NURS 180 Pharmacology Exam 4 2026 |WCU
1. A patient is prescribed Metformin for Type 2 Diabetes Mellitus. Which
diagnostic test requires the nurse to withhold this medication for 48 hours
before and after the procedure?
A. Computed Tomography (CT) scan with iodinated contrast
B. Magnetic Resonance Imaging (MRI) without contrast
C. Chest X-ray
D. Electrocardiogram (ECG)
Answer: A
Rationale: Metformin must be withheld before and 48 hours after procedures involving
iodinated contrast media to prevent the risk of acute renal failure and lactic acidosis.
2. A nurse is teaching a patient about the peak action of rapid-acting insulin,
such as Insulin Lispro (Humalog). The nurse should state the peak occurs within:
A. 30 to 90 minutes
B. 15 to 30 minutes
C. 2 to 4 hours
D. 6 to 10 hours
Answer: A
Rationale: Rapid-acting insulin (Lispro, Aspart) typically peaks between 30 and 90
minutes after administration.
,3. Which assessment finding is a priority to report for a patient taking
Levothyroxine for hypothyroidism?
A. Weight loss of 1 lb in a week
B. Cold intolerance
C. Constipation
D. Heart rate of 110 beats per minute
Answer: D
Rationale: Tachycardia (HR > 100) is a sign of Levothyroxine toxicity or hyperthyroidism
and must be reported immediately to prevent cardiac complications.
4. A patient with Addison’s disease is taking Prednisone. What is the most
important instruction regarding the discontinuation of this drug?
A. Taper the dose gradually as instructed by the provider.
B. Double the dose if you miss a day.
C. Stop the medication immediately if you feel better.
D. Switch to an over-the-counter anti-inflammatory if needed.
Answer: A
Rationale: Glucocorticoids must be tapered gradually to allow the adrenal glands to
resume natural cortisol production and prevent adrenal crisis.
5. A nurse is preparing to administer NPH insulin and Regular insulin in the same
syringe. Which action is correct?
A. Draw up the NPH insulin first.
B. Shake the NPH vial vigorously before drawing.
C. Draw up the Regular insulin first.
D. Administer the mixture intravenously.
Answer: C
Rationale: When mixing insulin, the clear (Regular) should be drawn before the cloudy
(NPH) to prevent contamination of the Regular insulin vial.
, 6. A patient is prescribed Spironolactone for hypertension. Which food item
should the nurse advise the patient to avoid?
A. Apples
B. White bread
C. Bananas
D. Chicken breast
Answer: C
Rationale: Spironolactone is a potassium-sparing diuretic. High-potassium foods like
bananas, oranges, and spinach should be limited to prevent hyperkalemia.
7. A patient receiving Doxorubicin (Adriamycin) for cancer treatment should be
closely monitored for which severe adverse effect?
A. Ototoxicity
B. Pulmonary fibrosis
C. Hemorrhagic cystitis
D. Cardiotoxicity
Answer: D
Rationale: Doxorubicin is known for its cardiotoxic effects, which can lead to irreversible
heart failure.
8. What is the therapeutic goal for a patient taking Desmopressin (DDAVP) for
Diabetes Insipidus?
A. Decreased urinary output and increased urine specific gravity
B. Increased blood glucose levels
C. Increased heart rate
D. Weight loss
Answer: A
Rationale: Desmopressin is an antidiuretic hormone replacement. Success is measured by
a decrease in urine volume and an increase in urine concentration (specific gravity).
1. A patient is prescribed Metformin for Type 2 Diabetes Mellitus. Which
diagnostic test requires the nurse to withhold this medication for 48 hours
before and after the procedure?
A. Computed Tomography (CT) scan with iodinated contrast
B. Magnetic Resonance Imaging (MRI) without contrast
C. Chest X-ray
D. Electrocardiogram (ECG)
Answer: A
Rationale: Metformin must be withheld before and 48 hours after procedures involving
iodinated contrast media to prevent the risk of acute renal failure and lactic acidosis.
2. A nurse is teaching a patient about the peak action of rapid-acting insulin,
such as Insulin Lispro (Humalog). The nurse should state the peak occurs within:
A. 30 to 90 minutes
B. 15 to 30 minutes
C. 2 to 4 hours
D. 6 to 10 hours
Answer: A
Rationale: Rapid-acting insulin (Lispro, Aspart) typically peaks between 30 and 90
minutes after administration.
,3. Which assessment finding is a priority to report for a patient taking
Levothyroxine for hypothyroidism?
A. Weight loss of 1 lb in a week
B. Cold intolerance
C. Constipation
D. Heart rate of 110 beats per minute
Answer: D
Rationale: Tachycardia (HR > 100) is a sign of Levothyroxine toxicity or hyperthyroidism
and must be reported immediately to prevent cardiac complications.
4. A patient with Addison’s disease is taking Prednisone. What is the most
important instruction regarding the discontinuation of this drug?
A. Taper the dose gradually as instructed by the provider.
B. Double the dose if you miss a day.
C. Stop the medication immediately if you feel better.
D. Switch to an over-the-counter anti-inflammatory if needed.
Answer: A
Rationale: Glucocorticoids must be tapered gradually to allow the adrenal glands to
resume natural cortisol production and prevent adrenal crisis.
5. A nurse is preparing to administer NPH insulin and Regular insulin in the same
syringe. Which action is correct?
A. Draw up the NPH insulin first.
B. Shake the NPH vial vigorously before drawing.
C. Draw up the Regular insulin first.
D. Administer the mixture intravenously.
Answer: C
Rationale: When mixing insulin, the clear (Regular) should be drawn before the cloudy
(NPH) to prevent contamination of the Regular insulin vial.
, 6. A patient is prescribed Spironolactone for hypertension. Which food item
should the nurse advise the patient to avoid?
A. Apples
B. White bread
C. Bananas
D. Chicken breast
Answer: C
Rationale: Spironolactone is a potassium-sparing diuretic. High-potassium foods like
bananas, oranges, and spinach should be limited to prevent hyperkalemia.
7. A patient receiving Doxorubicin (Adriamycin) for cancer treatment should be
closely monitored for which severe adverse effect?
A. Ototoxicity
B. Pulmonary fibrosis
C. Hemorrhagic cystitis
D. Cardiotoxicity
Answer: D
Rationale: Doxorubicin is known for its cardiotoxic effects, which can lead to irreversible
heart failure.
8. What is the therapeutic goal for a patient taking Desmopressin (DDAVP) for
Diabetes Insipidus?
A. Decreased urinary output and increased urine specific gravity
B. Increased blood glucose levels
C. Increased heart rate
D. Weight loss
Answer: A
Rationale: Desmopressin is an antidiuretic hormone replacement. Success is measured by
a decrease in urine volume and an increase in urine concentration (specific gravity).
