NUR 6011 ADV PHARMA EXAM MODULE
4|QUESTIONS AND ANSWERS| 2026
UPDATE| 100% CORRECT-WPU.
SECTION 1: DIABETES MELLITUS PHARMACOLOGY
(Questions 1-15)
Question 1
A patient with type 1 diabetes is prescribed insulin lispro (Humalog). Which
statement about this insulin is correct?
A. It should be given 30–60 minutes before meals.
B. It has an onset of 15 minutes and should be given just before (or
immediately after) meals.
C. It lasts 12–16 hours.
D. It is a long-acting insulin.
Correct Answer: B. It has an onset of 15 minutes and should be given just
before (or immediately after) meals.
Rationale: Insulin lispro is a rapid-acting insulin analog with an onset of
about 15 minutes, peak of 1–2 hours, and duration of 3–4 hours. It is best
given immediately before or just after a meal. Regular insulin (short-acting)
is given 30 minutes before meals.
Subtopic: Insulins – Rapid-Acting
Question 2
A patient with type 2 diabetes has an A1C of 8.5% on metformin
monotherapy. Which class of medication is most likely to be added next
according to current guidelines?
,A. Insulin glargine
B. SGLT2 inhibitor (e.g., empagliflozin) or GLP-1 agonist (e.g., semaglutide)
C. Sulfonylurea (e.g., glipizide)
D. Thiazolidinedione (e.g., pioglitazone)
Correct Answer: B. SGLT2 inhibitor or GLP-1 agonist
Rationale: Current guidelines prioritize SGLT2 inhibitors or GLP-1 receptor
agonists as add-on therapy to metformin, especially in patients with
cardiovascular disease, heart failure, or chronic kidney disease. These agents
have cardiovascular and renal benefits beyond glucose lowering.
Subtopic: Diabetes – Second-Line Agents
Question 3
A patient with type 2 diabetes is prescribed metformin (Glucophage). Which
instruction should the nurse include?
A. “Take this medication on an empty stomach.”
B. “This medication may cause weight gain.”
C. “Report any muscle pain or weakness to your provider.”
D. “This medication increases insulin production.”
Correct Answer: C. “Report any muscle pain or weakness to your provider.”
Rationale: Metformin can cause lactic acidosis, a rare but serious side effect.
Symptoms include muscle pain, weakness, malaise, and difficulty breathing.
Patients should report these immediately. Metformin is taken with meals to
reduce GI side effects, it causes weight loss or is weight-neutral, and it
decreases hepatic glucose production (not insulin production).
Subtopic: Metformin – Lactic Acidosis Risk
Question 4
A patient with type 1 diabetes is prescribed insulin glargine (Lantus). Which
statement about this insulin is correct?
A. It is a rapid-acting insulin given before meals.
B. It cannot be mixed with other insulins in the same syringe.
, C. It has a peak of 2–4 hours.
D. It is given twice daily.
Correct Answer: B. It cannot be mixed with other insulins in the same
syringe.
Rationale: Insulin glargine is a long-acting (peakless, duration ≈24 hours)
insulin and should not be mixed with other insulins in the same syringe (pH
incompatibility). It is given once daily at the same time each day and
provides basal insulin coverage.
Subtopic: Insulins – Long-Acting (Glargine)
Question 5
A patient with type 2 diabetes has an A1C of 9.2% on metformin alone. What
is the next step in medical nutrition therapy?
A. Start insulin immediately
B. Refer for bariatric surgery
C. Focus on carbohydrate reduction and weight loss if overweight
D. Discontinue metformin and start a sulfonylurea
Correct Answer: C. Focus on carbohydrate reduction and weight loss if
overweight
Rationale: The primary goal of MNT in type 2 diabetes is to achieve glycemic
control through lifestyle modifications (carbohydrate reduction, weight loss,
physical activity). If A1C remains above target after 3–6 months of lifestyle
changes and metformin, additional medication is considered.
Subtopic: Diabetes – MNT Goals
Question 6
A patient with diabetes has a blood glucose of 55 mg/dL and is conscious.
What is the appropriate treatment?
A. 15 g of carbohydrate (4 oz juice, 3–4 glucose tablets)
B. 30 g of carbohydrate
4|QUESTIONS AND ANSWERS| 2026
UPDATE| 100% CORRECT-WPU.
SECTION 1: DIABETES MELLITUS PHARMACOLOGY
(Questions 1-15)
Question 1
A patient with type 1 diabetes is prescribed insulin lispro (Humalog). Which
statement about this insulin is correct?
A. It should be given 30–60 minutes before meals.
B. It has an onset of 15 minutes and should be given just before (or
immediately after) meals.
C. It lasts 12–16 hours.
D. It is a long-acting insulin.
Correct Answer: B. It has an onset of 15 minutes and should be given just
before (or immediately after) meals.
Rationale: Insulin lispro is a rapid-acting insulin analog with an onset of
about 15 minutes, peak of 1–2 hours, and duration of 3–4 hours. It is best
given immediately before or just after a meal. Regular insulin (short-acting)
is given 30 minutes before meals.
Subtopic: Insulins – Rapid-Acting
Question 2
A patient with type 2 diabetes has an A1C of 8.5% on metformin
monotherapy. Which class of medication is most likely to be added next
according to current guidelines?
,A. Insulin glargine
B. SGLT2 inhibitor (e.g., empagliflozin) or GLP-1 agonist (e.g., semaglutide)
C. Sulfonylurea (e.g., glipizide)
D. Thiazolidinedione (e.g., pioglitazone)
Correct Answer: B. SGLT2 inhibitor or GLP-1 agonist
Rationale: Current guidelines prioritize SGLT2 inhibitors or GLP-1 receptor
agonists as add-on therapy to metformin, especially in patients with
cardiovascular disease, heart failure, or chronic kidney disease. These agents
have cardiovascular and renal benefits beyond glucose lowering.
Subtopic: Diabetes – Second-Line Agents
Question 3
A patient with type 2 diabetes is prescribed metformin (Glucophage). Which
instruction should the nurse include?
A. “Take this medication on an empty stomach.”
B. “This medication may cause weight gain.”
C. “Report any muscle pain or weakness to your provider.”
D. “This medication increases insulin production.”
Correct Answer: C. “Report any muscle pain or weakness to your provider.”
Rationale: Metformin can cause lactic acidosis, a rare but serious side effect.
Symptoms include muscle pain, weakness, malaise, and difficulty breathing.
Patients should report these immediately. Metformin is taken with meals to
reduce GI side effects, it causes weight loss or is weight-neutral, and it
decreases hepatic glucose production (not insulin production).
Subtopic: Metformin – Lactic Acidosis Risk
Question 4
A patient with type 1 diabetes is prescribed insulin glargine (Lantus). Which
statement about this insulin is correct?
A. It is a rapid-acting insulin given before meals.
B. It cannot be mixed with other insulins in the same syringe.
, C. It has a peak of 2–4 hours.
D. It is given twice daily.
Correct Answer: B. It cannot be mixed with other insulins in the same
syringe.
Rationale: Insulin glargine is a long-acting (peakless, duration ≈24 hours)
insulin and should not be mixed with other insulins in the same syringe (pH
incompatibility). It is given once daily at the same time each day and
provides basal insulin coverage.
Subtopic: Insulins – Long-Acting (Glargine)
Question 5
A patient with type 2 diabetes has an A1C of 9.2% on metformin alone. What
is the next step in medical nutrition therapy?
A. Start insulin immediately
B. Refer for bariatric surgery
C. Focus on carbohydrate reduction and weight loss if overweight
D. Discontinue metformin and start a sulfonylurea
Correct Answer: C. Focus on carbohydrate reduction and weight loss if
overweight
Rationale: The primary goal of MNT in type 2 diabetes is to achieve glycemic
control through lifestyle modifications (carbohydrate reduction, weight loss,
physical activity). If A1C remains above target after 3–6 months of lifestyle
changes and metformin, additional medication is considered.
Subtopic: Diabetes – MNT Goals
Question 6
A patient with diabetes has a blood glucose of 55 mg/dL and is conscious.
What is the appropriate treatment?
A. 15 g of carbohydrate (4 oz juice, 3–4 glucose tablets)
B. 30 g of carbohydrate
