NUR 2474 Pharmacology Exam 1: Modules 1-3:NUR2474 Exam 2:
Pharmacology for Professional Nursing Exam 2:NUR 2474
Pharmacology Final Exam:NUR 2474:NUR 2474 Package Deal
1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were
just admitted. Which patient should the nurse assess first?
a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin
insulin.
b. The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin)
c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache
d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) -
ANSWER:a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30
Novolin insulin.
*low/normal BGL and insulin will continue to drop glucose level. At risk for hypoglycemia.
2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and
are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which
formulation of insulin should the nurse prepare to administer?
a. No insulin should be administered.
b. NPH
c. 70/30 mix
d. Lispro (Humalog) - ANSWER:d. Lispro (Humalog)
*high blood sugar needs rapid acting insulin.
3. A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing
schedule for her. What is the recommended monitoring schedule?
a. Before each meal and before bed
b. In the morning for a fasting level and at 4 PM for the peak level
,c. Six or seven times a day
d. Three times a day, along with urine glucose testing - ANSWER:c. Six or seven times a day
*pregnancy can effect glucose levels. Frequent monitoring required.
4. An adolescent patient recently attended a health fair and had a serum glucose test. The patient
telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the
nurse's most accurate response?
a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes."
b. "At this level, you probably have diabetes. You will need an oral glucose tolerance test this week."
c. "This level is conclusive evidence that you have diabetes."
d. "This level is conclusive evidence that you do not have diabetes." - ANSWER:a. "Unless you were
fasting for longer than 8 hours, this does not necessarily mean you have diabetes."
*could be a normal level without fasting and does not mean diabetes unless it was high for a fasting
blood glucose level.
5. Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer
this drug?
a. Approximately 15 to 30 minutes before each meal
b. In the morning and at 4 PM
c. Once daily at bedtime
d. After meals and at bedtime - ANSWER:c. Once daily at bedtime
*goodnight glargine
6. A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is
the nurse concerned?
a. The beta blocker can cause insulin resistance.
b. Using the two agents together increases the risk of ketoacidosis.
c. Propranolol increases insulin requirements because of receptor blocking.
,d. The beta blocker can mask the symptoms of hypoglycemia. - ANSWER:d. The beta blocker can mask
the symptoms of hypoglycemia.
*beta blockers block adrenaline which signals the liver to release glucose in the blood when glucose is
low to avoid hypoglycemia.
7. Which statement is correct about the contrast between a carbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects. - ANSWER:a. Miglitol has not been associated with hepatic
dysfunction.
*key difference is that acarbose has been associated with rare cases of hepatic dysfunction
8. A nurse counsels a patient with diabetes who is starting therapy with an alpha- glucosidase inhibitor.
The patient should be educated about the potential for which adverse reactions? (Select all that apply.)
a. Hypoglycemia
b. Flatulence
c. Elevated iron levels in the blood
d. Fluid retention
e. Diarrhea - ANSWER:b. Flatulence
e. Diarrhea
*due to build up of gasses (flatulence) from to undigested carbohydrates reaching the colon and causing
an osmotic effect (diarrhea)
9. The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells
the nurse she does not want to take medications while she is pregnant. What will the nurse explain to
this patient?
a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
, b. Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c. No danger to the fetus exists until the third trimester.
d. Treatment is required only if the patient is experiencing symptoms. - ANSWER:b. Neuropsychologic
deficits in the fetus can occur if the condition is not treated.
*Thyroid hormones are crucial for the normal development of the fetal brain and nervous system and
must be treated in pregnancy.
10. A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine
(Synthroid). Which statement by the patient indicates a need for further teaching?
a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider." c. "If I take a
multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid." - ANSWER:d."If I take
calcium supplements, I may need to decrease my dose of Synthroid."
*this statement is incorrect since calcium interferes with the absorption of Synthroid, it may need to be
increased not decreased.
11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the
patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a temperature of
97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an
order for which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole) - ANSWER:c. Intravenous levothyroxine
*IV allows for a more rapid correction of thyroid hormone levels especially hypothyroidism with
symptoms of myxedema coma or severe hypothyroidism. This is considered a medical emergency.
12. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse learns
that the patient also takes warfarin (Coumadin). The nurse will notify the provider to discuss _____ the
_____ dose.
Pharmacology for Professional Nursing Exam 2:NUR 2474
Pharmacology Final Exam:NUR 2474:NUR 2474 Package Deal
1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were
just admitted. Which patient should the nurse assess first?
a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin
insulin.
b. The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin)
c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache
d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) -
ANSWER:a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30
Novolin insulin.
*low/normal BGL and insulin will continue to drop glucose level. At risk for hypoglycemia.
2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and
are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which
formulation of insulin should the nurse prepare to administer?
a. No insulin should be administered.
b. NPH
c. 70/30 mix
d. Lispro (Humalog) - ANSWER:d. Lispro (Humalog)
*high blood sugar needs rapid acting insulin.
3. A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing
schedule for her. What is the recommended monitoring schedule?
a. Before each meal and before bed
b. In the morning for a fasting level and at 4 PM for the peak level
,c. Six or seven times a day
d. Three times a day, along with urine glucose testing - ANSWER:c. Six or seven times a day
*pregnancy can effect glucose levels. Frequent monitoring required.
4. An adolescent patient recently attended a health fair and had a serum glucose test. The patient
telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the
nurse's most accurate response?
a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes."
b. "At this level, you probably have diabetes. You will need an oral glucose tolerance test this week."
c. "This level is conclusive evidence that you have diabetes."
d. "This level is conclusive evidence that you do not have diabetes." - ANSWER:a. "Unless you were
fasting for longer than 8 hours, this does not necessarily mean you have diabetes."
*could be a normal level without fasting and does not mean diabetes unless it was high for a fasting
blood glucose level.
5. Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer
this drug?
a. Approximately 15 to 30 minutes before each meal
b. In the morning and at 4 PM
c. Once daily at bedtime
d. After meals and at bedtime - ANSWER:c. Once daily at bedtime
*goodnight glargine
6. A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is
the nurse concerned?
a. The beta blocker can cause insulin resistance.
b. Using the two agents together increases the risk of ketoacidosis.
c. Propranolol increases insulin requirements because of receptor blocking.
,d. The beta blocker can mask the symptoms of hypoglycemia. - ANSWER:d. The beta blocker can mask
the symptoms of hypoglycemia.
*beta blockers block adrenaline which signals the liver to release glucose in the blood when glucose is
low to avoid hypoglycemia.
7. Which statement is correct about the contrast between a carbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects. - ANSWER:a. Miglitol has not been associated with hepatic
dysfunction.
*key difference is that acarbose has been associated with rare cases of hepatic dysfunction
8. A nurse counsels a patient with diabetes who is starting therapy with an alpha- glucosidase inhibitor.
The patient should be educated about the potential for which adverse reactions? (Select all that apply.)
a. Hypoglycemia
b. Flatulence
c. Elevated iron levels in the blood
d. Fluid retention
e. Diarrhea - ANSWER:b. Flatulence
e. Diarrhea
*due to build up of gasses (flatulence) from to undigested carbohydrates reaching the colon and causing
an osmotic effect (diarrhea)
9. The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells
the nurse she does not want to take medications while she is pregnant. What will the nurse explain to
this patient?
a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
, b. Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c. No danger to the fetus exists until the third trimester.
d. Treatment is required only if the patient is experiencing symptoms. - ANSWER:b. Neuropsychologic
deficits in the fetus can occur if the condition is not treated.
*Thyroid hormones are crucial for the normal development of the fetal brain and nervous system and
must be treated in pregnancy.
10. A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine
(Synthroid). Which statement by the patient indicates a need for further teaching?
a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider." c. "If I take a
multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid." - ANSWER:d."If I take
calcium supplements, I may need to decrease my dose of Synthroid."
*this statement is incorrect since calcium interferes with the absorption of Synthroid, it may need to be
increased not decreased.
11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the
patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a temperature of
97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an
order for which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole) - ANSWER:c. Intravenous levothyroxine
*IV allows for a more rapid correction of thyroid hormone levels especially hypothyroidism with
symptoms of myxedema coma or severe hypothyroidism. This is considered a medical emergency.
12. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse learns
that the patient also takes warfarin (Coumadin). The nurse will notify the provider to discuss _____ the
_____ dose.
