NUR5334 Endocrine Mock Exam Questions and Answers Spring 2025

Below are two sets of study aids—each with a rapid review sheet and a series of multiple‐choice
questions designed to challenge your clinical decision‐making and reinforce core concepts from
the presentations. One set is based on the “Drugs for Diabetes – An Update (Summer 2021)”
PowerPoint, and the other set is based on “Other Endocrine Drugs, Updated (June 2024).”



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Part I: Drugs for Diabetes – An Update
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A. Rapid Review Sheet – Drugs for Diabetes (Summer 2021)

General Treatment Paradigms

 First-line Therapy:
o Metformin remains the foundation for type 2 diabetes management
(unless contraindicated).
o Benefits: A1c reduction ~1–2%, improvement in weight and lipid profile,
insulin- sensitizing.
 Cardiovascular (CV) and Renal Protection:
o In patients with established cardiovascular disease or heart failure:
 SGLT-2 Inhibitors (e.g., empagliflozin, canagliflozin,
dapagliflozin) reduce HF hospitalization and may slow kidney
disease progression.
 GLP-1 Receptor Agonists (e.g., liraglutide, semaglutide, dulaglutide)
reduce major adverse cardiovascular events (MACE) and promote
weight loss.

Drug Class Overviews

 SGLT-2 Inhibitors:
o Mechanism: Block glucose reabsorption in the proximal renal tubule
→ increased urinary glucose excretion.
o Key Effects/AE’s: Modest A1c reduction (~0.8%), weight loss, reduction in
heart failure events; watch for dehydration, genital infections, and—particularly
with canagliflozin—the risk for amputations.
 GLP-1 Receptor Agonists:
o Mechanism: Enhance glucose‐dependent insulin secretion, reduce
glucagon release, slow gastric emptying, and reduce appetite.
o Key Effects/AE’s: Lower A1c (1–2%), support weight loss, generally low risk
for hypoglycemia; notable GI effects (nausea, early satiety), and a black box
warning for thyroid C-cell tumors (avoid in patients with personal/family
history of medullary thyroid carcinoma or MEN2).
 Combination Therapy:

, o Updated guidelines emphasize the importance of individualized care—choice
of add-on therapy (GLP-1 vs. SGLT-2) may depend on comorbidities like CV
disease, heart failure, and renal function.
 Recent Evidence Highlights (Summer 2021 Update):
o New clinical trials underscore the renal and CV benefits of SGLT-2 inhibitors and
potent efficacy of select GLP-1 agents.
o Studies continue to support early initiation of combination therapy for high-risk
patients.



B. Multiple-Choice Questions – Drugs for Diabetes (Summer 2021)

1. According to the Summer 2021 update, which drug remains the first-line
therapy for type 2 diabetes?
A. Liraglutide
B. Metformin
C. Empagliflozin
D. Pioglitazone
2. Which class of drugs is recommended in patients with type 2 diabetes and
heart failure due to their proven reduction in hospitalizations?
A. DPP-4 inhibitors
B. SGLT-2 inhibitors
C. GLP-1 agonists
D. Sulfonylureas
3. What is the primary mechanism of SGLT-2 inhibitors?
A. Increase pancreatic beta-cell insulin secretion
B. Enhance insulin receptor sensitivity
C. Block renal glucose reabsorption
D. Slow gastric emptying
4. Which adverse effect is especially associated with canagliflozin?
A. Pancreatitis
B. Increased risk of lower extremity amputations
C. Severe hypoglycemia
D. Thyroid C-cell tumors
5. GLP-1 receptor agonists lower A1c by approximately:
A. 0.5–1%
B. 1–2%
C. 2–3%
D. 3–4%
6. Which of the following is a common gastrointestinal side effect associated
with GLP-1 receptor agonists?
A. Diarrhea
B. Constipation
C. Nausea
D. Abdominal cramping (all of the above may occur, with nausea being most common)
7. In patients with type 2 diabetes and established cardiovascular disease,
which therapeutic benefit is most supported by recent data?
A. Reduction of microalbuminuria only

, B. Reduction of major adverse cardiovascular events (MACE)
C. Increase in insulin secretion
D. Enhanced hepatic glucose production
8. Which drug can be given orally as an update in the GLP-1 class?
A. Dulaglutide
B. Semaglutide
C. Exenatide
D. Liraglutide
9. For patients initiating combination therapy, what factor is most important when
choosing between adding an SGLT-2 inhibitor versus a GLP-1 receptor agonist?
A. Patient’s history of hypoglycemia
B. Patient’s preference for oral versus injectable medications
C. Presence of heart failure or atherosclerotic cardiovascular disease
D. Ability to pay for newer medications
10. Which outcome has been most notably improved by SGLT-2 inhibitors in
recent trials?
A. Weight loss exceeding 10 lbs
B. Reduction in heart failure hospitalizations
C. Significant reduction in A1c (>3%)
D. Complete resolution of diabetic neuropathy
11. A patient on metformin with stable heart failure should continue metformin
unless they develop which of the following?
A. Weight loss
B. Lactic acidosis risk factors (severe dehydration, acute illness)
C. Improved glycemic control
D. Elevated LDL cholesterol
12. Which of the following is NOT a typical adverse effect of SGLT-2 inhibitors?
A. Genital mycotic infections
B. Dehydration
C. Hypoglycemia
D. Volume depletion
13. According to updated guidelines, when should combination therapy with a GLP-1
agonist or SGLT-2 inhibitor be considered?
A. Only after failure of sulfonylureas
B. Early in patients with high cardiovascular risk
C. Only in patients with low BMI
D. After long-term insulin therapy
14. Which drug is known to slow gastric emptying and thereby improve
postprandial glucose control?
A. Metformin
B. Pioglitazone
C. Liraglutide
D. Canagliflozin
15. The Summer 2021 updates emphasize that treatment selection in type 2
diabetes should be individualized based on:
A. Baseline weight and A1c only
B. Comorbid conditions such as CV disease, heart failure, and renal function
C. Age alone
D. Prior use of sulfonylureas only