NSG124/NSG 124 Exam 4 V2 |
Pharmacology Q&A with Rationale |
Herzing University
1. A patient with type 2 diabetes is scheduled for a CT scan with intravenous contrast. Which
medication must be held for 48 hours before and after the procedure?
A. Metformin
B. Glipizide
C. Pioglitazone
D. Sitagliptin
Correct Answer: A
Rationale: Metformin should be held because the combination of iodinated contrast and
metformin increases the risk of lactic acidosis. Renal function must be verified as normal
before resuming the medication after the 48-hour period. This is a critical safety protocol
to prevent acute kidney injury.
2. A nurse is preparing to administer Lispro insulin. When is the most appropriate time to
administer this medication?
A. 30 to 60 minutes before a meal
B. Immediately after the patient finishes eating
C. At bedtime
,D. 15 minutes before a meal
Correct Answer: D
Rationale: Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. It should be
given within 15 minutes of a meal to ensure that insulin peaks while the patient is digesting
food. Administering it too early without food present could lead to severe hypoglycemia.
3. Which lab value should the nurse monitor closely for a patient taking Propylthiouracil
(PTU) for hyperthyroidism?
A. White Blood Cell (WBC) count
B. Serum Potassium
C. Blood Urea Nitrogen (BUN)
D. Hemoglobin A1c
Correct Answer: A
Rationale: PTU can cause agranulocytosis, which is a significant drop in the white blood
cell count. Patients should be taught to report symptoms of infection, such as fever or sore
throat, immediately. Monitoring the CBC with differential is a standard of care for patients
on antithyroid medications.
4. A patient is prescribed Levothyroxine for hypothyroidism. Which instruction should the
nurse include in the teaching plan?
A. Take the medication with a full glass of milk.
, B. Switch brands if the cost is too high.
C. Take the medication on an empty stomach in the morning.
D. Expect to stop the medication once symptoms improve.
Correct Answer: C
Rationale: Levothyroxine is best absorbed on an empty stomach, ideally 30 to 60 minutes
before breakfast. It should be taken at the same time every day to maintain a steady state of
the hormone. Patients must also be informed that this is typically a lifelong therapy.
5. A patient on long-term Prednisone therapy for an autoimmune disorder is being
discharged. Why is it important to taper the dose?
A. To prevent the development of Cushing’s syndrome
B. To avoid gastric ulceration
C. To minimize the risk of hyperglycemia
D. To prevent adrenal insufficiency crisis
Correct Answer: D
Rationale: Exogenous steroids suppress the hypothalamic-pituitary-adrenal (HPA) axis,
causing the adrenal glands to stop producing cortisol. Abrupt withdrawal can result in a
life-threatening adrenal crisis because the glands cannot immediately resume production.
Tapering allows the adrenal glands to slowly regain their normal function.
Pharmacology Q&A with Rationale |
Herzing University
1. A patient with type 2 diabetes is scheduled for a CT scan with intravenous contrast. Which
medication must be held for 48 hours before and after the procedure?
A. Metformin
B. Glipizide
C. Pioglitazone
D. Sitagliptin
Correct Answer: A
Rationale: Metformin should be held because the combination of iodinated contrast and
metformin increases the risk of lactic acidosis. Renal function must be verified as normal
before resuming the medication after the 48-hour period. This is a critical safety protocol
to prevent acute kidney injury.
2. A nurse is preparing to administer Lispro insulin. When is the most appropriate time to
administer this medication?
A. 30 to 60 minutes before a meal
B. Immediately after the patient finishes eating
C. At bedtime
,D. 15 minutes before a meal
Correct Answer: D
Rationale: Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. It should be
given within 15 minutes of a meal to ensure that insulin peaks while the patient is digesting
food. Administering it too early without food present could lead to severe hypoglycemia.
3. Which lab value should the nurse monitor closely for a patient taking Propylthiouracil
(PTU) for hyperthyroidism?
A. White Blood Cell (WBC) count
B. Serum Potassium
C. Blood Urea Nitrogen (BUN)
D. Hemoglobin A1c
Correct Answer: A
Rationale: PTU can cause agranulocytosis, which is a significant drop in the white blood
cell count. Patients should be taught to report symptoms of infection, such as fever or sore
throat, immediately. Monitoring the CBC with differential is a standard of care for patients
on antithyroid medications.
4. A patient is prescribed Levothyroxine for hypothyroidism. Which instruction should the
nurse include in the teaching plan?
A. Take the medication with a full glass of milk.
, B. Switch brands if the cost is too high.
C. Take the medication on an empty stomach in the morning.
D. Expect to stop the medication once symptoms improve.
Correct Answer: C
Rationale: Levothyroxine is best absorbed on an empty stomach, ideally 30 to 60 minutes
before breakfast. It should be taken at the same time every day to maintain a steady state of
the hormone. Patients must also be informed that this is typically a lifelong therapy.
5. A patient on long-term Prednisone therapy for an autoimmune disorder is being
discharged. Why is it important to taper the dose?
A. To prevent the development of Cushing’s syndrome
B. To avoid gastric ulceration
C. To minimize the risk of hyperglycemia
D. To prevent adrenal insufficiency crisis
Correct Answer: D
Rationale: Exogenous steroids suppress the hypothalamic-pituitary-adrenal (HPA) axis,
causing the adrenal glands to stop producing cortisol. Abrupt withdrawal can result in a
life-threatening adrenal crisis because the glands cannot immediately resume production.
Tapering allows the adrenal glands to slowly regain their normal function.
