FNP652/FNP6552 FAMILY PRIMARY CARE I
MIDTERM EXAM: (LATEST 2026/ 2027
UPDATE), WITH CORRECT/ACCURATE
ANSWERS
AT (GCU) GRAND CANYON UNIVERSITY
FNP6552 FAMILY PRIMARY CARE I
Part 1 (Questions 1–25)
Question 1
What is pioglitazone?
A. Insulin secretagogue
B. Thiazolidinedione – insulin sensitizer
C. DPP-4 inhibitor
D. GLP-1 agonist
Answer: B. Thiazolidinedione – insulin sensitizer
Rationale: Pioglitazone (Actos) is a thiazolidinedione that improves insulin sensitivity in peripheral tissues,
helping reduce blood glucose in T2DM. It does not stimulate insulin secretion.
Question 2
Which is NOT a symptom of Type 1 Diabetes Mellitus?
A. Polyuria
B. Polydipsia
C. Unintended weight loss
D. Recent, unintended weight gain
Answer: D. Recent, unintended weight gain
Rationale: Type 1 DM typically presents with weight loss due to insulin deficiency. Weight gain is not
characteristic of T1DM onset.
,Question 3
What lab should be measured before starting thiazolidinediones?
A. Creatinine
B. ALT
C. Hemoglobin
D. TSH
Answer: B. ALT
Rationale: Thiazolidinediones (pioglitazone, rosiglitazone) can cause hepatotoxicity. Liver function tests,
including ALT, must be monitored.
Question 4
What does a hemoglobin A1C measure?
A. Fasting glucose
B. Postprandial glucose
C. Average blood glucose over 90–120 days
D. Insulin levels
Answer: C. Average blood glucose over 90–120 days
Rationale: Hemoglobin A1C reflects long-term glycemic control and is a key diagnostic and monitoring tool
for diabetes management.
Question 5
Which test should be ordered for a patient presenting with acanthosis nigricans?
A. Lipid panel
B. Fasting blood sugar (FBS)
C. Liver function test
D. Thyroid panel
Answer: B. Fasting blood sugar (FBS)
Rationale: Acanthosis nigricans is often a marker of insulin resistance. FBS helps screen for T2DM.
Question 6
,Which drug should be avoided in diabetic patients with gastroparesis?
A. Metformin
B. Liraglutide (Victoza)
C. Glipizide
D. Pioglitazone
Answer: B. Liraglutide (Victoza)
Rationale: GLP-1 agonists (like liraglutide) slow gastric emptying, which can exacerbate gastroparesis
symptoms.
Question 7
What percentage of total daily insulin is released as basal insulin?
A. 10–20%
B. 30–40%
C. 50–60%
D. 80–90%
Answer: C. 50–60%
Rationale: Basal insulin provides background insulin to maintain glucose levels between meals and
overnight, constituting roughly 50–60% of total daily insulin secretion.
Question 8
Which diabetes drug class has been associated with pancreatitis?
A. Sulfonylureas
B. GLP-1 agonists
C. Thiazolidinediones
D. Metformin
Answer: B. GLP-1 agonists
Rationale: GLP-1 receptor agonists (semaglutide, liraglutide, dulaglutide) carry a risk of pancreatitis and
require monitoring for abdominal pain and elevated enzymes.
Question 9
What is a cardiovascular effect of hyperinsulinemia?
A. Increased angiotensin II responsiveness
B. Bradycardia
, C. Hypotension
D. Decreased aldosterone
Answer: A. Increased angiotensin II responsiveness
Rationale: Hyperinsulinemia increases vascular responsiveness to angiotensin II, contributing to
hypertension and cardiovascular risk.
Question 10
Which insulin type is primarily used for postprandial glucose control?
A. Basal insulin
B. Rapid-acting insulin
C. Intermediate-acting insulin
D. Long-acting insulin
Answer: B. Rapid-acting insulin
Rationale: Rapid-acting insulins (lispro, aspart, glulisine) are administered at mealtime to control
postprandial glucose excursions.
Question 11
Which symptom is most common in hyperglycemia?
A. Polyuria
B. Bradycardia
C. Hypothermia
D. Weight gain
Answer: A. Polyuria
Rationale: Hyperglycemia leads to osmotic diuresis, causing increased urine output, thirst, and dehydration.
Question 12
Which oral diabetes medication is associated with risk of lactic acidosis?
A. Metformin
B. Pioglitazone
C. Glipizide
D. Sitagliptin
Answer: A. Metformin
MIDTERM EXAM: (LATEST 2026/ 2027
UPDATE), WITH CORRECT/ACCURATE
ANSWERS
AT (GCU) GRAND CANYON UNIVERSITY
FNP6552 FAMILY PRIMARY CARE I
Part 1 (Questions 1–25)
Question 1
What is pioglitazone?
A. Insulin secretagogue
B. Thiazolidinedione – insulin sensitizer
C. DPP-4 inhibitor
D. GLP-1 agonist
Answer: B. Thiazolidinedione – insulin sensitizer
Rationale: Pioglitazone (Actos) is a thiazolidinedione that improves insulin sensitivity in peripheral tissues,
helping reduce blood glucose in T2DM. It does not stimulate insulin secretion.
Question 2
Which is NOT a symptom of Type 1 Diabetes Mellitus?
A. Polyuria
B. Polydipsia
C. Unintended weight loss
D. Recent, unintended weight gain
Answer: D. Recent, unintended weight gain
Rationale: Type 1 DM typically presents with weight loss due to insulin deficiency. Weight gain is not
characteristic of T1DM onset.
,Question 3
What lab should be measured before starting thiazolidinediones?
A. Creatinine
B. ALT
C. Hemoglobin
D. TSH
Answer: B. ALT
Rationale: Thiazolidinediones (pioglitazone, rosiglitazone) can cause hepatotoxicity. Liver function tests,
including ALT, must be monitored.
Question 4
What does a hemoglobin A1C measure?
A. Fasting glucose
B. Postprandial glucose
C. Average blood glucose over 90–120 days
D. Insulin levels
Answer: C. Average blood glucose over 90–120 days
Rationale: Hemoglobin A1C reflects long-term glycemic control and is a key diagnostic and monitoring tool
for diabetes management.
Question 5
Which test should be ordered for a patient presenting with acanthosis nigricans?
A. Lipid panel
B. Fasting blood sugar (FBS)
C. Liver function test
D. Thyroid panel
Answer: B. Fasting blood sugar (FBS)
Rationale: Acanthosis nigricans is often a marker of insulin resistance. FBS helps screen for T2DM.
Question 6
,Which drug should be avoided in diabetic patients with gastroparesis?
A. Metformin
B. Liraglutide (Victoza)
C. Glipizide
D. Pioglitazone
Answer: B. Liraglutide (Victoza)
Rationale: GLP-1 agonists (like liraglutide) slow gastric emptying, which can exacerbate gastroparesis
symptoms.
Question 7
What percentage of total daily insulin is released as basal insulin?
A. 10–20%
B. 30–40%
C. 50–60%
D. 80–90%
Answer: C. 50–60%
Rationale: Basal insulin provides background insulin to maintain glucose levels between meals and
overnight, constituting roughly 50–60% of total daily insulin secretion.
Question 8
Which diabetes drug class has been associated with pancreatitis?
A. Sulfonylureas
B. GLP-1 agonists
C. Thiazolidinediones
D. Metformin
Answer: B. GLP-1 agonists
Rationale: GLP-1 receptor agonists (semaglutide, liraglutide, dulaglutide) carry a risk of pancreatitis and
require monitoring for abdominal pain and elevated enzymes.
Question 9
What is a cardiovascular effect of hyperinsulinemia?
A. Increased angiotensin II responsiveness
B. Bradycardia
, C. Hypotension
D. Decreased aldosterone
Answer: A. Increased angiotensin II responsiveness
Rationale: Hyperinsulinemia increases vascular responsiveness to angiotensin II, contributing to
hypertension and cardiovascular risk.
Question 10
Which insulin type is primarily used for postprandial glucose control?
A. Basal insulin
B. Rapid-acting insulin
C. Intermediate-acting insulin
D. Long-acting insulin
Answer: B. Rapid-acting insulin
Rationale: Rapid-acting insulins (lispro, aspart, glulisine) are administered at mealtime to control
postprandial glucose excursions.
Question 11
Which symptom is most common in hyperglycemia?
A. Polyuria
B. Bradycardia
C. Hypothermia
D. Weight gain
Answer: A. Polyuria
Rationale: Hyperglycemia leads to osmotic diuresis, causing increased urine output, thirst, and dehydration.
Question 12
Which oral diabetes medication is associated with risk of lactic acidosis?
A. Metformin
B. Pioglitazone
C. Glipizide
D. Sitagliptin
Answer: A. Metformin
