NURS 180 | NURS180 Exam 3: Pharmacology - WCU
Updated and Latest Questions and Correct
Answers with Rationale
1. A patient is prescribed Insulin Lispro (Humalog) for postprandial glucose control. When
should the nurse instruct the patient to eat after receiving this injection?
A. 60 minutes after
B. 30 to 45 minutes after
C. Within 15 minutes
D. Immediately before the next meal
Correct Answer: C
Expert Explanation: Insulin Lispro is a rapid-acting insulin that has an onset of action
within 15 minutes. It is critical for the patient to have food available immediately to
prevent rapid-onset hypoglycemia. The nurse must assess the patient for symptoms like
diaphoresis and tachycardia shortly after administration. Peak levels are reached within 30
to 90 minutes, which represents the highest risk period for the patient. Education should
focus on the synchronization of medication administration with meal consumption for
safety.
2. A patient with type 2 diabetes is scheduled for a CT scan with intravenous contrast. Which
medication must the nurse ensure is held for 48 hours after the procedure?
A. Glipizide
B. Sitagliptin
C. Pioglitazone
D. Metformin
Correct Answer: D
Expert Explanation: Metformin must be discontinued before and held for 48 hours after
procedures involving iodinated contrast media. The interaction between contrast dye and
metformin can lead to acute renal failure and lactic acidosis. The nurse should monitor
serum creatinine levels to ensure renal function has returned to baseline before restarting
the drug. This protocol is a vital safety measure to protect the patient’s kidney health.
Patients should be educated on the risks of lactic acidosis, including symptoms like malaise
and respiratory distress.
3. A patient is taking Furosemide (Lasix) for heart failure. Which laboratory value should the
nurse prioritize monitoring?
A. Serum Sodium
,B. Serum Potassium
C. Serum Calcium
D. Serum Magnesium
Correct Answer: B
Expert Explanation: Furosemide is a loop diuretic that causes the excretion of water and
electrolytes, specifically potassium. Hypokalemia is a common and dangerous adverse
effect that can lead to life-threatening cardiac arrhythmias. The nurse should encourage the
consumption of potassium-rich foods or administer supplements as prescribed. Monitoring
for signs of muscle weakness and cramping is essential for early detection of electrolyte
imbalances. Regular laboratory testing is required to adjust the dosage and ensure patient
safety during therapy.
4. Which instruction should the nurse include for a patient newly prescribed Omeprazole
(Prilosec) for GERD?
A. Take the medication 30 minutes before the first meal of the day.
B. Take the medication with an antacid to increase absorption.
C. Crush the tablet if you have difficulty swallowing.
D. Take the medication only when you feel heartburn symptoms.
Correct Answer: A
Expert Explanation: Proton pump inhibitors like Omeprazole are most effective when
taken on an empty stomach about 30 minutes before eating. This timing allows the
medication to inhibit the proton pumps that are activated by meal ingestion. Patients
should be cautioned not to crush or chew delayed-release capsules to maintain the drug’s
integrity. Long-term use of this medication can lead to decreased bone density and
increased risk of fractures. The nurse should emphasize that this is a daily maintenance
medication, not an as-needed rescue drug.
5. A patient is starting Levothyroxine (Synthroid) for hypothyroidism. Which statement by the
patient indicates a need for further teaching?
A. I should see an immediate improvement in my energy levels tomorrow.
B. I will take this medicine every morning on an empty stomach.
C. I will notify my doctor if I feel my heart racing.
D. I need to have my blood checked regularly for TSH levels.
Correct Answer: A
Expert Explanation: Levothyroxine has a long half-life and typically takes several weeks to
achieve a therapeutic steady state. The patient should not expect an immediate resolution
, of symptoms after the first few doses. It is important to take the medication at the same
time every morning to ensure consistent absorption. Signs of toxicity, such as tremors and
palpitations, must be reported to the provider immediately. This medication is usually a
lifelong therapy and requires periodic lab monitoring for dosage adjustment.
6. A patient is prescribed Spironolactone (Aldactone). Which food choice should the nurse
advise the patient to avoid?
A. Apples
B. White rice
C. Bananas
D. Green beans
Correct Answer: C
Expert Explanation: Spironolactone is a potassium-sparing diuretic that can lead to the
retention of potassium in the body. Bananas are very high in potassium and could
contribute to the development of hyperkalemia. The nurse must monitor for symptoms of
high potassium, such as cardiac dysrhythmias and muscle twitching. Patients should also
be warned to avoid salt substitutes, as many contain potassium chloride instead of sodium.
Monitoring renal function is essential, as decreased clearance can further elevate
potassium levels.
7. The nurse is preparing to administer Ondansetron (Zofran) to a patient receiving
chemotherapy. What is the primary purpose of this drug?
A. To stimulate appetite
B. To prevent nausea and vomiting
C. To reduce gastric acid secretion
D. To increase gastrointestinal motility
Correct Answer: B
Expert Explanation: Ondansetron is a serotonin (5-HT3) receptor antagonist specifically
used to prevent nausea and vomiting. It is most effective when administered before the
onset of symptoms, particularly prior to chemotherapy or surgery. The nurse should assess
for common side effects such as headaches, dizziness, and constipation. A rare but serious
side effect is the prolongation of the QT interval on an EKG. Ensuring the patient is
comfortable and hydrated is a key nursing priority during emetogenic treatments.
8. A patient is prescribed Sucralfate (Carafate) for a duodenal ulcer. When is the best time for
the nurse to administer this medication?
A. Immediately after meals
B. Twice daily with breakfast and dinner
Updated and Latest Questions and Correct
Answers with Rationale
1. A patient is prescribed Insulin Lispro (Humalog) for postprandial glucose control. When
should the nurse instruct the patient to eat after receiving this injection?
A. 60 minutes after
B. 30 to 45 minutes after
C. Within 15 minutes
D. Immediately before the next meal
Correct Answer: C
Expert Explanation: Insulin Lispro is a rapid-acting insulin that has an onset of action
within 15 minutes. It is critical for the patient to have food available immediately to
prevent rapid-onset hypoglycemia. The nurse must assess the patient for symptoms like
diaphoresis and tachycardia shortly after administration. Peak levels are reached within 30
to 90 minutes, which represents the highest risk period for the patient. Education should
focus on the synchronization of medication administration with meal consumption for
safety.
2. A patient with type 2 diabetes is scheduled for a CT scan with intravenous contrast. Which
medication must the nurse ensure is held for 48 hours after the procedure?
A. Glipizide
B. Sitagliptin
C. Pioglitazone
D. Metformin
Correct Answer: D
Expert Explanation: Metformin must be discontinued before and held for 48 hours after
procedures involving iodinated contrast media. The interaction between contrast dye and
metformin can lead to acute renal failure and lactic acidosis. The nurse should monitor
serum creatinine levels to ensure renal function has returned to baseline before restarting
the drug. This protocol is a vital safety measure to protect the patient’s kidney health.
Patients should be educated on the risks of lactic acidosis, including symptoms like malaise
and respiratory distress.
3. A patient is taking Furosemide (Lasix) for heart failure. Which laboratory value should the
nurse prioritize monitoring?
A. Serum Sodium
,B. Serum Potassium
C. Serum Calcium
D. Serum Magnesium
Correct Answer: B
Expert Explanation: Furosemide is a loop diuretic that causes the excretion of water and
electrolytes, specifically potassium. Hypokalemia is a common and dangerous adverse
effect that can lead to life-threatening cardiac arrhythmias. The nurse should encourage the
consumption of potassium-rich foods or administer supplements as prescribed. Monitoring
for signs of muscle weakness and cramping is essential for early detection of electrolyte
imbalances. Regular laboratory testing is required to adjust the dosage and ensure patient
safety during therapy.
4. Which instruction should the nurse include for a patient newly prescribed Omeprazole
(Prilosec) for GERD?
A. Take the medication 30 minutes before the first meal of the day.
B. Take the medication with an antacid to increase absorption.
C. Crush the tablet if you have difficulty swallowing.
D. Take the medication only when you feel heartburn symptoms.
Correct Answer: A
Expert Explanation: Proton pump inhibitors like Omeprazole are most effective when
taken on an empty stomach about 30 minutes before eating. This timing allows the
medication to inhibit the proton pumps that are activated by meal ingestion. Patients
should be cautioned not to crush or chew delayed-release capsules to maintain the drug’s
integrity. Long-term use of this medication can lead to decreased bone density and
increased risk of fractures. The nurse should emphasize that this is a daily maintenance
medication, not an as-needed rescue drug.
5. A patient is starting Levothyroxine (Synthroid) for hypothyroidism. Which statement by the
patient indicates a need for further teaching?
A. I should see an immediate improvement in my energy levels tomorrow.
B. I will take this medicine every morning on an empty stomach.
C. I will notify my doctor if I feel my heart racing.
D. I need to have my blood checked regularly for TSH levels.
Correct Answer: A
Expert Explanation: Levothyroxine has a long half-life and typically takes several weeks to
achieve a therapeutic steady state. The patient should not expect an immediate resolution
, of symptoms after the first few doses. It is important to take the medication at the same
time every morning to ensure consistent absorption. Signs of toxicity, such as tremors and
palpitations, must be reported to the provider immediately. This medication is usually a
lifelong therapy and requires periodic lab monitoring for dosage adjustment.
6. A patient is prescribed Spironolactone (Aldactone). Which food choice should the nurse
advise the patient to avoid?
A. Apples
B. White rice
C. Bananas
D. Green beans
Correct Answer: C
Expert Explanation: Spironolactone is a potassium-sparing diuretic that can lead to the
retention of potassium in the body. Bananas are very high in potassium and could
contribute to the development of hyperkalemia. The nurse must monitor for symptoms of
high potassium, such as cardiac dysrhythmias and muscle twitching. Patients should also
be warned to avoid salt substitutes, as many contain potassium chloride instead of sodium.
Monitoring renal function is essential, as decreased clearance can further elevate
potassium levels.
7. The nurse is preparing to administer Ondansetron (Zofran) to a patient receiving
chemotherapy. What is the primary purpose of this drug?
A. To stimulate appetite
B. To prevent nausea and vomiting
C. To reduce gastric acid secretion
D. To increase gastrointestinal motility
Correct Answer: B
Expert Explanation: Ondansetron is a serotonin (5-HT3) receptor antagonist specifically
used to prevent nausea and vomiting. It is most effective when administered before the
onset of symptoms, particularly prior to chemotherapy or surgery. The nurse should assess
for common side effects such as headaches, dizziness, and constipation. A rare but serious
side effect is the prolongation of the QT interval on an EKG. Ensuring the patient is
comfortable and hydrated is a key nursing priority during emetogenic treatments.
8. A patient is prescribed Sucralfate (Carafate) for a duodenal ulcer. When is the best time for
the nurse to administer this medication?
A. Immediately after meals
B. Twice daily with breakfast and dinner
