NR 565 / NR565 ADVANCED
PHARMACOLOGY FINAL EXAM REVIEW |
MORE THAN 100 QUESTIONS AND
ANSWERS| RATED A | LATEST, 2026|
CHAMBERLAIN
1. What is the expected onset of insulin glargine (U-100)?
A. Immediate
B. 15 minutes
C. 1–2 hours
D. 6–8 hours
Rationale:
Insulin glargine is a long-acting basal insulin designed to provide steady glucose
control over 24 hours. Its onset is approximately 1–2 hours, with no pronounced peak.
This reduces the risk of hypoglycemia compared to intermediate-acting insulins. It is
not intended for rapid correction of hyperglycemia.
2. How many minutes before a meal should insulin lispro (Humalog)
be administered?
A. Immediately after the meal
B. 30 minutes before the meal
C. 15 minutes before the meal
D. 60 minutes before the meal
,Rationale:
Insulin lispro is a rapid-acting insulin with an onset of 10–15 minutes. Administering it
shortly before meals mimics physiologic insulin release and helps control postprandial
glucose spikes. Giving it too early increases hypoglycemia risk, while delayed dosing
reduces efficacy.
3. When might insulin requirements increase?
A. Weight loss
B. Increased physical activity
C. Infection, pregnancy, steroid use
D. Improved glycemic control
Rationale:
Insulin requirements increase during periods of stress such as infection, pregnancy,
puberty, or corticosteroid therapy. These states increase insulin resistance and
hepatic glucose output. Failure to adjust insulin doses may result in hyperglycemia or
diabetic ketoacidosis.
4. Which factors may result in hypoglycemia?
A. Decreased insulin dose
B. Illness with fever
C. Increased exercise, vomiting, alcohol use
D. Increased carbohydrate intake
Rationale:
Hypoglycemia occurs when glucose utilization exceeds supply. Increased physical
activity, reduced food intake due to vomiting or diarrhea, and alcohol consumption can
all lower blood glucose levels. Alcohol inhibits gluconeogenesis, significantly
increasing hypoglycemia risk.
,5. Which symptoms should patients be taught to recognize as
hypoglycemia?
A. Polyuria and polydipsia
B. Warm, dry skin
C. Sweating, confusion, palpitations, shakiness
D. Kussmaul respirations
Rationale:
Hypoglycemia activates the sympathetic nervous system, causing sweating, tremors,
palpitations, and anxiety. Neuroglycopenic symptoms such as confusion and altered
mental status occur as glucose delivery to the brain decreases. Severe untreated
hypoglycemia can lead to seizures or coma.
6. Which medication class may mask the signs of hypoglycemia?
A. ACE inhibitors
B. Diuretics
C. Beta-blockers
D. Calcium channel blockers
Rationale:
Beta-blockers blunt adrenergic responses such as tachycardia and tremors, which are
early warning signs of hypoglycemia. Patients may not recognize low blood sugar until
neuroglycopenic symptoms occur. Extra caution and frequent glucose monitoring are
required.
, 7. A blood glucose level less than which value defines
hypoglycemia?
A. <90 mg/dL
B. <80 mg/dL
C. <70 mg/dL
D. <60 mg/dL
Rationale:
Hypoglycemia is clinically defined as a blood glucose level below 70 mg/dL. At this
threshold, counter-regulatory hormones are activated. Early recognition and treatment
are essential to prevent severe neurologic consequences.
8. What is the primary mechanism of action of metformin?
A. Stimulates insulin secretion
B. Delays carbohydrate absorption
C. Decreases hepatic glucose production and increases insulin sensitivity
D. Inhibits glucagon release
Rationale:
Metformin reduces hepatic gluconeogenesis and improves peripheral insulin
sensitivity. It does not stimulate insulin release, which is why hypoglycemia is rare.
This mechanism makes it first-line therapy for type 2 diabetes.
9. Which are common adverse effects of metformin?
A. Hypoglycemia and weight gain
B. Constipation and edema
C. GI upset, nausea, diarrhea, weight loss
D. Hypertension
Rationale:
Gastrointestinal side effects are the most common adverse effects of metformin.
PHARMACOLOGY FINAL EXAM REVIEW |
MORE THAN 100 QUESTIONS AND
ANSWERS| RATED A | LATEST, 2026|
CHAMBERLAIN
1. What is the expected onset of insulin glargine (U-100)?
A. Immediate
B. 15 minutes
C. 1–2 hours
D. 6–8 hours
Rationale:
Insulin glargine is a long-acting basal insulin designed to provide steady glucose
control over 24 hours. Its onset is approximately 1–2 hours, with no pronounced peak.
This reduces the risk of hypoglycemia compared to intermediate-acting insulins. It is
not intended for rapid correction of hyperglycemia.
2. How many minutes before a meal should insulin lispro (Humalog)
be administered?
A. Immediately after the meal
B. 30 minutes before the meal
C. 15 minutes before the meal
D. 60 minutes before the meal
,Rationale:
Insulin lispro is a rapid-acting insulin with an onset of 10–15 minutes. Administering it
shortly before meals mimics physiologic insulin release and helps control postprandial
glucose spikes. Giving it too early increases hypoglycemia risk, while delayed dosing
reduces efficacy.
3. When might insulin requirements increase?
A. Weight loss
B. Increased physical activity
C. Infection, pregnancy, steroid use
D. Improved glycemic control
Rationale:
Insulin requirements increase during periods of stress such as infection, pregnancy,
puberty, or corticosteroid therapy. These states increase insulin resistance and
hepatic glucose output. Failure to adjust insulin doses may result in hyperglycemia or
diabetic ketoacidosis.
4. Which factors may result in hypoglycemia?
A. Decreased insulin dose
B. Illness with fever
C. Increased exercise, vomiting, alcohol use
D. Increased carbohydrate intake
Rationale:
Hypoglycemia occurs when glucose utilization exceeds supply. Increased physical
activity, reduced food intake due to vomiting or diarrhea, and alcohol consumption can
all lower blood glucose levels. Alcohol inhibits gluconeogenesis, significantly
increasing hypoglycemia risk.
,5. Which symptoms should patients be taught to recognize as
hypoglycemia?
A. Polyuria and polydipsia
B. Warm, dry skin
C. Sweating, confusion, palpitations, shakiness
D. Kussmaul respirations
Rationale:
Hypoglycemia activates the sympathetic nervous system, causing sweating, tremors,
palpitations, and anxiety. Neuroglycopenic symptoms such as confusion and altered
mental status occur as glucose delivery to the brain decreases. Severe untreated
hypoglycemia can lead to seizures or coma.
6. Which medication class may mask the signs of hypoglycemia?
A. ACE inhibitors
B. Diuretics
C. Beta-blockers
D. Calcium channel blockers
Rationale:
Beta-blockers blunt adrenergic responses such as tachycardia and tremors, which are
early warning signs of hypoglycemia. Patients may not recognize low blood sugar until
neuroglycopenic symptoms occur. Extra caution and frequent glucose monitoring are
required.
, 7. A blood glucose level less than which value defines
hypoglycemia?
A. <90 mg/dL
B. <80 mg/dL
C. <70 mg/dL
D. <60 mg/dL
Rationale:
Hypoglycemia is clinically defined as a blood glucose level below 70 mg/dL. At this
threshold, counter-regulatory hormones are activated. Early recognition and treatment
are essential to prevent severe neurologic consequences.
8. What is the primary mechanism of action of metformin?
A. Stimulates insulin secretion
B. Delays carbohydrate absorption
C. Decreases hepatic glucose production and increases insulin sensitivity
D. Inhibits glucagon release
Rationale:
Metformin reduces hepatic gluconeogenesis and improves peripheral insulin
sensitivity. It does not stimulate insulin release, which is why hypoglycemia is rare.
This mechanism makes it first-line therapy for type 2 diabetes.
9. Which are common adverse effects of metformin?
A. Hypoglycemia and weight gain
B. Constipation and edema
C. GI upset, nausea, diarrhea, weight loss
D. Hypertension
Rationale:
Gastrointestinal side effects are the most common adverse effects of metformin.
