Blood Glucose
A nurse should administer regular insulin at what time in relation to meals?
A. 5 minutes before eating
B. 15 minutes before eating
C. 30 minutes before eating
D. At bedtime
Answer: C. 30 minutes before eating
Rationale: Regular insulin has an onset of 30–60 minutes.
Which medication delays carbohydrate absorption in the intestine?
A. Acarbose
B. Metformin
C. Sitagliptin
D. Glargine
Answer: A. Acarbose
Rationale: Alpha-glucosidase inhibitors slow breakdown of carbohydrates.
Which drug is used as a glucose-elevating agent in severe hypoglycemia?
A. Glucagon
B. Sitagliptin
C. Pioglitazone
D. Liraglutide
Answer: A. Glucagon
Rationale: Glucagon raises blood glucose by stimulating glycogen breakdown.
Which antitussive should be avoided in patients with a history of opioid abuse?
A. Dextromethorphan
B. Benzonatate
C. Codeine
D. Guaifenesin
Answer: C. Codeine
Rationale: Codeine is an opioid with abuse potential.
Which is the priority teaching for a patient prescribed diphenhydramine?
A. Avoid taking with dairy products
B. Expect urinary frequency
C. Take on an empty stomach
D. Avoid driving due to drowsiness
Answer: D. Avoid driving due to drowsiness
Rationale: First-gen antihistamines cause sedation and impaired alertness.
Which insulin cannot be mixed with other insulins?
A. Lispro
B. NPH
C. Regular
D. Glargine
Answer: D. Glargine
Rationale: Long-acting insulin glargine should not be mixed due to altered absorption.
What should be monitored in a patient taking pioglitazone?
A. Renal function
B. Liver function
C. White blood cell count
D. Platelets
Answer: B. Liver function
Rationale: Thiazolidinediones may cause hepatotoxicity.
Which assessment is MOST important for a patient on metformin?
A. AST/ALT
B. BUN/Creatinine
C. WBC count
D. Potassium
Answer: B. BUN/Creatinine
Rationale: Metformin is contraindicated in renal impairment due to lactic acidosis risk.
Which medication helps thin respiratory secretions?
A. Diphenhydramine
B. Guaifenesin
C. Loratadine
D. Phenylephrine
Answer: B. Guaifenesin
Rationale: Expectorants like guaifenesin loosen secretions to make coughing more effective.
A patient with asthma is prescribed acetylcysteine. What is the purpose?
A. Decrease inflammation
B. Thin respiratory secretions
C. Block histamine
D. Raise blood glucose
Answer: B. Thin respiratory secretions
Rationale: Acetylcysteine is a mucolytic that breaks down thick mucus.
What is a priority nursing assessment before giving insulin?
A. Hemoglobin level
B. Blood glucose level
C. White blood cell count
D. Platelet count
Answer: B. Blood glucose level
Rationale: Insulin dosing depends on current glucose levels.
Which drug must be stopped at least 1 week before surgery due to delayed gastric emptying?
A. Metformin
B. Acarbose
C. Sitagliptin
D. Liraglutide
Answer: D. Liraglutide
Rationale: GLP-1 agonists slow gastric emptying, affecting anesthesia safety
Which drug should be used with caution in patients with hypertension?
A. Pseudoephedrine
B. Acetylcysteine
C. Loratadine
D. Diphenhydramine
Answer: A. Pseudoephedrine
Rationale: Decongestants can raise blood pressure.
Which medication is also used as the antidote for acetaminophen overdose?
A. Guaifenesin
B. Diphenhydramine
C. Acetylcysteine
D. Loratadine
Answer: C. Acetylcysteine
Rationale: Acetylcysteine replenishes glutathione, reversing acetaminophen toxicity.
Which oral antidiabetic is contraindicated with contrast dye procedures?
A. Glyburide
B. Acarbose
C. Metformin
D. Pioglitazone
Answer: C. Metformin
Rationale: Metformin increases risk of lactic acidosis with contrast dye.
Which is the priority action for a patient with blood glucose of 58 mg/dL and confusion? airway is patent and patient can swallow.
A. Administer oral juice or crackers
B. Start IV antibiotics
C. Check blood pressure
D. Administer long-acting insulin
Answer: A. Administer oral juice or crackers
Rationale: Initial hypoglycemia treatment is rapid oral glucose if patient can swallow.
Which is a first-generation antihistamine?
A. Loratadine
B. Cetirizine
C. Fexofenadine
D. Diphenhydramine
Answer: d. Diphenhydramine
Rationale: First-gen antihistamines cause sedation; second-gen cause less drowsiness.
Which antihistamine is least likely to cause sedation?
A. Hydroxyzine
B. Diphenhydramine
C. Loratadine
D. Chlorpheniramine
Answer: C. Loratadine
Rationale: Loratadine is a second-gen antihistamine with minimal CNS effects.
A patient on glyburide should be monitored for:
A. Hypoglycemia
B. hypertension
C. Constipation
D. Weight loss
Answer: A. Hypoglycemia
Rationale: Sulfonylureas increase insulin secretion, risking hypoglycemia.
Which drug is the first-line therapy for type 2 diabetes?
A. Glyburide
B. Codeine
C. Metformin
D. Acarbose
Answer: C. Metformin
Rationale: Metformin is the preferred initial oral agent for type 2 diabetes.
Which medication is an intranasal corticosteroid?
A. Diphenhydramine
B. Fluticasone
C. Loratadine
D. Pseudoephedrine
Answer: B. Fluticasone
Rationale: Fluticasone is a steroid nasal spray used for allergic rhinitis.
Which symptom should be monitored when giving codeine for cough suppression?
A. Constipation and sedation
B. Muscle weakness
C. Tachycardia
D. Hypertension
Answer: A. Constipation and sedation
Rationale: Opioid antitussives cause CNS depression and constipation.