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NUR2474 PHARMACOLOGY FINAL EXAM COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS

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NUR2474 PHARMACOLOGY FINAL EXAM COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS

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NUR2474 PHARMACOLOGY FINAL EXAM 2024-2025 COMPLETE

QUESTIONS AND CORRECT DETAILED ANSWERS

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)

Ans: a. The NPO patient with a blood glucose level of 80 mg/dL who just received
20 units of 70/30 Novolin insulin.

*low/normal BGL and insulin will continue to drop glucose level. At risk for
hypoglycemia.

Quiz 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)

Ans: d. Lispro (Humalog)

*high blood sugar needs rapid acting insulin.

,Quiz 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

Ans: c. Six or seven times a day

*pregnancy can effect glucose levels. Frequent monitoring required.

Quiz 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."

Ans: a. "Unless you were fasting for longer than 8 hours, this does not necessarily
mean you have diabetes."

*could be a normal level without fasting and does not mean diabetes unless it was
high for a fasting blood glucose level.

Quiz 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

Ans: c. Once daily at bedtime

*goodnight glargine

Quiz 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.

,Ans: d. The beta blocker can mask the symptoms of hypoglycemia.

*beta blockers block adrenaline which signals the liver to release glucose in the
blood when glucose is low to avoid hypoglycemia.

Quiz 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.
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects.

Ans: a. Miglitol has not been associated with hepatic dysfunction.

*key difference is that acarbose has been associated with rare cases of hepatic
dysfunction

Quiz 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

Ans: b. Flatulence
e. Diarrhea

*due to build up of gasses (flatulence) from to undigested carbohydrates reaching
the colon and causing an osmotic effect (diarrhea)

Quiz 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.

Ans: b. Neuropsychologic deficits in the fetus can occur if the condition is not
treated.

*Thyroid hormones are crucial for the normal development of the fetal brain and
nervous system and must be treated in pregnancy.

, Quiz 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."

Ans: d."If I take calcium supplements, I may need to decrease my dose of
Synthroid."

*this statement is incorrect since calcium interferes with the absorption of Synthroid,
it may need to be increased not decreased.

Quiz 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)

Ans: c. Intravenous levothyroxine

*IV allows for a more rapid correction of thyroid hormone levels especially
hypothyroidism with symptoms of myxedema coma or severe hypothyroidism. This is
considered a medical emergency.

Quiz 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 notify the provider to discuss _____ the _____ dose.

a. reducing levothyroxine
b. reducing warfarin
c. increasing levothyroxine
d. increasing warfarin

Ans: b. reducing warfarin

*Levothyroxine (Synthroid) can potentially increase the effects of warfarin, leading to
an increased risk of bleeding.

Quiz 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?

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