NCLEX RN Endocrine Medications
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with type 1 diabetes mellitus is prescribed insulin lispro. When
should the nurse administer this medication?
A. 1 hour before meals
B. At bedtime
C. Within 15 minutes before a meal
D. 2 hours after a meal
Answer: Within 15 minutes before a meal
Rationale: Insulin lispro is a rapid-acting insulin. It begins working quickly and
is generally administered shortly before meals to control the rise in blood
glucose after eating.
2. Which insulin has the longest duration of action?
A. Regular insulin
B. NPH insulin
C. Insulin lispro
D. Insulin glargine
Answer: Insulin glargine
Rationale: Insulin glargine is a long-acting basal insulin that provides
relatively steady insulin activity over approximately 24 hours and has no
pronounced peak.
3. The nurse is teaching a client about insulin glargine. Which statement
indicates correct understanding?
,A. “I can mix it with regular insulin in the same syringe.”
B. “I should take it only when my blood glucose is elevated.”
C. “I should not mix this insulin with other insulins.”
D. “I should expect a pronounced peak about 2 hours after administration.”
Answer: I should not mix this insulin with other insulins.
Rationale: Insulin glargine should not be mixed with other insulin
preparations because mixing can alter its pharmacokinetic properties.
4. A client receiving regular insulin becomes shaky, diaphoretic, and
confused. What should the nurse suspect?
A. Hyperkalemia
B. Hyperglycemia
C. Diabetic ketoacidosis
D. Hypoglycemia
Answer: Hypoglycemia
Rationale: Tremors, sweating, confusion, tachycardia, and hunger are
common manifestations of hypoglycemia and require prompt treatment.
5. Which medication is used to treat severe hypoglycemia in an
unconscious client?
A. Metformin
B. Regular insulin
C. Glucagon
D. Pioglitazone
Answer: Glucagon
Rationale: Glucagon raises blood glucose by stimulating hepatic glycogen
breakdown. It can be administered when a client with severe hypoglycemia
cannot safely take oral glucose.
6. Which instruction is most important for a client taking metformin?
A. Take the medication on an empty stomach.
B. Take it with meals to reduce gastrointestinal adverse effects.
,C. Avoid all carbohydrates.
D. Stop taking it whenever blood glucose improves.
Answer: Take it with meals to reduce gastrointestinal adverse effects.
Rationale: Metformin commonly causes gastrointestinal effects such as
nausea and diarrhea. Taking it with meals improves tolerance.
7. Which serious adverse effect is associated with metformin?
A. Severe hypokalemia
B. Agranulocytosis
C. Lactic acidosis
D. Pulmonary fibrosis
Answer: Lactic acidosis
Rationale: Although uncommon, metformin-associated lactic acidosis is a
serious potential complication, particularly in clients with significant renal
impairment or other conditions that increase lactate accumulation.
8. Before administering metformin, which laboratory value is especially
important for the nurse to assess?
A. Serum calcium
B. Hemoglobin
C. Renal function
D. Serum amylase
Answer: Renal function
Rationale: Metformin is primarily eliminated by the kidneys. Renal
impairment increases the risk of drug accumulation and lactic acidosis.
9. A client taking a sulfonylurea should be taught to monitor for which
adverse effect?
A. Hypernatremia
B. Hypoglycemia
C. Hypercalcemia
D. Respiratory alkalosis
Answer: Hypoglycemia
, Rationale: Sulfonylureas stimulate pancreatic insulin secretion and can cause
hypoglycemia, especially when meals are skipped or intake is inadequate.
10.Which medication belongs to the sulfonylurea class?
A. Metformin
B. Sitagliptin
C. Glipizide
D. Empagliflozin
Answer: Glipizide
Rationale: Glipizide is a sulfonylurea that increases insulin secretion from
pancreatic beta cells.
11.A client taking glipizide reports sweating, tremors, and palpitations.
What is the nurse's priority action?
A. Administer the next dose of glipizide.
B. Encourage exercise.
C. Check the client's blood glucose level.
D. Restrict oral fluids.
Answer: Check the client's blood glucose level.
Rationale: These symptoms suggest hypoglycemia. The blood glucose level
should be assessed promptly so appropriate treatment can be initiated.
12.Which medication is an SGLT2 inhibitor?
A. Pioglitazone
B. Sitagliptin
C. Empagliflozin
D. Glyburide
Answer: Empagliflozin
Rationale: Empagliflozin is an SGLT2 inhibitor that lowers blood glucose by
reducing renal glucose reabsorption and increasing urinary glucose excretion.
13.Which adverse effect should the nurse monitor for in a client taking an
SGLT2 inhibitor?
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client with type 1 diabetes mellitus is prescribed insulin lispro. When
should the nurse administer this medication?
A. 1 hour before meals
B. At bedtime
C. Within 15 minutes before a meal
D. 2 hours after a meal
Answer: Within 15 minutes before a meal
Rationale: Insulin lispro is a rapid-acting insulin. It begins working quickly and
is generally administered shortly before meals to control the rise in blood
glucose after eating.
2. Which insulin has the longest duration of action?
A. Regular insulin
B. NPH insulin
C. Insulin lispro
D. Insulin glargine
Answer: Insulin glargine
Rationale: Insulin glargine is a long-acting basal insulin that provides
relatively steady insulin activity over approximately 24 hours and has no
pronounced peak.
3. The nurse is teaching a client about insulin glargine. Which statement
indicates correct understanding?
,A. “I can mix it with regular insulin in the same syringe.”
B. “I should take it only when my blood glucose is elevated.”
C. “I should not mix this insulin with other insulins.”
D. “I should expect a pronounced peak about 2 hours after administration.”
Answer: I should not mix this insulin with other insulins.
Rationale: Insulin glargine should not be mixed with other insulin
preparations because mixing can alter its pharmacokinetic properties.
4. A client receiving regular insulin becomes shaky, diaphoretic, and
confused. What should the nurse suspect?
A. Hyperkalemia
B. Hyperglycemia
C. Diabetic ketoacidosis
D. Hypoglycemia
Answer: Hypoglycemia
Rationale: Tremors, sweating, confusion, tachycardia, and hunger are
common manifestations of hypoglycemia and require prompt treatment.
5. Which medication is used to treat severe hypoglycemia in an
unconscious client?
A. Metformin
B. Regular insulin
C. Glucagon
D. Pioglitazone
Answer: Glucagon
Rationale: Glucagon raises blood glucose by stimulating hepatic glycogen
breakdown. It can be administered when a client with severe hypoglycemia
cannot safely take oral glucose.
6. Which instruction is most important for a client taking metformin?
A. Take the medication on an empty stomach.
B. Take it with meals to reduce gastrointestinal adverse effects.
,C. Avoid all carbohydrates.
D. Stop taking it whenever blood glucose improves.
Answer: Take it with meals to reduce gastrointestinal adverse effects.
Rationale: Metformin commonly causes gastrointestinal effects such as
nausea and diarrhea. Taking it with meals improves tolerance.
7. Which serious adverse effect is associated with metformin?
A. Severe hypokalemia
B. Agranulocytosis
C. Lactic acidosis
D. Pulmonary fibrosis
Answer: Lactic acidosis
Rationale: Although uncommon, metformin-associated lactic acidosis is a
serious potential complication, particularly in clients with significant renal
impairment or other conditions that increase lactate accumulation.
8. Before administering metformin, which laboratory value is especially
important for the nurse to assess?
A. Serum calcium
B. Hemoglobin
C. Renal function
D. Serum amylase
Answer: Renal function
Rationale: Metformin is primarily eliminated by the kidneys. Renal
impairment increases the risk of drug accumulation and lactic acidosis.
9. A client taking a sulfonylurea should be taught to monitor for which
adverse effect?
A. Hypernatremia
B. Hypoglycemia
C. Hypercalcemia
D. Respiratory alkalosis
Answer: Hypoglycemia
, Rationale: Sulfonylureas stimulate pancreatic insulin secretion and can cause
hypoglycemia, especially when meals are skipped or intake is inadequate.
10.Which medication belongs to the sulfonylurea class?
A. Metformin
B. Sitagliptin
C. Glipizide
D. Empagliflozin
Answer: Glipizide
Rationale: Glipizide is a sulfonylurea that increases insulin secretion from
pancreatic beta cells.
11.A client taking glipizide reports sweating, tremors, and palpitations.
What is the nurse's priority action?
A. Administer the next dose of glipizide.
B. Encourage exercise.
C. Check the client's blood glucose level.
D. Restrict oral fluids.
Answer: Check the client's blood glucose level.
Rationale: These symptoms suggest hypoglycemia. The blood glucose level
should be assessed promptly so appropriate treatment can be initiated.
12.Which medication is an SGLT2 inhibitor?
A. Pioglitazone
B. Sitagliptin
C. Empagliflozin
D. Glyburide
Answer: Empagliflozin
Rationale: Empagliflozin is an SGLT2 inhibitor that lowers blood glucose by
reducing renal glucose reabsorption and increasing urinary glucose excretion.
13.Which adverse effect should the nurse monitor for in a client taking an
SGLT2 inhibitor?
