When
should the nurse instruct the patient to eat their meal?
A. 5 to 15 minutes after administration
B. Immediately before administration
C. 30 to 60 minutes after administration
D. At least 2 hours after administration
Correct Answer: A
Insulin aspart is a rapid-acting insulin with an onset of 10 to 20 minutes. Therefore, the
patient should consume food within 5 to 15 minutes of administration to prevent
hypoglycemia. Administering the dose too early or too late relative to mealtime increases
the risk of unstable blood glucose levels.
2. Which of the following instructions is most important for a patient newly prescribed insulin
glargine?
A. Mix the glargine in the same syringe with NPH to reduce the number of injections.
B. Expect a cloudy appearance in the vial before drawing up the medication.
,C. Check for a peak in action approximately 4 hours after administration.
D. Administer the dose at the same time every day to maintain a steady state.
Correct Answer: D
Insulin glargine is a long-acting insulin that provides a basal level of insulin over 24 hours
without a significant peak. It must never be mixed with any other insulin in the same
syringe because the low pH can cause precipitation. Consistent timing of administration is
crucial for maintaining stable glycemic control throughout the day.
3. A patient is prescribed NPH insulin twice daily. The nurse understands that this insulin is
categorized as:
A. Rapid-acting
B. Intermediate-acting
C. Short-acting
D. Long-acting
Correct Answer: B
NPH is an intermediate-acting insulin that typically has an onset of 1 to 2 hours and a peak
of 4 to 12 hours. It is characterized by its cloudy appearance and is often used to provide
coverage for half the day or overnight. Nurses must ensure the suspension is gently rotated
to mix the crystals before administration.
, 4. When teaching a patient about metformin, which potential side effect requires immediate
notification of the healthcare provider?
A. Mild abdominal cramping
B. Metallic taste in the mouth
C. Occasional diarrhea
D. Muscle pain and hyperventilation
Correct Answer: D
Metformin carries a black box warning for lactic acidosis, a rare but life-threatening
complication. Symptoms of lactic acidosis include malaise, myalgia, respiratory distress,
and abdominal pain. While GI upset is common when starting metformin, muscle pain
combined with rapid breathing suggests a serious metabolic shift.
5. A nurse is reviewing the chart of a patient scheduled for an IV contrast study. Which
conditions would represent a contraindication or a reason to temporarily hold Metformin?
(Select all that apply)
A. A, B, C, and E
B. Planned abdominal CT with iodinated contrast
C. Active binge drinking of alcohol
D. History of Type 2 Diabetes
E. Heart Failure requiring pharmacological management
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 4) |
Concordia
1. A nurse is preparing to administer insulin aspart to a patient with Type 1 diabetes. When
should the nurse instruct the patient to eat their meal?
A. 5 to 15 minutes after administration
B. Immediately before administration
C. 30 to 60 minutes after administration
D. At least 2 hours after administration
Correct Answer: A
Insulin aspart is a rapid-acting insulin with an onset of 10 to 20 minutes. Therefore, the
patient should consume food within 5 to 15 minutes of administration to prevent
hypoglycemia. Administering the dose too early or too late relative to mealtime increases
the risk of unstable blood glucose levels.
2. Which of the following instructions is most important for a patient newly prescribed insulin
glargine?
A. Mix the glargine in the same syringe with NPH to reduce the number of injections.
B. Expect a cloudy appearance in the vial before drawing up the medication.
,C. Check for a peak in action approximately 4 hours after administration.
D. Administer the dose at the same time every day to maintain a steady state.
Correct Answer: D
Insulin glargine is a long-acting insulin that provides a basal level of insulin over 24 hours
without a significant peak. It must never be mixed with any other insulin in the same
syringe because the low pH can cause precipitation. Consistent timing of administration is
crucial for maintaining stable glycemic control throughout the day.
3. A patient is prescribed NPH insulin twice daily. The nurse understands that this insulin is
categorized as:
A. Rapid-acting
B. Intermediate-acting
C. Short-acting
D. Long-acting
Correct Answer: B
NPH is an intermediate-acting insulin that typically has an onset of 1 to 2 hours and a peak
of 4 to 12 hours. It is characterized by its cloudy appearance and is often used to provide
coverage for half the day or overnight. Nurses must ensure the suspension is gently rotated
to mix the crystals before administration.
, 4. When teaching a patient about metformin, which potential side effect requires immediate
notification of the healthcare provider?
A. Mild abdominal cramping
B. Metallic taste in the mouth
C. Occasional diarrhea
D. Muscle pain and hyperventilation
Correct Answer: D
Metformin carries a black box warning for lactic acidosis, a rare but life-threatening
complication. Symptoms of lactic acidosis include malaise, myalgia, respiratory distress,
and abdominal pain. While GI upset is common when starting metformin, muscle pain
combined with rapid breathing suggests a serious metabolic shift.
5. A nurse is reviewing the chart of a patient scheduled for an IV contrast study. Which
conditions would represent a contraindication or a reason to temporarily hold Metformin?
(Select all that apply)
A. A, B, C, and E
B. Planned abdominal CT with iodinated contrast
C. Active binge drinking of alcohol
D. History of Type 2 Diabetes
E. Heart Failure requiring pharmacological management
