NU 578 | Unit 4
OBJECTIVE ASSESSMENT - EXAM
NU 578 Unit 4 Exam (2026/2027
Update) University Of South
Alabama, Questions & Answers
(Verified Answers) | Complete
A+ Guide - PDF
Pharmacology for Advanced Practice Nurses | Certification Exam
100 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
* Thyroid & Adrenal Disorders & Drug Therapy * Osteoporosis, Gout & Arthritis Management
* Diabetes Mellitus & Antidiabetic Agents * GERD, Peptic Ulcer & Antiulcer Therapy
* NSAIDs, Corticosteroids & DMARDs * Nausea, Vomiting & Motility Disorders
COVER PAGE - 1
, SECTION 1 | Endocrine Pharmacology | Q1-Q30 | NU 578 Unit 4 Exam (2026/2027 Update) University Of Sou
Q1. A 58-year-old woman with newly diagnosed hypothyroidism is started on levothyroxine 75
mcg daily. Which nursing instruction is most important to ensure optimal absorption of this
medication?
A. Take the medication with a high-fiber breakfast to prevent constipation.
B. Administer the tablet with a full glass of water on an empty stomach 30-60 minutes before
breakfast.
C. Take the medication at bedtime with a calcium supplement to enhance bone protection.
D. Crush the tablet and mix with applesauce if the patient has difficulty swallowing.
Correct Answer: B
Rationale:
Levothyroxine should
Levothyroxine should be
be taken
taken on
on an
an empty
empty stomach
stomach with
with water
water 30-60
30-60 minutes
minutes before
before breakfast
breakfast to
to optimize
optimize
absorption.
absorption. Food, fiber, calcium, and iron can significantly reduce absorption. The tablet should not be
Food, fiber, calcium, and iron can significantly reduce absorption. The tablet should not be
crushed
crushed unless
unless using
using a
a specific
specific liquid
liquid formulation.
formulation.
Q2. A 45-year-old man with type 2 diabetes mellitus is prescribed metformin 1000 mg twice
daily. The nurse should include which instruction regarding the most common adverse effect of
this medication?
A. Take with food to reduce gastrointestinal upset such as diarrhea and nausea.
B. Avoid all dairy products to prevent hypercalcemia.
C. Monitor for signs of hypoglycemia every 2 hours while awake.
D. Take on an empty stomach to maximize insulin secretion.
Correct Answer: A
Rationale:
Metformin commonly
Metformin commonly causes
causes GI
GI adverse
adverse effects
effects including
including diarrhea,
diarrhea, nausea,
nausea, and
and abdominal
abdominal discomfort.
discomfort. Taking
Taking
itit with
with food
food helps
helps minimize
minimize these
these effects.
effects. Metformin
Metformin does
does not
not cause
cause hypoglycemia
hypoglycemia when
when used
used alone
alone and
and does
does
not stimulate insulin secretion.
not stimulate insulin secretion.
Unit 4 Exam (2026/2027 Update) University Of South Alabama, Questions & Answers (Verified Answers) | Complete A+ Guide - PDF -- 2026/2027 | Passing Score: 80% | Pag
, SECTION 1 | Endocrine Pharmacology | Q1-Q30 | NU 578 Unit 4 Exam (2026/2027 Update) University Of Sou
Q3. A 62-year-old patient with Graves disease is started on methimazole 10 mg daily. Which
laboratory value should the nurse monitor most closely during the first 3 months of therapy?
A. Serum creatinine to detect nephrotoxicity
B. White blood cell count to detect agranulocytosis
C. Hemoglobin A1c to monitor glycemic control
D. Platelet count to detect thrombocytopenia
Correct Answer: B
Rationale:
Methimazole
Methimazole cancan cause
cause agranulocytosis,
agranulocytosis, aa potentially
potentially life-threatening
life-threatening decrease
decrease in
in neutrophils.
neutrophils. Patients
Patients should
should
be instructed
be instructed to
to report
report fever,
fever, sore
sore throat,
throat, or
or signs
signs of
of infection
infection immediately.
immediately. WBC
WBC monitoring
monitoring is
is essential,
essential,
especially in
especially in the
the first
first 3
3 months.
months.
Q4. A 55-year-old patient with Addison disease is prescribed hydrocortisone 20 mg in the
morning and 10 mg in the afternoon. The nurse recognizes that this dosing schedule mimics
which natural physiological process?
A. The circadian rhythm of endogenous cortisol secretion
B. The pulsatile release of growth hormone during sleep
C. The feedback inhibition of thyroid-stimulating hormone
D. The diurnal variation of insulin sensitivity
Correct Answer: A
Rationale:
Hydrocortisone
Hydrocortisone dosing
dosing mimics
mimics the
the natural
natural circadian
circadian rhythm
rhythm of
of cortisol
cortisol secretion,
secretion, which
which peaks
peaks in
in the
the early
early
morning
morning and declines throughout the day. Morning dosing provides the highest concentration when the
and declines throughout the day. Morning dosing provides the highest concentration when the body
body
naturally needs
naturally needs itit most.
most.
Unit 4 Exam (2026/2027 Update) University Of South Alabama, Questions & Answers (Verified Answers) | Complete A+ Guide - PDF -- 2026/2027 | Passing Score: 80% | Pag
, SECTION 1 | Endocrine Pharmacology | Q1-Q30 | NU 578 Unit 4 Exam (2026/2027 Update) University Of Sou
Q5. A 48-year-old patient with type 1 diabetes is learning to administer insulin glargine. Which
statement by the patient indicates correct understanding of this insulin's action profile?
A. I should take this insulin 30 minutes before each meal to cover my food intake.
B. This insulin provides a steady baseline level and should be taken at the same time every day.
C. I can mix this insulin with my rapid-acting insulin in the same syringe.
D. This insulin will peak in 2 hours and I need to eat a snack then to prevent hypoglycemia.
Correct Answer: B
Rationale:
Insulin
Insulin glargine
glargine is
is a
a long-acting
long-acting basal
basal insulin
insulin that
that provides
provides a
a steady,
steady, peakless
peakless level
level over
over 24
24 hours.
hours. It
It should
should
not be
not be mixed
mixed with
with other
other insulins
insulins and
and is
is not
not taken
taken for
for meal
meal coverage.
coverage. It
It is
is administered
administered once
once daily
daily at
at a
a
consistent time.
consistent time.
Q6. A 70-year-old patient with osteoporosis is prescribed alendronate 70 mg weekly. Which
instruction is essential for the nurse to provide to prevent esophageal injury?
A. Take the medication with orange juice to enhance calcium absorption.
B. Swallow the tablet with a full glass of plain water and remain upright for at least 30 minutes.
C. Chew the tablet thoroughly before swallowing to aid dissolution.
D. Take the medication at bedtime with a glass of milk to protect the stomach lining.
Correct Answer: B
Rationale:
Alendronate
Alendronate can
can cause
cause severe
severe esophageal
esophageal irritation
irritation and
and ulceration.
ulceration. It
It must
must be
be taken
taken with
with a
a full
full glass
glass of
of plain
plain
water only,
water only, and
and the
the patient
patient must
must remain
remain upright
upright (sitting
(sitting or
or standing)
standing) for
for at
at least
least 30
30 minutes
minutes to
to ensure
ensure the
the tablet
tablet
reaches the
reaches the stomach.
stomach.
Unit 4 Exam (2026/2027 Update) University Of South Alabama, Questions & Answers (Verified Answers) | Complete A+ Guide - PDF -- 2026/2027 | Passing Score: 80% | Pag
OBJECTIVE ASSESSMENT - EXAM
NU 578 Unit 4 Exam (2026/2027
Update) University Of South
Alabama, Questions & Answers
(Verified Answers) | Complete
A+ Guide - PDF
Pharmacology for Advanced Practice Nurses | Certification Exam
100 100%
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
* Thyroid & Adrenal Disorders & Drug Therapy * Osteoporosis, Gout & Arthritis Management
* Diabetes Mellitus & Antidiabetic Agents * GERD, Peptic Ulcer & Antiulcer Therapy
* NSAIDs, Corticosteroids & DMARDs * Nausea, Vomiting & Motility Disorders
COVER PAGE - 1
, SECTION 1 | Endocrine Pharmacology | Q1-Q30 | NU 578 Unit 4 Exam (2026/2027 Update) University Of Sou
Q1. A 58-year-old woman with newly diagnosed hypothyroidism is started on levothyroxine 75
mcg daily. Which nursing instruction is most important to ensure optimal absorption of this
medication?
A. Take the medication with a high-fiber breakfast to prevent constipation.
B. Administer the tablet with a full glass of water on an empty stomach 30-60 minutes before
breakfast.
C. Take the medication at bedtime with a calcium supplement to enhance bone protection.
D. Crush the tablet and mix with applesauce if the patient has difficulty swallowing.
Correct Answer: B
Rationale:
Levothyroxine should
Levothyroxine should be
be taken
taken on
on an
an empty
empty stomach
stomach with
with water
water 30-60
30-60 minutes
minutes before
before breakfast
breakfast to
to optimize
optimize
absorption.
absorption. Food, fiber, calcium, and iron can significantly reduce absorption. The tablet should not be
Food, fiber, calcium, and iron can significantly reduce absorption. The tablet should not be
crushed
crushed unless
unless using
using a
a specific
specific liquid
liquid formulation.
formulation.
Q2. A 45-year-old man with type 2 diabetes mellitus is prescribed metformin 1000 mg twice
daily. The nurse should include which instruction regarding the most common adverse effect of
this medication?
A. Take with food to reduce gastrointestinal upset such as diarrhea and nausea.
B. Avoid all dairy products to prevent hypercalcemia.
C. Monitor for signs of hypoglycemia every 2 hours while awake.
D. Take on an empty stomach to maximize insulin secretion.
Correct Answer: A
Rationale:
Metformin commonly
Metformin commonly causes
causes GI
GI adverse
adverse effects
effects including
including diarrhea,
diarrhea, nausea,
nausea, and
and abdominal
abdominal discomfort.
discomfort. Taking
Taking
itit with
with food
food helps
helps minimize
minimize these
these effects.
effects. Metformin
Metformin does
does not
not cause
cause hypoglycemia
hypoglycemia when
when used
used alone
alone and
and does
does
not stimulate insulin secretion.
not stimulate insulin secretion.
Unit 4 Exam (2026/2027 Update) University Of South Alabama, Questions & Answers (Verified Answers) | Complete A+ Guide - PDF -- 2026/2027 | Passing Score: 80% | Pag
, SECTION 1 | Endocrine Pharmacology | Q1-Q30 | NU 578 Unit 4 Exam (2026/2027 Update) University Of Sou
Q3. A 62-year-old patient with Graves disease is started on methimazole 10 mg daily. Which
laboratory value should the nurse monitor most closely during the first 3 months of therapy?
A. Serum creatinine to detect nephrotoxicity
B. White blood cell count to detect agranulocytosis
C. Hemoglobin A1c to monitor glycemic control
D. Platelet count to detect thrombocytopenia
Correct Answer: B
Rationale:
Methimazole
Methimazole cancan cause
cause agranulocytosis,
agranulocytosis, aa potentially
potentially life-threatening
life-threatening decrease
decrease in
in neutrophils.
neutrophils. Patients
Patients should
should
be instructed
be instructed to
to report
report fever,
fever, sore
sore throat,
throat, or
or signs
signs of
of infection
infection immediately.
immediately. WBC
WBC monitoring
monitoring is
is essential,
essential,
especially in
especially in the
the first
first 3
3 months.
months.
Q4. A 55-year-old patient with Addison disease is prescribed hydrocortisone 20 mg in the
morning and 10 mg in the afternoon. The nurse recognizes that this dosing schedule mimics
which natural physiological process?
A. The circadian rhythm of endogenous cortisol secretion
B. The pulsatile release of growth hormone during sleep
C. The feedback inhibition of thyroid-stimulating hormone
D. The diurnal variation of insulin sensitivity
Correct Answer: A
Rationale:
Hydrocortisone
Hydrocortisone dosing
dosing mimics
mimics the
the natural
natural circadian
circadian rhythm
rhythm of
of cortisol
cortisol secretion,
secretion, which
which peaks
peaks in
in the
the early
early
morning
morning and declines throughout the day. Morning dosing provides the highest concentration when the
and declines throughout the day. Morning dosing provides the highest concentration when the body
body
naturally needs
naturally needs itit most.
most.
Unit 4 Exam (2026/2027 Update) University Of South Alabama, Questions & Answers (Verified Answers) | Complete A+ Guide - PDF -- 2026/2027 | Passing Score: 80% | Pag
, SECTION 1 | Endocrine Pharmacology | Q1-Q30 | NU 578 Unit 4 Exam (2026/2027 Update) University Of Sou
Q5. A 48-year-old patient with type 1 diabetes is learning to administer insulin glargine. Which
statement by the patient indicates correct understanding of this insulin's action profile?
A. I should take this insulin 30 minutes before each meal to cover my food intake.
B. This insulin provides a steady baseline level and should be taken at the same time every day.
C. I can mix this insulin with my rapid-acting insulin in the same syringe.
D. This insulin will peak in 2 hours and I need to eat a snack then to prevent hypoglycemia.
Correct Answer: B
Rationale:
Insulin
Insulin glargine
glargine is
is a
a long-acting
long-acting basal
basal insulin
insulin that
that provides
provides a
a steady,
steady, peakless
peakless level
level over
over 24
24 hours.
hours. It
It should
should
not be
not be mixed
mixed with
with other
other insulins
insulins and
and is
is not
not taken
taken for
for meal
meal coverage.
coverage. It
It is
is administered
administered once
once daily
daily at
at a
a
consistent time.
consistent time.
Q6. A 70-year-old patient with osteoporosis is prescribed alendronate 70 mg weekly. Which
instruction is essential for the nurse to provide to prevent esophageal injury?
A. Take the medication with orange juice to enhance calcium absorption.
B. Swallow the tablet with a full glass of plain water and remain upright for at least 30 minutes.
C. Chew the tablet thoroughly before swallowing to aid dissolution.
D. Take the medication at bedtime with a glass of milk to protect the stomach lining.
Correct Answer: B
Rationale:
Alendronate
Alendronate can
can cause
cause severe
severe esophageal
esophageal irritation
irritation and
and ulceration.
ulceration. It
It must
must be
be taken
taken with
with a
a full
full glass
glass of
of plain
plain
water only,
water only, and
and the
the patient
patient must
must remain
remain upright
upright (sitting
(sitting or
or standing)
standing) for
for at
at least
least 30
30 minutes
minutes to
to ensure
ensure the
the tablet
tablet
reaches the
reaches the stomach.
stomach.
Unit 4 Exam (2026/2027 Update) University Of South Alabama, Questions & Answers (Verified Answers) | Complete A+ Guide - PDF -- 2026/2027 | Passing Score: 80% | Pag
