NR 293 Pharmacology Week 4 Study Guide (ATI-Based) 2026
|Chamberlain College
1. A nurse is teaching a patient about insulin lispro. At what time should the
nurse instruct the patient to eat?
A. Within 15 minutes of injection
B. 30 to 60 minutes after injection
C. 2 hours before injection
D. At bedtime
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes; the patient must eat
immediately to prevent hypoglycemia.
2. Which instruction should a nurse provide to a patient starting metformin for
type 2 diabetes?
A. Take the medication on an empty stomach.
B. Expect significant weight gain.
C. Monitor for signs of hyperkalemia.
D. Discontinue the medication 48 hours before a scheduled CT scan with contrast.
Answer: D
Rationale: Metformin must be held 48 hours before and after contrast dye procedures to
prevent lactic acidosis and renal failure.
,3. A patient is prescribed levothyroxine for hypothyroidism. When should the
nurse instruct the patient to take this medication?
A. 30 to 60 minutes before breakfast on an empty stomach
B. At bedtime with a snack
C. With a high-fiber breakfast
D. Directly after the largest meal of the day
Answer: A
Rationale: Levothyroxine absorption is increased when taken on an empty stomach, at
least 30-60 minutes before food.
4. What is the peak time for NPH insulin?
A. 1 to 2 hours
B. 18 to 24 hours
C. 4 to 12 hours
D. 15 to 30 minutes
Answer: C
Rationale: NPH is an intermediate-acting insulin with a peak effect occurring between 4
and 12 hours after administration.
5. A nurse is caring for a patient receiving desmopressin for diabetes insipidus.
Which finding indicates the medication is effective?
A. Increased heart rate
B. Decreased urine output
C. Decreased urine specific gravity
D. Increased blood glucose
Answer: B
Rationale: Desmopressin is an antidiuretic hormone; effective treatment results in
decreased urine output and increased urine specific gravity.
, 6. A patient taking propylthiouracil (PTU) for hyperthyroidism should be
monitored for which serious adverse effect?
A. Agranulocytosis
B. Polyuria
C. Tinnitus
D. Hyperglycemia
Answer: A
Rationale: PTU can cause agranulocytosis (a dangerous drop in white blood cells); patients
should report fever or sore throat immediately.
7. When mixing regular insulin and NPH insulin in one syringe, which step is
correct?
A. Draw up the NPH insulin first.
B. Shake both vials vigorously before drawing.
C. Draw up the regular insulin first.
D. It is not safe to mix these two types of insulin.
Answer: C
Rationale: Regular (clear) insulin should be drawn into the syringe before NPH (cloudy)
insulin to prevent contaminating the regular vial.
8. A patient is prescribed pioglitazone. The nurse should monitor the patient for
which contraindication or precaution?
A. Glaucoma
B. Heart failure
C. Hypothyroidism
D. Vitamin B12 deficiency
Answer: B
Rationale: Pioglitazone can cause fluid retention and is contraindicated in patients with
severe heart failure.
|Chamberlain College
1. A nurse is teaching a patient about insulin lispro. At what time should the
nurse instruct the patient to eat?
A. Within 15 minutes of injection
B. 30 to 60 minutes after injection
C. 2 hours before injection
D. At bedtime
Answer: A
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes; the patient must eat
immediately to prevent hypoglycemia.
2. Which instruction should a nurse provide to a patient starting metformin for
type 2 diabetes?
A. Take the medication on an empty stomach.
B. Expect significant weight gain.
C. Monitor for signs of hyperkalemia.
D. Discontinue the medication 48 hours before a scheduled CT scan with contrast.
Answer: D
Rationale: Metformin must be held 48 hours before and after contrast dye procedures to
prevent lactic acidosis and renal failure.
,3. A patient is prescribed levothyroxine for hypothyroidism. When should the
nurse instruct the patient to take this medication?
A. 30 to 60 minutes before breakfast on an empty stomach
B. At bedtime with a snack
C. With a high-fiber breakfast
D. Directly after the largest meal of the day
Answer: A
Rationale: Levothyroxine absorption is increased when taken on an empty stomach, at
least 30-60 minutes before food.
4. What is the peak time for NPH insulin?
A. 1 to 2 hours
B. 18 to 24 hours
C. 4 to 12 hours
D. 15 to 30 minutes
Answer: C
Rationale: NPH is an intermediate-acting insulin with a peak effect occurring between 4
and 12 hours after administration.
5. A nurse is caring for a patient receiving desmopressin for diabetes insipidus.
Which finding indicates the medication is effective?
A. Increased heart rate
B. Decreased urine output
C. Decreased urine specific gravity
D. Increased blood glucose
Answer: B
Rationale: Desmopressin is an antidiuretic hormone; effective treatment results in
decreased urine output and increased urine specific gravity.
, 6. A patient taking propylthiouracil (PTU) for hyperthyroidism should be
monitored for which serious adverse effect?
A. Agranulocytosis
B. Polyuria
C. Tinnitus
D. Hyperglycemia
Answer: A
Rationale: PTU can cause agranulocytosis (a dangerous drop in white blood cells); patients
should report fever or sore throat immediately.
7. When mixing regular insulin and NPH insulin in one syringe, which step is
correct?
A. Draw up the NPH insulin first.
B. Shake both vials vigorously before drawing.
C. Draw up the regular insulin first.
D. It is not safe to mix these two types of insulin.
Answer: C
Rationale: Regular (clear) insulin should be drawn into the syringe before NPH (cloudy)
insulin to prevent contaminating the regular vial.
8. A patient is prescribed pioglitazone. The nurse should monitor the patient for
which contraindication or precaution?
A. Glaucoma
B. Heart failure
C. Hypothyroidism
D. Vitamin B12 deficiency
Answer: B
Rationale: Pioglitazone can cause fluid retention and is contraindicated in patients with
severe heart failure.
