1. Decreased ALT and AST level Mild hyperglycemia Hypotension Water
Somatropin (Humatrope) is being given to a female patient with Turner syndrome. Which of the following findings is associated with this medication?
Decreased ALT and AST level
Mild hyperglycemia
Hypotension
Water
The answer is B. Somatropin is a growth hormone. Excess growth hormone causes insulin resistance and hyperglycemia. Option A : Elevated AST and ALT is expectd. Option C : Hypertension, not hypotension is a side effect. Option D is not related symptom to this medication

2. Any time of the day Early morning Lunch Before
A nurse provides instructions to a client regarding the administration of the prednisone and instructs the client that the best time to take the medication is during :
Any time of the day
Early morning
Lunch
Before
The answer is B. Prednisone is a corticosteroid (glucocorticoids) is administered early in the morning because it helps in reducing adrenal insufficiency and stimulate the burst of glucocorticoids released naturally by the adrenal glands each morning.

3. Alopacia Jaundice Diarrhea Drowsiness
A patient with diabetes insipidus is taking antidiuretic hormone. Which of the following symptoms would alert the need to decrease the dosage?
Alopacia
Jaundice
Diarrhea
Drowsiness
The answer is D. One of the side effects of taking antidiuretic hormone is water intoxication which is manifested by a headache, drowsiness, light-headedness and shortness of breath. This could indicate the need to reduce the dosage. Options A, B and C are not signs to this medication.

4. Metformin Warfarin Zoloft Epinephrine
Which one of the following medications decreases the action of thyroid hormone?
Metformin
Warfarin
Zoloft
Epinephrine
The answer is D. Metformin, an oral hypoglycemic drug when taken with a thyroid hormone decreases its action. Options B (anticoagulant).Option C (antidepressant) and option D (sympathomimetic) increase the action of thyroid hormone

5. An addition of an oral hypoglycemic medication
Prednisone is prescribed for a patient with diabetes mellitus who is using Humulin 70/30 daily. Which of the following prescription-changes does the nurse expect during the therapy with the prednisone?
An addition of an oral hypoglycemic medication
Increased dosage of prednisone
Increased dosage of humulin 70/30
Decreased dosage of humulin 70/30
The answer is C. Prednisone a glucocorticoid increases blood glucose level hence people with diabetes need to increase the dosage of thir insulin. Options A, B, and D will not help the cause

6. Runny nose Headache Flushing Nausea
A nurse is instructing a patient regarding intranasal Vasopressin (Pitressin). The nurse tells the patient that which of the following is a side effect specific to the medication?
Runny nose
Headache
Flushing
Nausea
The answer is A. Vasopressin administered via intranasal route causes nasal congestion/runny nose. Options B, C, and D are the side effects of the medication administered intravenously.

7. Addison's disease Cushing’s syndrome Grave’s disease Myxoedema
A nurse is performing an assessment on a newly admitted patient who is taking propylthiouracil (PTU) daily. The nurse suspects that the client has a history of :
Addison's disease
Cushing’s syndrome
Grave’s disease
Myxoedema
The answer is C. Propylthiouracil inhibits the synthesis of thyroid hormone and is used to treat Grave’s disease or hyperthyroidism. Options A and B are disorders related to adrenal function. Options A and B are disorders related to adrenal function. Option C indicates hypothyroidism.

8. Cold intolerance Tremors Coarse, dry hair Muscle cramps
A nurse is giving discharge instructions to a patient who is taking levothyroxine (Synthroid). The nurse instructs the patient to notify the physician if which of the following occurs?
Cold intolerance
Tremors
Coarse, dry hair
Muscle cramps
The answer is B. Excessive doses of levothyroxine can produce signs and symptoms of hyperthyroidism whih includes heat tolerance, tremors, nervousness, tachycardia, chest pain, hyperthermia and insomnia. Options A, C and D are signs of hypothyroidism.

9. During bed time After lunch Taken with food Taken on an empt stomach
A nurse is giving instructions a patient who is taking levothyroxine (Synthoid). The nurse tells the patient that the best time to take this medication is :
During bed time
After lunch
Taken with food
Taken on an empt stomach
The answer is D. Levothyroxine is taken on an empty stomach usually before breakfast to enhance the absorption

10. Desmopressin acetate (DDAVP) is given to a patient with diabetes insipidus. Which of the following therapeutic responses should you expect?
Decreased blood pressure
Decreased attention span
Deceased urinary output
Decreased blood sugar
The answer is C. The therapeutic response of this medication is decreased urine because it promotes renal conservation of water. Options A, B and D are effects unrelated to this medication.

11. A patient of adrenal insufficiency is to be discharged and is given Prednisolone as a home medication. The nurse instructs the patient the following except :
To avoid aspirin-containing products
To avoid foods rich in potassium
To avoid caffeinated drinks
To avoid individuals with respiratory infections
The answer is B. One of the side effects of taking prednisolone is hypokalemia so a potassium rich food should be included in the diet. Should not be avoided. Steroids have a tendency to cause peptic ulcer and one should not increase the risk of ulceration by taking aspirin. Those who are on long term steroid therapy are susceptible to infections and should avoid individuals with respiratory infections

12. Blurred vision Neuralgia Use of vitamins Use of nitroprusside
Sildenafil (Viagra) is given to a patient with erectile dysfunction. Which of the following is a contraindication for this medication?
Blurred vision
Neuralgia
Use of vitamins
Use of nitroprusside
The answer is D. Sildenafil is contraindicated in patients taking nitrates, nitroprusside and betablockers. Options A and B are the side effects of this medication. Option C is not contraindicated with the use of sildenafil.

13. Soft drinks Oatmeal Alcohol Organ meats
Glipizide (Glucotrol) is prescribed to a patient with diabetes mellitus. The nurse instructs the patient to avoid which of the following?
Soft drinks
Oatmeal
Alcohol
Organ meats
The answer is C. Alcohol when consumed while taking glipizide, a disulfiram-like (Antabuse) reaction occurs. Patient may have flushing, headache and nausea. In addition large amounts of alcohol cause hypoglycemia. Options A, B and D need not be avoided.

14. Withdraws regular insulin first Withdraws NPH insulin first
A nurse is teaching a patient on how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the patient, indicates the need for further teaching?
Withdraws regular insulin first
Withdraws NPH insulin first
Injects an amount of air equivalent to the desired dose of insulin
Injects air into the NPH insulin first
The answer is B. The regular insulin is drawn into the syringe first then the NPH. This will avoid contaminating the regular insulin vial with another type. Options A, C and D are correct actions for preparing regular and NPH insulins.

15. A patient is taking insulin glargine injection daily
A patient is taking insulin glargine injection daily. The nurse instructs the client that the onset of action will likely to be:
2-4 hours after administration
4-12 hours after administration
6-12 hours after administration
18-24 hours after administration
The answer is A. Insulin glargine is a long-acting insulin with an onset of 2-4 hours, no peak and its duration of action is 24 hours.

16. Store it at room temperature Store it in the freezer
A private nurse visits a patient who is taking Humulin NPH insulin daily. The patient asks the nurse on how to store the unopened vials of insulin. The nurse tells the patient to :
Store it at room temperature
Store it in the freezer
Store it in the refrigerator
Keep the insulin in a dry place under sunlight
The answer isC. Unopened insulin is stored in the refrigerator until the expiry date. Option A: only opened vials are stored at room temperature and it will only last for 28 days. Option B: It should never be stored in the freezer. Option D : insulin is sensitive to light and should not be kept in sunlight.

17. A patient with diabetes mellitus type I was prescribed Exenatide (Bydureon). The nurse will take which of the following appropriate action?
Withdraw the insulin from the prefilled pen into an insulin syringe
Monitor for signs of nausea, vomiting and gastric upset
Administer the medication twice a day
The answer is D. Exenatide is only used to treat diabetes mellitus type 2 only. Therefore, holding the medication and calling the physician to question the order is appropriate. Option A : A prefilled pen is ready for injection; there is no need to withdraw. Options B and C : although are correct about the medication, it should not be administered in these kind of situations

18. Insulin glargine Insulin aspart Insulin isophane Insulin lispro
Which of the following insulins cannot be mixed with any other type of insulin?
Insulin glargine
Insulin aspart
Insulin isophane
Insulin lispro
The answer is A. Only insulin glargine cannot be mixed with any other type of insulin

19. All of the following medications cause hypoglycemia except :
Salicylates
Oral contraceptives
Sulfonamides
Anticoagulants
The answer is B. Oral contraceptive cause hyperglycemia not hypoglycemia. Medications such as thiazide diuretics, corticosteroids, oral contraceptives, estrogen and sympathomimetics cause hyperglycemia.

20. A nurse is providing instruction to a patient who is prescribed Repaglinide (Prandin). All of which is true regarding this medication except :
Do not skip the dose when a meal is not taken
Dizziness may occur while taking it
Has quicker and shorter duration of action
Used to treat type II diabetes mellitus
The answer is A. Repaglinide (Prandin) is a meglitinide type of antidiabetic which has a quick onset of action whichallows a patient to take the medication with meals and skip a dose when a meal is skipped.