NURS 615 CERTIFICATION PAPER 2026
FULL SOLUTION GRADED A+
● What is the medication of choice for hypertensive crisis with
pheochromocytoma? Answer: Surgical resection of the tumor is the first
treatment of choice either my open laparotomy or laparoscopy either
surgical option requires prior treatment of nonspecific irreversible
adrenergic adraonoreceptor blocker phenoxybenzamine or a shorter
acting alpha antagonists, prazosin, terazosin, and doxazosin. Mainly use
phenozibenamine in practice. Doing so promotes the surgery to proceed
while minimizing the likelihood of severe intraoperative hypertension
which is likely when the tumor is manipulated.
● What is the onset of action, peak of action, and duration of action of
each insulin preparation? Answer: (Intermediate Acting) NPH
Onset-60-90 min after administration,
Peak 48 hrs
Duration 10-18 hrs.
(Short Acting) Regular Onset 30-60 min
Peak 2-4 hrs
Duration 6-10 hrs
(Long Acting) Aspart, Lispro, Glulisine
,Onset less than 15 min
Peak 1-2 hrs
Duration 3-6 hrs
(Long Acting) Glargine, Detemir
Onset 1-2 hrs
Peak NO PEAK
Duration 24 hrs
● Identify the symptoms of hypoglycemia, hyperglycemia, and
ketoacidosis. Answer: Hypoglycemia- dizziness, confusion, diaphoresis,
tachycardia
Hyperglycemia- polyphagia, polydipsia, polyuria, blurred vision, and
fatigue
Ketoacidosis- hallmark symptoms include acetone breath like nail polish
remover or fruity breath. Also abdominal pain, nausea, vomiting and
sob.
● When changing from NPH to glargine insulin, how will you adjust the
patient's dose? Answer: The initial dose of glargine is reduced by 20% to
prevent hypoglycemia.
● How does metformin work? Answer: Decreases hyperglycemia by
decreasing hepatic glucose production called hepatic gluconeogenesis.
, The average person with type 2 diabetes has three times the rate of
gluconeogenesis, metformin treatment reduces this by over 1/3rd. The
molecular mechanism of metformin isn't completely understood. In
addition to suppressing hepatic glucose production, metformin increases
insulin sensitivity, enhances peripheral glucose uptake by inducing the
phosphorilization of glu4 enhancer factor, decreases insulin induced
suppression of fatty acid oxidation, and decreases absorption of glucose
from the GI tract. Also of note** Metformin helps reduce LDL
cholesterol and triglyceride levels and is not associated with weight gain,
in some people it helps promote weight loss**
● What diagnostic testing is required before and throughout therapy with
metformin? Answer: Metformin is not metabolized, it is cleared from the
body by tubular secretion and is secreted unchanged in the urine.
Metformin is undetectable in blood plasma within 24 hrs of a single oral
dose the average elimination half-life in plasma is 6.2 hrs as it is
secreted in the urine you should check a serum crt to assess renal
function.
● What is the action of gliptin? Answer: The mechanism of DDP-4
inhibitors is to increase incretin levels incretin are GLP1 and GIP which
inhibit glucagon release in which in turn increases insulin secretion,
decreases gastric emptying, and decreases blood glucose levels
● How do GLP agonists work? Answer: They bind directly to a receptor
in the pancreatic beta cell. These agents work in the same pathway as the
DPP-4 inhibitors as mentioned above but are generally considered more
potent.
FULL SOLUTION GRADED A+
● What is the medication of choice for hypertensive crisis with
pheochromocytoma? Answer: Surgical resection of the tumor is the first
treatment of choice either my open laparotomy or laparoscopy either
surgical option requires prior treatment of nonspecific irreversible
adrenergic adraonoreceptor blocker phenoxybenzamine or a shorter
acting alpha antagonists, prazosin, terazosin, and doxazosin. Mainly use
phenozibenamine in practice. Doing so promotes the surgery to proceed
while minimizing the likelihood of severe intraoperative hypertension
which is likely when the tumor is manipulated.
● What is the onset of action, peak of action, and duration of action of
each insulin preparation? Answer: (Intermediate Acting) NPH
Onset-60-90 min after administration,
Peak 48 hrs
Duration 10-18 hrs.
(Short Acting) Regular Onset 30-60 min
Peak 2-4 hrs
Duration 6-10 hrs
(Long Acting) Aspart, Lispro, Glulisine
,Onset less than 15 min
Peak 1-2 hrs
Duration 3-6 hrs
(Long Acting) Glargine, Detemir
Onset 1-2 hrs
Peak NO PEAK
Duration 24 hrs
● Identify the symptoms of hypoglycemia, hyperglycemia, and
ketoacidosis. Answer: Hypoglycemia- dizziness, confusion, diaphoresis,
tachycardia
Hyperglycemia- polyphagia, polydipsia, polyuria, blurred vision, and
fatigue
Ketoacidosis- hallmark symptoms include acetone breath like nail polish
remover or fruity breath. Also abdominal pain, nausea, vomiting and
sob.
● When changing from NPH to glargine insulin, how will you adjust the
patient's dose? Answer: The initial dose of glargine is reduced by 20% to
prevent hypoglycemia.
● How does metformin work? Answer: Decreases hyperglycemia by
decreasing hepatic glucose production called hepatic gluconeogenesis.
, The average person with type 2 diabetes has three times the rate of
gluconeogenesis, metformin treatment reduces this by over 1/3rd. The
molecular mechanism of metformin isn't completely understood. In
addition to suppressing hepatic glucose production, metformin increases
insulin sensitivity, enhances peripheral glucose uptake by inducing the
phosphorilization of glu4 enhancer factor, decreases insulin induced
suppression of fatty acid oxidation, and decreases absorption of glucose
from the GI tract. Also of note** Metformin helps reduce LDL
cholesterol and triglyceride levels and is not associated with weight gain,
in some people it helps promote weight loss**
● What diagnostic testing is required before and throughout therapy with
metformin? Answer: Metformin is not metabolized, it is cleared from the
body by tubular secretion and is secreted unchanged in the urine.
Metformin is undetectable in blood plasma within 24 hrs of a single oral
dose the average elimination half-life in plasma is 6.2 hrs as it is
secreted in the urine you should check a serum crt to assess renal
function.
● What is the action of gliptin? Answer: The mechanism of DDP-4
inhibitors is to increase incretin levels incretin are GLP1 and GIP which
inhibit glucagon release in which in turn increases insulin secretion,
decreases gastric emptying, and decreases blood glucose levels
● How do GLP agonists work? Answer: They bind directly to a receptor
in the pancreatic beta cell. These agents work in the same pathway as the
DPP-4 inhibitors as mentioned above but are generally considered more
potent.
