HESI Endocrine Pharmacology
Question Bank: Insulin &
Antithyroid Drugs Mastery
Table of Contents
Subtopic 1: Insulin Types, Pharmacokinetics, and Administration....................3
Subtopic 2: Antithyroid Drugs – Mechanism, Indications, and Side Effects....11
Subtopic 3: Insulin Therapy in Special Populations (Pediatrics, Pregnancy,
Older Adults)..................................................................................................20
Subtopic 4: Management of Diabetic Emergencies (DKA and HHS) and Insulin
Use.................................................................................................................29
Subtopic 5: Patient Education and Self-Management of Insulin and Antithyroid
Therapy..........................................................................................................37
Subtopic 6: Managing Complications and Adverse Effects of Insulin and
Antithyroid Agents.........................................................................................46
Subtopic 7: Insulin Therapy in Special Populations (Pediatrics, Geriatrics, and
Pregnancy).....................................................................................................55
Subtopic 8: Drug Interactions and Patient Education Related to Insulin and
Antithyroid Agents.........................................................................................63
Subtopic 9: Emergency Management and Acute Complications in Endocrine
Drug Therapy.................................................................................................72
Subtopic 10: Case-Based Critical Thinking and Clinical Decision-Making in
Endocrine Pharmacology...............................................................................80
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Subtopic 1: Insulin Types, Pharmacokinetics,
and Administration
Question 1:
Which of the following insulins has the fastest onset of action?
A. NPH insulin
B. Regular insulin
C. Insulin lispro
D. Insulin detemir
Correct Answer: C. Insulin lispro
Rationale: Insulin lispro is a rapid-acting insulin with an onset of action within
15 minutes, making it the fastest among the listed types. Regular insulin has
a slower onset (30–60 minutes), NPH is intermediate-acting, and insulin
detemir is long-acting.
Question 2:
A nurse is teaching a patient how to mix NPH and regular insulin. What is the
correct order of mixing?
A. Inject air into NPH, then regular; draw up NPH, then regular
B. Inject air into regular, then NPH; draw up NPH, then regular
C. Inject air into NPH, then regular; draw up regular, then NPH
D. Inject air into regular, then NPH; draw up regular, then NPH
Correct Answer: C. Inject air into NPH, then regular; draw up regular, then
NPH
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Rationale: Air is injected into both vials to prevent vacuum creation, but
regular insulin must be drawn up first to avoid contaminating it with NPH,
which is cloudy.
Question 3:
Which insulin type should never be mixed with any other insulin in the same
syringe?
A. NPH insulin
B. Regular insulin
C. Insulin lispro
D. Insulin glargine
Correct Answer: D. Insulin glargine
Rationale: Insulin glargine has a unique pH and formulation that prevents it
from being mixed with other insulins, as this can alter its long-acting
properties.
Question 4:
A patient is prescribed insulin detemir once daily. What is the primary
purpose of this insulin?
A. To treat postprandial hyperglycemia
B. To maintain basal insulin levels
C. To correct hypoglycemia
D. To prevent ketone formation after meals
Correct Answer: B. To maintain basal insulin levels
Rationale: Insulin detemir is a long-acting insulin used to provide a steady
level of insulin throughout the day, mimicking the body's basal insulin
secretion.