NR 566 MIDTERM/NR566 ADVANCED
PHARMACOLOGY FOR CARE OF THE FAMILY MIDTERM EXAM NEWEST
2025/2026
ACTUAL EXAM COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS /ALREADY
GRADED A+
Insulin Treatment Algorithm for Type 1 DM ......answer.....Total daily insulin requirement is 0.3 to 0.5
units/kg body weight/d with titration to glycemic targets. Higher doses for acute illness.
Adjustments made after reviewing patterns over 3 days. Hypoglycemia addressed first, then
hyperglycemia. Adjustments up or down done in increments of 1 unit.
Criteria for screening asymptomatic adults
......answer.....Individuals ≥45 yr and who have a BMI ≥25 kg/m2 should be tested. If normal,
the test should be repeated at 3 yr intervals.
Individuals <45 yr and who have a BMI ≥25 kg/m2 and have additional risk factors should
have more frequent testing.
Additional risk factors are the following:
• Physically inactive
• First-degree relative with diabetes
• Members of high-risk ethnic group (African American,
Hispanic, Native American, Asian American, Pacific Islander)
• Delivered a baby weighing >9 lb or previously diagnosed with GDM
1
, • Hypertensive (B/P ≥140/90 mm Hg)
• HDL cholesterol ≤35 mg/dL and/or triglyceride level ≥250 mg/dL
• Have polycystic ovary syndrome (PCOS)
• IGT or IFG on previous testing
• Have other clinical conditions associated with insulin resistance (PCOS or acanthosis
nigricans)
• History of CVD
Rapid Acting Insulin ......answer.....Humalog, Novolog, Apidra
Short Acting Insulin ......answer.....Regular (Humulin R, Novolin R)
Intermediate Acting Insulin ......answer.....Isophane (NPH, Humulin N)
Long Acting Insulin ......answer.....Lantus, Levimir
Fixed Combo Insulin ......answer.....70/30 (NPH/regular ratio)
50/50 (NPH/regular ratio)
75/25 (NPH/lispro)
70/30 (NPH/aspart)
A1C Treatment Goal ......answer.....Less than 7%
Daily dose of insulin for initiation ......answer.....0.1/kg or 10 units
A1C monitoring during oral or insulin diabetes management ......answer.....Because Hb A1c reflects
mean glycemia over the preceding 2 to 3 months, it should be measured at least twice a year if
2
, patients are meeting treatment goals or have stable glycemic control; it should be measured every 3
months if therapy has changed or if patients are not meeting treatment goals
Correlate mean plasma glucose level according to A1C ......answer.....Hemoglobin A1c Levels
Mean Plasma Glucose (mg/dL)
6=
126 7=
154
8=
183
9=
212
10=
240
11=
269
12=
290
Clinical manifestations of diabetic autonomic neuropathy ......answer.....Resting tachycardia, exercise
intolerance, orthostatic hypotension, constipation, gastroparesis, erectile dysfunction, sweat gland
dysfunction, impaired neurovascular function, and the potential for autonomic failure in response to
hypoglycemia.
Hypoglycemia treatment (amount of carbohydrates and examples) ......answer.....They should take 15
gm of carbohydrate and recheck their sugars in 15 minutes.
Drug monitoring with metformin ......answer.....Monitor B12 levels
3
, Antidiabetic medications associated with photosensitivity ......answer.....Sulfonylureas
Antidiabetics to avoid in the elderly & why
......answer.....Sulfonylureas produces severe hypoglycemia.
Glimepiride produces hypoglycemia.
Glyburide is the most likely to cause hypoglycemia.
Metformin due to older adults often have renal insufficiency or heart failure.
Alpha-glucosidase inhibitors are not well tolerated.
All meds should be started at the lowest possible dose.
Improving patient compliance with diabetes treatment
......answer.....Nonadherence to the treatment regimen may result in increased risk for complications
and reduced life expectancy. Healthcare providers should be aware of potential problems with
nonadherence, discuss the importance of adherence at each followup visit, and assist patients in
removing barriers to adherence such as lack of social support and cost of the treatment regimen. A
team approach with the patient as an active partner should be maximized. Ways to deal with
nonadherence are discussed in Chapter 6. Patient education booklets are available from the ADA,
which can be accessed on the Internet at www.diabetes.org.
Diabetic medications to avoid when taking digoxin
......answer.....Metformin - dig may increase the effect of metformin leading to lactic acidosis.
Diabetic medications with need for renal dose adjustment ......answer.....Metformin
Diabetic medications associated with increased risk for genital mycotic infections
......answer.....Selective Sodium Glucose Cotransporter 2 (SGLT-2)
Time anticipated for total reversal of hyperthyroid symptoms with methimazole ......answer.....A
treatment typically requires 6 to 12 months for total reversal of hyperthyroid symptoms.
4
PHARMACOLOGY FOR CARE OF THE FAMILY MIDTERM EXAM NEWEST
2025/2026
ACTUAL EXAM COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS /ALREADY
GRADED A+
Insulin Treatment Algorithm for Type 1 DM ......answer.....Total daily insulin requirement is 0.3 to 0.5
units/kg body weight/d with titration to glycemic targets. Higher doses for acute illness.
Adjustments made after reviewing patterns over 3 days. Hypoglycemia addressed first, then
hyperglycemia. Adjustments up or down done in increments of 1 unit.
Criteria for screening asymptomatic adults
......answer.....Individuals ≥45 yr and who have a BMI ≥25 kg/m2 should be tested. If normal,
the test should be repeated at 3 yr intervals.
Individuals <45 yr and who have a BMI ≥25 kg/m2 and have additional risk factors should
have more frequent testing.
Additional risk factors are the following:
• Physically inactive
• First-degree relative with diabetes
• Members of high-risk ethnic group (African American,
Hispanic, Native American, Asian American, Pacific Islander)
• Delivered a baby weighing >9 lb or previously diagnosed with GDM
1
, • Hypertensive (B/P ≥140/90 mm Hg)
• HDL cholesterol ≤35 mg/dL and/or triglyceride level ≥250 mg/dL
• Have polycystic ovary syndrome (PCOS)
• IGT or IFG on previous testing
• Have other clinical conditions associated with insulin resistance (PCOS or acanthosis
nigricans)
• History of CVD
Rapid Acting Insulin ......answer.....Humalog, Novolog, Apidra
Short Acting Insulin ......answer.....Regular (Humulin R, Novolin R)
Intermediate Acting Insulin ......answer.....Isophane (NPH, Humulin N)
Long Acting Insulin ......answer.....Lantus, Levimir
Fixed Combo Insulin ......answer.....70/30 (NPH/regular ratio)
50/50 (NPH/regular ratio)
75/25 (NPH/lispro)
70/30 (NPH/aspart)
A1C Treatment Goal ......answer.....Less than 7%
Daily dose of insulin for initiation ......answer.....0.1/kg or 10 units
A1C monitoring during oral or insulin diabetes management ......answer.....Because Hb A1c reflects
mean glycemia over the preceding 2 to 3 months, it should be measured at least twice a year if
2
, patients are meeting treatment goals or have stable glycemic control; it should be measured every 3
months if therapy has changed or if patients are not meeting treatment goals
Correlate mean plasma glucose level according to A1C ......answer.....Hemoglobin A1c Levels
Mean Plasma Glucose (mg/dL)
6=
126 7=
154
8=
183
9=
212
10=
240
11=
269
12=
290
Clinical manifestations of diabetic autonomic neuropathy ......answer.....Resting tachycardia, exercise
intolerance, orthostatic hypotension, constipation, gastroparesis, erectile dysfunction, sweat gland
dysfunction, impaired neurovascular function, and the potential for autonomic failure in response to
hypoglycemia.
Hypoglycemia treatment (amount of carbohydrates and examples) ......answer.....They should take 15
gm of carbohydrate and recheck their sugars in 15 minutes.
Drug monitoring with metformin ......answer.....Monitor B12 levels
3
, Antidiabetic medications associated with photosensitivity ......answer.....Sulfonylureas
Antidiabetics to avoid in the elderly & why
......answer.....Sulfonylureas produces severe hypoglycemia.
Glimepiride produces hypoglycemia.
Glyburide is the most likely to cause hypoglycemia.
Metformin due to older adults often have renal insufficiency or heart failure.
Alpha-glucosidase inhibitors are not well tolerated.
All meds should be started at the lowest possible dose.
Improving patient compliance with diabetes treatment
......answer.....Nonadherence to the treatment regimen may result in increased risk for complications
and reduced life expectancy. Healthcare providers should be aware of potential problems with
nonadherence, discuss the importance of adherence at each followup visit, and assist patients in
removing barriers to adherence such as lack of social support and cost of the treatment regimen. A
team approach with the patient as an active partner should be maximized. Ways to deal with
nonadherence are discussed in Chapter 6. Patient education booklets are available from the ADA,
which can be accessed on the Internet at www.diabetes.org.
Diabetic medications to avoid when taking digoxin
......answer.....Metformin - dig may increase the effect of metformin leading to lactic acidosis.
Diabetic medications with need for renal dose adjustment ......answer.....Metformin
Diabetic medications associated with increased risk for genital mycotic infections
......answer.....Selective Sodium Glucose Cotransporter 2 (SGLT-2)
Time anticipated for total reversal of hyperthyroid symptoms with methimazole ......answer.....A
treatment typically requires 6 to 12 months for total reversal of hyperthyroid symptoms.
4
