lOMoARcPSD|235 896 49
NUR 2474 PHARMACOLOGY
FINAL EXAM
1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four
patients who were just admitted. Which patient should the nurse assess first?
a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of
70/30 Novolin insulin
b. The patient with a pulse of 58 beats per minute who is about to receive digoxin
(Lanoxin)
c. The patient with a blood pressure of 136/92 mm Hg who complains of having a
headache
d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin
(Vancocin)
2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a
sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar
level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer?
a. No insulin should be administered.
b. NPH
c. 70/30 mix
d. Lispro (Humalog)
3. A patient with type 1 diabetes recently became pregnant. The nurse plans a blood
glucose testing schedule for her. What is the recommended monitoring schedule?
a. Before each meal and before bed
b. In the morning for a fasting level and at 4 PM for the peak level
c. Six or seven times a day
d. Three times a day, along with urine glucose testing
, lOMoARcPSD|235 896 49
4. An adolescent patient recently attended a health fair and had a serum glucose test.
The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I
have diabetes?" What is the nurse's most accurate response?
a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you
have diabetes."
b. "At this level, you probably have diabetes. You will need an oral glucose tolerance
test this week."
c. "This level is conclusive evidence that you have diabetes."
d. "This level is conclusive evidence that you do not have diabetes."
5. Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the
nurse administer this drug?
a. Approximately 15 to 30 minutes before each meal
b. In the morning and at 4 PM
c. Once daily at bedtime
d. After meals and at bedtime
6. A patient with type 1 diabetes who takes insulin reports taking propranolol for
hypertension. Why is the nurse concerned?
a. The beta blocker can cause insulin resistance.
b. Using the two agents together increases the risk of ketoacidosis.
c. Propranolol increases insulin requirements because of receptor blocking.
d. The beta blocker can mask the symptoms of hypoglycemia.
7. Which statement is correct about the contrast between a carbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
, lOMoARcPSD|235 896 49
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects.
8. A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for which
adverse reactions? (Select all that apply.)
a. Hypoglycemia
b. Flatulence
c. Elevated iron levels in the blood
d. Fluid retention
e. Diarrhea
9. The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism.
The patient tells the nurse she does not want to take medications while she is pregnant.
What will the nurse explain to this patient?
a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
b. Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c. No danger to the fetus exists until the third trimester.
d. Treatment is required only if the patient is experiencing symptoms.
10. A nurse is teaching a patient who has been diagnosed with hypothyroidism
about levothyroxine (Synthroid). Which statement by the patient indicates a need for
further teaching?
a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
, lOMoARcPSD|235 896 49
11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse
assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per
minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The
nurse will contact the provider to request an order for which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole)
12. A patient is admitted to the hospital and will begin taking levothyroxine
(Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The
nurse will notifythe provider to discuss the dose.
a. reducing levothyroxine
b. reducing warfarin
c. increasing levothyroxine
d. increasing warfarin
13. An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is
0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine
(Levothroid) 100 mcg/day PO. What will the nurse do?
a. Administer the medication as ordered.
b. Contact the provider to discuss giving the levothyroxine IV.
c. Request an order to give desiccated thyroid (Armour Thyroid).
d. Suggest that the provider lower the dose.
14. A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine
(Synthroid). The child comes to the clinic for a well-child check up. The nurse will expect
the provider to:
NUR 2474 PHARMACOLOGY
FINAL EXAM
1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four
patients who were just admitted. Which patient should the nurse assess first?
a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of
70/30 Novolin insulin
b. The patient with a pulse of 58 beats per minute who is about to receive digoxin
(Lanoxin)
c. The patient with a blood pressure of 136/92 mm Hg who complains of having a
headache
d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin
(Vancocin)
2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a
sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar
level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer?
a. No insulin should be administered.
b. NPH
c. 70/30 mix
d. Lispro (Humalog)
3. A patient with type 1 diabetes recently became pregnant. The nurse plans a blood
glucose testing schedule for her. What is the recommended monitoring schedule?
a. Before each meal and before bed
b. In the morning for a fasting level and at 4 PM for the peak level
c. Six or seven times a day
d. Three times a day, along with urine glucose testing
, lOMoARcPSD|235 896 49
4. An adolescent patient recently attended a health fair and had a serum glucose test.
The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I
have diabetes?" What is the nurse's most accurate response?
a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you
have diabetes."
b. "At this level, you probably have diabetes. You will need an oral glucose tolerance
test this week."
c. "This level is conclusive evidence that you have diabetes."
d. "This level is conclusive evidence that you do not have diabetes."
5. Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the
nurse administer this drug?
a. Approximately 15 to 30 minutes before each meal
b. In the morning and at 4 PM
c. Once daily at bedtime
d. After meals and at bedtime
6. A patient with type 1 diabetes who takes insulin reports taking propranolol for
hypertension. Why is the nurse concerned?
a. The beta blocker can cause insulin resistance.
b. Using the two agents together increases the risk of ketoacidosis.
c. Propranolol increases insulin requirements because of receptor blocking.
d. The beta blocker can mask the symptoms of hypoglycemia.
7. Which statement is correct about the contrast between a carbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
, lOMoARcPSD|235 896 49
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects.
8. A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for which
adverse reactions? (Select all that apply.)
a. Hypoglycemia
b. Flatulence
c. Elevated iron levels in the blood
d. Fluid retention
e. Diarrhea
9. The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism.
The patient tells the nurse she does not want to take medications while she is pregnant.
What will the nurse explain to this patient?
a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
b. Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c. No danger to the fetus exists until the third trimester.
d. Treatment is required only if the patient is experiencing symptoms.
10. A nurse is teaching a patient who has been diagnosed with hypothyroidism
about levothyroxine (Synthroid). Which statement by the patient indicates a need for
further teaching?
a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
, lOMoARcPSD|235 896 49
11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse
assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per
minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The
nurse will contact the provider to request an order for which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole)
12. A patient is admitted to the hospital and will begin taking levothyroxine
(Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The
nurse will notifythe provider to discuss the dose.
a. reducing levothyroxine
b. reducing warfarin
c. increasing levothyroxine
d. increasing warfarin
13. An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is
0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine
(Levothroid) 100 mcg/day PO. What will the nurse do?
a. Administer the medication as ordered.
b. Contact the provider to discuss giving the levothyroxine IV.
c. Request an order to give desiccated thyroid (Armour Thyroid).
d. Suggest that the provider lower the dose.
14. A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine
(Synthroid). The child comes to the clinic for a well-child check up. The nurse will expect
the provider to:
