NUR2474 Pharmacology Final Exam
Study online at https://quizlet.com/_gddxg5
1. 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): 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 hypo-
glycemia.
2. 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): d. Lispro (Humalog)
*high blood sugar needs rapid acting insulin.
3. 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: c. Six or seven times a
day
*pregnancy can effect glucose levels. Frequent monitoring required.
, NUR2474 Pharmacology Final Exam
Study online at https://quizlet.com/_gddxg5
4. 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.": 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.
5. 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: c. Once daily at bedtime
*goodnight glargine
6. 6. A patient with type 1 diabetes who takes insulin reports taking propra-
nolol 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.: 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.
7. 7. Which statement is correct about the contrast between a carbose and
miglitol?
, NUR2474 Pharmacology Final Exam
Study online at https://quizlet.com/_gddxg5
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.: a. Miglitol has not been associ-
ated with hepatic dysfunction.
*key difference is that acarbose has been associated with rare cases of hepatic
dysfunction
8. 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: b. Flatulence
e. Diarrhea
*due to build up of gasses (flatulence) from to undigested carbohydrates reaching
the colon and causing an osmotic effect (diarrhea)
9. 9. The nurse is caring for a pregnant patient recently diagnosed with hy-
pothyroidism. The patient tells the nurse she does not want to take medica-
tions 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 conse-
quence.
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.: 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.
10. 10. A nurse is teaching a patient who has been diagnosed with hypothy-
roidism about levothyroxine (Synthroid). Which statement by the patient indi-
cates a need for further teaching?
, NUR2474 Pharmacology Final Exam
Study online at https://quizlet.com/_gddxg5
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 Syn-
throid.": 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.
11. 11. A patient with hypothyroidism begins taking PO levothyroxine (Syn-
throid). 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): c. Intravenous levothyroxine
*IV allows for a more rapid correction of thyroid hormone levels especially hy-
pothyroidism with symptoms of myxedema coma or severe hypothyroidism. This is
considered a medical emergency.
12. 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: b. reducing warfarin
*Levothyroxine (Synthroid) can potentially increase the effects of warfarin, leading
to an increased risk of bleeding.
13. 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?
Study online at https://quizlet.com/_gddxg5
1. 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): 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 hypo-
glycemia.
2. 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): d. Lispro (Humalog)
*high blood sugar needs rapid acting insulin.
3. 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: c. Six or seven times a
day
*pregnancy can effect glucose levels. Frequent monitoring required.
, NUR2474 Pharmacology Final Exam
Study online at https://quizlet.com/_gddxg5
4. 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.": 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.
5. 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: c. Once daily at bedtime
*goodnight glargine
6. 6. A patient with type 1 diabetes who takes insulin reports taking propra-
nolol 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.: 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.
7. 7. Which statement is correct about the contrast between a carbose and
miglitol?
, NUR2474 Pharmacology Final Exam
Study online at https://quizlet.com/_gddxg5
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.: a. Miglitol has not been associ-
ated with hepatic dysfunction.
*key difference is that acarbose has been associated with rare cases of hepatic
dysfunction
8. 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: b. Flatulence
e. Diarrhea
*due to build up of gasses (flatulence) from to undigested carbohydrates reaching
the colon and causing an osmotic effect (diarrhea)
9. 9. The nurse is caring for a pregnant patient recently diagnosed with hy-
pothyroidism. The patient tells the nurse she does not want to take medica-
tions 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 conse-
quence.
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.: 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.
10. 10. A nurse is teaching a patient who has been diagnosed with hypothy-
roidism about levothyroxine (Synthroid). Which statement by the patient indi-
cates a need for further teaching?
, NUR2474 Pharmacology Final Exam
Study online at https://quizlet.com/_gddxg5
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 Syn-
throid.": 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.
11. 11. A patient with hypothyroidism begins taking PO levothyroxine (Syn-
throid). 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): c. Intravenous levothyroxine
*IV allows for a more rapid correction of thyroid hormone levels especially hy-
pothyroidism with symptoms of myxedema coma or severe hypothyroidism. This is
considered a medical emergency.
12. 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: b. reducing warfarin
*Levothyroxine (Synthroid) can potentially increase the effects of warfarin, leading
to an increased risk of bleeding.
13. 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?
