NU180/ NU 180 EXAM 3: (NEW 2025/ 2026
UPDATE) NURSING AND HEALTHCARE II
GUIDE| QUESTIONS & ANSWERS|NU180/
NU 180 EXAM 3: (NEW 2025/ 2026 UPDATE)
NURSING AN D HEALTHCARE II GUIDE|
QUESTIONS & ANSWERS|
PHARMACOLOGY & MEDICATION ADMINISTRATION
1. A patient is prescribed levothyroxine for the treatment of
hypothyroidism. Which instruction should the nurse include in the
teaching plan?
• A) Take the medication with a full meal to avoid GI upset
• B) Wait at least 15 minutes after eating before taking the pill
• C) Take the medication at bedtime with a glass of milk
• D) Take the medication on an empty stomach 30-60 minutes
before breakfast ✓
Rationale: Levothyroxine is best absorbed when taken on an empty
stomach in the early morning. Food can significantly interfere with
absorption of the synthetic thyroid hormone. Patients should wait at least
30 to 60 minutes before consuming any food or caffeine. Calcium and iron
supplements should be spaced at least 4 hours apart from this drug .
,2. A nurse is monitoring a patient receiving intravenous morphine.
Which assessment finding should the nurse prioritize as the most
serious adverse effect?
• A) Constipation and abdominal distension
• B) Nausea and vomiting following administration
• C) Itching and localized redness at the injection site
• D) A respiratory rate of 8 breaths per minute ✓
Rationale: Respiratory depression is the most life-threatening adverse
effect associated with opioid analgesics like morphine. A respiratory rate
below 10 to 12 breaths per minute requires immediate nursing
intervention. The nurse should be prepared to administer naloxone if the
patient is overly sedated or has significant respiratory compromise .
3. A patient is receiving gentamicin for a severe infection. Which
laboratory value should the nurse monitor most closely to prevent
toxicity?
• A) Serum Creatinine and Blood Urea Nitrogen (BUN) ✓
• B) Serum Potassium levels
• C) Alanine Aminotransferase (ALT)
• D) Prothrombin Time (PT)
Rationale: Aminoglycosides like gentamicin carry a high risk for
nephrotoxicity and ototoxicity. Serum creatinine and BUN are the primary
indicators of renal function and must be monitored regularly. If these
,values rise, it may indicate kidney damage requiring dosage adjustment or
discontinuation .
4. A patient newly diagnosed with Type 2 Diabetes is started on
Metformin. What is the most common side effect the nurse should
discuss?
• A) Weight gain and fluid retention
• B) Hypoglycemia in the early morning
• C) Gastrointestinal upset such as diarrhea and nausea ✓
• D) Metallic taste and increased appetite
Rationale: Metformin often causes gastrointestinal side effects including
diarrhea, nausea, and abdominal cramping. These symptoms are usually
dose-related and often improve over time as the patient adjusts. Taking
the medication with food can help minimize these uncomfortable gastric
effects .
5. A nurse is preparing to administer insulin lispro to a patient. When
should the nurse instruct the patient to eat?
• A) Within 15 minutes of receiving the injection ✓
• B) Exactly 45 minutes after the injection
• C) One hour before the injection is given
• D) Two hours after the injection to allow it to peak
Rationale: Insulin lispro is a rapid-acting insulin with an onset of action
between 15 and 30 minutes. To prevent severe hypoglycemia, the patient
, must have a meal ready and consume it shortly after administration. Peak
action occurs within 0.5 to 2.5 hours, which aligns with the rise in
postprandial glucose .
6. Which characteristic is true regarding NPH insulin?
• A) It is an intermediate-acting insulin and appears cloudy ✓
• B) It has an onset of 15 minutes and is short-acting
• C) It is a clear solution and can be given IV
• D) It is usually administered only once a day at bedtime
Rationale: NPH is an intermediate-acting insulin that has a cloudy
appearance due to the addition of protamine. It typically has an onset of 1
to 2 hours and a peak effect at 4 to 12 hours. Because it is a suspension,
the vial should be gently rolled between the hands to mix it before use .
7. A patient with diabetes is found unresponsive with a blood glucose
level of 42 mg/dL. Which medication should the nurse anticipate
administering?
• A) Regular Insulin
• B) Glyburide
• C) Glucagon ✓
• D) Metformin
Rationale: Glucagon is the emergency treatment for severe hypoglycemia
when the patient is unconscious or unable to swallow. It works by
stimulating the liver to convert stored glycogen into glucose. Regular
UPDATE) NURSING AND HEALTHCARE II
GUIDE| QUESTIONS & ANSWERS|NU180/
NU 180 EXAM 3: (NEW 2025/ 2026 UPDATE)
NURSING AN D HEALTHCARE II GUIDE|
QUESTIONS & ANSWERS|
PHARMACOLOGY & MEDICATION ADMINISTRATION
1. A patient is prescribed levothyroxine for the treatment of
hypothyroidism. Which instruction should the nurse include in the
teaching plan?
• A) Take the medication with a full meal to avoid GI upset
• B) Wait at least 15 minutes after eating before taking the pill
• C) Take the medication at bedtime with a glass of milk
• D) Take the medication on an empty stomach 30-60 minutes
before breakfast ✓
Rationale: Levothyroxine is best absorbed when taken on an empty
stomach in the early morning. Food can significantly interfere with
absorption of the synthetic thyroid hormone. Patients should wait at least
30 to 60 minutes before consuming any food or caffeine. Calcium and iron
supplements should be spaced at least 4 hours apart from this drug .
,2. A nurse is monitoring a patient receiving intravenous morphine.
Which assessment finding should the nurse prioritize as the most
serious adverse effect?
• A) Constipation and abdominal distension
• B) Nausea and vomiting following administration
• C) Itching and localized redness at the injection site
• D) A respiratory rate of 8 breaths per minute ✓
Rationale: Respiratory depression is the most life-threatening adverse
effect associated with opioid analgesics like morphine. A respiratory rate
below 10 to 12 breaths per minute requires immediate nursing
intervention. The nurse should be prepared to administer naloxone if the
patient is overly sedated or has significant respiratory compromise .
3. A patient is receiving gentamicin for a severe infection. Which
laboratory value should the nurse monitor most closely to prevent
toxicity?
• A) Serum Creatinine and Blood Urea Nitrogen (BUN) ✓
• B) Serum Potassium levels
• C) Alanine Aminotransferase (ALT)
• D) Prothrombin Time (PT)
Rationale: Aminoglycosides like gentamicin carry a high risk for
nephrotoxicity and ototoxicity. Serum creatinine and BUN are the primary
indicators of renal function and must be monitored regularly. If these
,values rise, it may indicate kidney damage requiring dosage adjustment or
discontinuation .
4. A patient newly diagnosed with Type 2 Diabetes is started on
Metformin. What is the most common side effect the nurse should
discuss?
• A) Weight gain and fluid retention
• B) Hypoglycemia in the early morning
• C) Gastrointestinal upset such as diarrhea and nausea ✓
• D) Metallic taste and increased appetite
Rationale: Metformin often causes gastrointestinal side effects including
diarrhea, nausea, and abdominal cramping. These symptoms are usually
dose-related and often improve over time as the patient adjusts. Taking
the medication with food can help minimize these uncomfortable gastric
effects .
5. A nurse is preparing to administer insulin lispro to a patient. When
should the nurse instruct the patient to eat?
• A) Within 15 minutes of receiving the injection ✓
• B) Exactly 45 minutes after the injection
• C) One hour before the injection is given
• D) Two hours after the injection to allow it to peak
Rationale: Insulin lispro is a rapid-acting insulin with an onset of action
between 15 and 30 minutes. To prevent severe hypoglycemia, the patient
, must have a meal ready and consume it shortly after administration. Peak
action occurs within 0.5 to 2.5 hours, which aligns with the rise in
postprandial glucose .
6. Which characteristic is true regarding NPH insulin?
• A) It is an intermediate-acting insulin and appears cloudy ✓
• B) It has an onset of 15 minutes and is short-acting
• C) It is a clear solution and can be given IV
• D) It is usually administered only once a day at bedtime
Rationale: NPH is an intermediate-acting insulin that has a cloudy
appearance due to the addition of protamine. It typically has an onset of 1
to 2 hours and a peak effect at 4 to 12 hours. Because it is a suspension,
the vial should be gently rolled between the hands to mix it before use .
7. A patient with diabetes is found unresponsive with a blood glucose
level of 42 mg/dL. Which medication should the nurse anticipate
administering?
• A) Regular Insulin
• B) Glyburide
• C) Glucagon ✓
• D) Metformin
Rationale: Glucagon is the emergency treatment for severe hypoglycemia
when the patient is unconscious or unable to swallow. It works by
stimulating the liver to convert stored glycogen into glucose. Regular
