BIOL 351 | BIOL351 Module 6: Pharmacology
Updated and Latest Questions and Correct
Answers with Rationale - Portage Learning
1. A patient with Type 2 Diabetes is prescribed Metformin. Which of the following best
describes the primary mechanism of action of this medication?
A. Stimulating the pancreas to release more insulin
B. Increasing glucose reabsorption in the kidneys
C. Slowing the breakdown of carbohydrates in the small intestine
D. Decreasing hepatic glucose production and improving insulin sensitivity
Correct Answer: D
Explanation: Metformin is a biguanide that works primarily by inhibiting gluconeogenesis
in the liver. It also increases peripheral glucose uptake and use by improving insulin
sensitivity in the muscles. Unlike sulfonylureas, it does not promote insulin secretion,
which minimizes the risk of hypoglycemia. This medication is typically the first-line choice
for Type 2 Diabetes due to its efficacy and safety profile. Patients should be monitored for
gastrointestinal side effects and renal function while on this therapy.
2. A nurse is preparing to administer Insulin Lispro to a patient. When should the nurse
instruct the patient to eat their meal?
A. 30 to 60 minutes after the injection
B. 2 hours after the injection
C. Immediately or within 15 minutes of the injection
D. At least 30 minutes before the injection
Correct Answer: C
Explanation: Insulin Lispro is a rapid-acting insulin with an onset of action between 15 to
30 minutes. Because of its quick onset, the patient must have food available to prevent a
rapid drop in blood glucose levels. If the meal is delayed after administration, the patient is
at high risk for severe hypoglycemia. This differs from regular insulin, which requires a
longer lead time before eating. Proper education on the timing of rapid-acting insulin is
vital for effective glycemic control.
3. Which laboratory value is the most important for a nurse to monitor in a patient receiving
Levothyroxine for hypothyroidism?
A. Blood Urea Nitrogen (BUN)
B. Thyroid-Stimulating Hormone (TSH)
,C. Serum Potassium
D. Hemoglobin A1c
Correct Answer: B
Explanation: TSH is the gold standard for monitoring the effectiveness and dosage of
thyroid replacement therapy. If TSH levels remain high, it indicates that the levothyroxine
dose may be too low for the patient. Conversely, a very low TSH level might suggest that the
patient is receiving too much thyroid hormone. TSH levels are usually checked every 6 to 8
weeks after starting therapy or changing the dose. Stabilization of TSH levels confirms that
the patient has reached a euthyroid state.
4. A patient is diagnosed with hyperthyroidism and is started on Propylthiouracil (PTU).
Which side effect should the nurse prioritize during education?
A. Weight gain and bradycardia
B. Hyperglycemia and increased thirst
C. Agranulocytosis and liver toxicity
D. Insomnia and hand tremors
Correct Answer: C
Explanation: Propylthiouracil works by inhibiting the synthesis of thyroid hormones and
the peripheral conversion of T4 to T3. Agranulocytosis is a rare but life-threatening side
effect characterized by a severe decrease in white blood cell counts. Patients should be
instructed to report any signs of infection, such as fever or sore throat, immediately.
Additionally, the FDA has issued a boxed warning for PTU regarding its potential for severe
liver injury. Monitoring liver function tests and CBC counts is essential throughout the
duration of the treatment.
5. A patient with Addison’s disease is taking Fludrocortisone. What is the primary therapeutic
goal of this medication?
A. To reduce inflammation in the joints
B. To suppress the immune system before surgery
C. To replace mineralocorticoids and maintain fluid and electrolyte balance
D. To lower blood glucose levels during stress
Correct Answer: C
Explanation: Fludrocortisone is a mineralocorticoid used to treat adrenocortical
insufficiency by mimicking the effects of aldosterone. It promotes the reabsorption of
sodium and the excretion of potassium in the renal tubules. This action helps maintain
normal blood pressure and fluid volume in patients with Addison’s disease. Patients on this
medication must be monitored for signs of fluid overload, such as edema or hypertension.
, It is crucial to educate the patient on the importance of salt intake and monitoring for
hypokalemia.
6. Which of the following is a common side effect of Glipizide, a sulfonylurea?
A. Lactic acidosis
B. Weight loss
C. Vitamin B12 deficiency
D. Hypoglycemia
Correct Answer: D
Explanation: Glipizide works by stimulating the beta cells of the pancreas to release more
insulin into the bloodstream. Because insulin secretion is promoted regardless of current
blood glucose levels, hypoglycemia is the most common adverse effect. This medication is
most effective when the pancreas still has some functional beta cells. Patients should be
taught to recognize the symptoms of low blood sugar, such as shakiness and sweating.
Weight gain is also a frequent side effect due to the increased anabolic effects of insulin.
7. A patient is prescribed Exenatide, a GLP-1 receptor agonist. How should the nurse describe
the mechanism of this drug?
A. It increases glucose excretion through the urine
B. It inhibits the enzyme that breaks down natural incretins
C. It mimics natural incretin hormones to stimulate insulin and suppress glucagon
D. It provides a basal level of insulin throughout the day
Correct Answer: C
Explanation: Exenatide is an injectable medication that mimics the action of glucagon-like
peptide-1 (GLP-1). It enhances glucose-dependent insulin secretion and slows gastric
emptying, which helps control postprandial glucose levels. It also suppresses the secretion
of glucagon, a hormone that raises blood sugar. Many patients experience weight loss as a
secondary benefit because the drug increases satiety. The nurse should monitor the patient
for signs of pancreatitis, a known risk with GLP-1 therapy.
8. A patient is taking Prednisone for a chronic inflammatory condition. Why must the
medication be tapered off gradually rather than stopped abruptly?
A. To prevent the development of drug tolerance
B. To prevent the patient from experiencing immediate weight gain
C. To minimize the risk of gastrointestinal bleeding
D. To allow the adrenal glands to resume natural cortisol production
Updated and Latest Questions and Correct
Answers with Rationale - Portage Learning
1. A patient with Type 2 Diabetes is prescribed Metformin. Which of the following best
describes the primary mechanism of action of this medication?
A. Stimulating the pancreas to release more insulin
B. Increasing glucose reabsorption in the kidneys
C. Slowing the breakdown of carbohydrates in the small intestine
D. Decreasing hepatic glucose production and improving insulin sensitivity
Correct Answer: D
Explanation: Metformin is a biguanide that works primarily by inhibiting gluconeogenesis
in the liver. It also increases peripheral glucose uptake and use by improving insulin
sensitivity in the muscles. Unlike sulfonylureas, it does not promote insulin secretion,
which minimizes the risk of hypoglycemia. This medication is typically the first-line choice
for Type 2 Diabetes due to its efficacy and safety profile. Patients should be monitored for
gastrointestinal side effects and renal function while on this therapy.
2. A nurse is preparing to administer Insulin Lispro to a patient. When should the nurse
instruct the patient to eat their meal?
A. 30 to 60 minutes after the injection
B. 2 hours after the injection
C. Immediately or within 15 minutes of the injection
D. At least 30 minutes before the injection
Correct Answer: C
Explanation: Insulin Lispro is a rapid-acting insulin with an onset of action between 15 to
30 minutes. Because of its quick onset, the patient must have food available to prevent a
rapid drop in blood glucose levels. If the meal is delayed after administration, the patient is
at high risk for severe hypoglycemia. This differs from regular insulin, which requires a
longer lead time before eating. Proper education on the timing of rapid-acting insulin is
vital for effective glycemic control.
3. Which laboratory value is the most important for a nurse to monitor in a patient receiving
Levothyroxine for hypothyroidism?
A. Blood Urea Nitrogen (BUN)
B. Thyroid-Stimulating Hormone (TSH)
,C. Serum Potassium
D. Hemoglobin A1c
Correct Answer: B
Explanation: TSH is the gold standard for monitoring the effectiveness and dosage of
thyroid replacement therapy. If TSH levels remain high, it indicates that the levothyroxine
dose may be too low for the patient. Conversely, a very low TSH level might suggest that the
patient is receiving too much thyroid hormone. TSH levels are usually checked every 6 to 8
weeks after starting therapy or changing the dose. Stabilization of TSH levels confirms that
the patient has reached a euthyroid state.
4. A patient is diagnosed with hyperthyroidism and is started on Propylthiouracil (PTU).
Which side effect should the nurse prioritize during education?
A. Weight gain and bradycardia
B. Hyperglycemia and increased thirst
C. Agranulocytosis and liver toxicity
D. Insomnia and hand tremors
Correct Answer: C
Explanation: Propylthiouracil works by inhibiting the synthesis of thyroid hormones and
the peripheral conversion of T4 to T3. Agranulocytosis is a rare but life-threatening side
effect characterized by a severe decrease in white blood cell counts. Patients should be
instructed to report any signs of infection, such as fever or sore throat, immediately.
Additionally, the FDA has issued a boxed warning for PTU regarding its potential for severe
liver injury. Monitoring liver function tests and CBC counts is essential throughout the
duration of the treatment.
5. A patient with Addison’s disease is taking Fludrocortisone. What is the primary therapeutic
goal of this medication?
A. To reduce inflammation in the joints
B. To suppress the immune system before surgery
C. To replace mineralocorticoids and maintain fluid and electrolyte balance
D. To lower blood glucose levels during stress
Correct Answer: C
Explanation: Fludrocortisone is a mineralocorticoid used to treat adrenocortical
insufficiency by mimicking the effects of aldosterone. It promotes the reabsorption of
sodium and the excretion of potassium in the renal tubules. This action helps maintain
normal blood pressure and fluid volume in patients with Addison’s disease. Patients on this
medication must be monitored for signs of fluid overload, such as edema or hypertension.
, It is crucial to educate the patient on the importance of salt intake and monitoring for
hypokalemia.
6. Which of the following is a common side effect of Glipizide, a sulfonylurea?
A. Lactic acidosis
B. Weight loss
C. Vitamin B12 deficiency
D. Hypoglycemia
Correct Answer: D
Explanation: Glipizide works by stimulating the beta cells of the pancreas to release more
insulin into the bloodstream. Because insulin secretion is promoted regardless of current
blood glucose levels, hypoglycemia is the most common adverse effect. This medication is
most effective when the pancreas still has some functional beta cells. Patients should be
taught to recognize the symptoms of low blood sugar, such as shakiness and sweating.
Weight gain is also a frequent side effect due to the increased anabolic effects of insulin.
7. A patient is prescribed Exenatide, a GLP-1 receptor agonist. How should the nurse describe
the mechanism of this drug?
A. It increases glucose excretion through the urine
B. It inhibits the enzyme that breaks down natural incretins
C. It mimics natural incretin hormones to stimulate insulin and suppress glucagon
D. It provides a basal level of insulin throughout the day
Correct Answer: C
Explanation: Exenatide is an injectable medication that mimics the action of glucagon-like
peptide-1 (GLP-1). It enhances glucose-dependent insulin secretion and slows gastric
emptying, which helps control postprandial glucose levels. It also suppresses the secretion
of glucagon, a hormone that raises blood sugar. Many patients experience weight loss as a
secondary benefit because the drug increases satiety. The nurse should monitor the patient
for signs of pancreatitis, a known risk with GLP-1 therapy.
8. A patient is taking Prednisone for a chronic inflammatory condition. Why must the
medication be tapered off gradually rather than stopped abruptly?
A. To prevent the development of drug tolerance
B. To prevent the patient from experiencing immediate weight gain
C. To minimize the risk of gastrointestinal bleeding
D. To allow the adrenal glands to resume natural cortisol production
