NUR 242 Week 9 Pharmacology Study Guide 2026 |Galen College
1. A patient is prescribed insulin lispro. When should the nurse instruct the
patient to administer this medication?
A. 30 to 60 minutes before a meal
B. 15 minutes before or with a meal
C. Immediately after eating
D. At bedtime without food
Answer: B
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 15 minutes, meaning it
should be given shortly before or with a meal to prevent hypoglycemia.
2. Which laboratory value is most important to monitor in a patient taking
metformin for Type 2 Diabetes?
A. Serum amylase
B. Prothrombin time (PT)
C. Thyroid stimulating hormone (TSH)
D. Glomerular filtration rate (GFR)
Answer: D
Rationale: Metformin is excreted by the kidneys and can cause lactic acidosis if renal
function is impaired; therefore, monitoring GFR or creatinine is essential.
,3. A patient is scheduled for a CT scan with IV contrast and takes metformin
daily. What is the priority nursing action?
A. Double the dose the morning of the procedure
B. Check blood glucose every hour during the scan
C. Administer metformin with a full glass of water
D. Hold metformin 48 hours before and after the procedure
Answer: D
Rationale: Metformin combined with iodine-containing contrast media can lead to acute
renal failure and lactic acidosis; it is typically held 48 hours before and after contrast use.
4. What is the primary mechanism of action of glyburide?
A. Increases insulin sensitivity in the liver
B. Slows the absorption of carbohydrates in the gut
C. Stimulates the release of insulin from pancreatic beta cells
D. Prevents the breakdown of GLP-1
Answer: C
Rationale: Glyburide is a sulfonylurea that works by stimulating the pancreas to secrete
more insulin.
5. A patient with Type 1 Diabetes is found unconscious and clammy. What is the
priority medication to administer if IV access is unavailable?
A. Regular insulin subcutaneously
B. Dextrose 5% in water IV
C. Oral glucose gel
D. Glucagon intramuscularly
Answer: D
Rationale: Glucagon is used for emergency treatment of severe hypoglycemia when the
patient is unconscious and IV access is not established.
, 6. When teaching a patient about levothyroxine, which instruction should be
included?
A. Take the medication with a high-calcium breakfast
B. Stop the medication immediately if the heart rate increases
C. Take the medication on an empty stomach 30-60 minutes before breakfast
D. Take the medication only when feeling tired
Answer: C
Rationale: Levothyroxine absorption is best on an empty stomach, and it should not be
taken with food or minerals like calcium.
7. Which assessment finding indicates that a patient’s levothyroxine dose may
be too high?
A. Bradycardia and weight gain
B. Palpitations and insomnia
C. Constipation and lethargy
D. Dry skin and cold intolerance
Answer: B
Rationale: Symptoms of hyperthyroidism, such as tachycardia, palpitations, and insomnia,
suggest an excessive dose of levothyroxine.
8. A patient is prescribed propylthiouracil (PTU). Which laboratory test should
the nurse monitor closely for serious adverse effects?
A. Blood Urea Nitrogen (BUN)
B. Serum potassium for hyperkalemia
C. Complete Blood Count (CBC) for agranulocytosis
D. Serum sodium
Answer: C
Rationale: A serious adverse effect of PTU is agranulocytosis (a severe reduction in white
blood cells), requiring monitoring of the CBC.
1. A patient is prescribed insulin lispro. When should the nurse instruct the
patient to administer this medication?
A. 30 to 60 minutes before a meal
B. 15 minutes before or with a meal
C. Immediately after eating
D. At bedtime without food
Answer: B
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 15 minutes, meaning it
should be given shortly before or with a meal to prevent hypoglycemia.
2. Which laboratory value is most important to monitor in a patient taking
metformin for Type 2 Diabetes?
A. Serum amylase
B. Prothrombin time (PT)
C. Thyroid stimulating hormone (TSH)
D. Glomerular filtration rate (GFR)
Answer: D
Rationale: Metformin is excreted by the kidneys and can cause lactic acidosis if renal
function is impaired; therefore, monitoring GFR or creatinine is essential.
,3. A patient is scheduled for a CT scan with IV contrast and takes metformin
daily. What is the priority nursing action?
A. Double the dose the morning of the procedure
B. Check blood glucose every hour during the scan
C. Administer metformin with a full glass of water
D. Hold metformin 48 hours before and after the procedure
Answer: D
Rationale: Metformin combined with iodine-containing contrast media can lead to acute
renal failure and lactic acidosis; it is typically held 48 hours before and after contrast use.
4. What is the primary mechanism of action of glyburide?
A. Increases insulin sensitivity in the liver
B. Slows the absorption of carbohydrates in the gut
C. Stimulates the release of insulin from pancreatic beta cells
D. Prevents the breakdown of GLP-1
Answer: C
Rationale: Glyburide is a sulfonylurea that works by stimulating the pancreas to secrete
more insulin.
5. A patient with Type 1 Diabetes is found unconscious and clammy. What is the
priority medication to administer if IV access is unavailable?
A. Regular insulin subcutaneously
B. Dextrose 5% in water IV
C. Oral glucose gel
D. Glucagon intramuscularly
Answer: D
Rationale: Glucagon is used for emergency treatment of severe hypoglycemia when the
patient is unconscious and IV access is not established.
, 6. When teaching a patient about levothyroxine, which instruction should be
included?
A. Take the medication with a high-calcium breakfast
B. Stop the medication immediately if the heart rate increases
C. Take the medication on an empty stomach 30-60 minutes before breakfast
D. Take the medication only when feeling tired
Answer: C
Rationale: Levothyroxine absorption is best on an empty stomach, and it should not be
taken with food or minerals like calcium.
7. Which assessment finding indicates that a patient’s levothyroxine dose may
be too high?
A. Bradycardia and weight gain
B. Palpitations and insomnia
C. Constipation and lethargy
D. Dry skin and cold intolerance
Answer: B
Rationale: Symptoms of hyperthyroidism, such as tachycardia, palpitations, and insomnia,
suggest an excessive dose of levothyroxine.
8. A patient is prescribed propylthiouracil (PTU). Which laboratory test should
the nurse monitor closely for serious adverse effects?
A. Blood Urea Nitrogen (BUN)
B. Serum potassium for hyperkalemia
C. Complete Blood Count (CBC) for agranulocytosis
D. Serum sodium
Answer: C
Rationale: A serious adverse effect of PTU is agranulocytosis (a severe reduction in white
blood cells), requiring monitoring of the CBC.
