BP/Diabetes Medications

BP Medications

100

1. A patient is started on lisinopril (ACE inhibitor). A morning lab shows potassium (K+) 5.6 mEq/L. What should the LPN do first?

• A) Administer a potassium supplement with breakfast
• B) Hold lisinopril and notify the RN
• C) Recheck potassium in 2 hours
• D) Encourage increased potassium intake for the patient

Answer: B
Rationale: ACE inhibitors can cause hyperkalemia. A K+ of 5.6 is elevated and requires RN attention before continuing the med.

200

7. A patient on metoprolol (beta-blocker) has heart rate 54 bpm and BP 110/70 mmHg. What should the LPN do?

• A) Increase the metoprolol dose
• B) Administer a PRN hypotension medication
• C) Hold the medication and notify the RN
• D) Do nothing and continue monitoring 

Answer: C
Rationale: Bradycardia (HR < 60) can be a sign to hold beta-blocker and notify the RN.

Diuretics

100

2. A patient taking furosemide (a loop diuretic) reports leg cramps. The LPN should anticipate which electrolyte disturbance?

• A) Hyperkalemia
• B) Hypokalemia
• C) Hypercalcemia
• D) Hyponatremia

Answer: B
Rationale: Loop diuretics commonly cause hypokalemia due to potassium loss in the distal tubule.

200

3. A patient on hydrochlorothiazide reports dizziness when standing up. The best action is:

• A) Administer IV fluids immediately
• B) Administer another diuretic
• C) Instruct the patient to move slowly and monitor orthostatic BP
• D) Hold the medication 

Answer: C
Rationale: Thiazide diuretics can cause orthostatic hypotension; advise slow position changes and monitor BP.

Insulins

100

5. Which statement best describes peak activity for glargine insulin?

• A) It has a sharp peak at 2–4 hours
• B) It has no pronounced peak; provides a relatively flat effect
• C) It peaks at 6–8 hours
• D) It peaks immediately after injection

Answer: B
Rationale: Glargine is designed to be “peakless” or have a flat action profile, reducing peak-related hypoglycemia risk.

200

9. A patient cannot swallow due to altered consciousness during hypoglycemia. What is the appropriate action?

• A) Give oral glucose tablets
• B) Administer glucagon IM or SC (per protocol) or IV dextrose if trained
• C) Wait for EMS
• D) Provide a glass of juice once conscious

Answer: B
Rationale: Unconscious hypoglycemia requires glucagon or IV dextrose per protocol; do not give oral carbohydrates.

Diabetes PO Meds

100

Which serious adverse effect should the nurse monitor for in a patient taking Metformin?

A. Hypoglycemia
B. Lactic acidosis
C. Hypertension
D. Weight gain

Correct Answer: B

Rationale: A rare but life-threatening side effect of metformin is lactic acidosis, especially in patients with kidney problems.

200

Which laboratory value is most important to monitor in a patient taking Metformin?

A. Hemoglobin
B. Creatinine
C. Platelets
D. Potassium

Correct Answer: B

Rationale: Metformin is excreted by the kidneys, so renal function (creatinine) must be monitored to prevent toxicity.