NUR 123 Exam #2 Fall 2025

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Free NUR 123 Exam #2 Fall 2025 Questions

1.

The patient received NPH insulin 30 units subcutaneously at 0730. What time is the nurse most likely to observe signs and symptoms of hypoglycemia?

  • 1130-1430
  • 1130-1930
  • 1530-1930
  • 0930-1030

Explanation

Explanation
Correct Answer:
A. 1130-1430

Explanation:
NPH insulin (Neutral Protamine Hagedorn) is an intermediate-acting insulin, which typically peaks in 4 to 12 hours after administration. Given that the patient received 30 units at 0730, the peak action of NPH insulin would likely occur between 1130 and 1430. During this time, blood glucose levels are more likely to drop, which may lead to signs and symptoms of hypoglycemia, such as shakiness, sweating, and confusion. Therefore, the nurse should closely monitor the patient during this window.

2.

What drug reduces skeletal muscle metabolism activity seen in malignant hyperthermia?

  • Dantrolene
  • Neostigmine
  • Flumazenil
  • Midazolam

Explanation

Explanation
Correct Answer:
A. Dantrolene

Explanation:
Dantrolene is the primary treatment for malignant hyperthermia, a life-threatening condition triggered by certain anesthetic agents. It works by inhibiting calcium release from the sarcoplasmic reticulum, reducing muscle contraction and metabolism.

3.

Education for the nurse caring for the patient receiving the hormonal agent leuprolide would include which instructions?

  • The drug may cause hot flashes, erectile dysfunction, and decreased libido.
  • Vaginal bleeding may occur.
  • An increased dose of warfarin will be necessary.
  • Liver function tests must be assessed weekly.

Explanation

Explanation
Correct Answer:
A. The drug may cause hot flashes, erectile dysfunction, and decreased libido.

Explanation:
Leuprolide is a GnRH agonist used in the treatment of hormone-sensitive cancers such as prostate cancer and endometriosis. It works by suppressing the production of sex hormones, which can lead to symptoms such as hot flashes, erectile dysfunction, and decreased libido. These side effects are commonly associated with the drug’s mechanism of action in reducing testosterone levels in men and estrogen levels in women. The nurse should inform patients of these potential effects to ensure they are prepared and can manage them effectively.

4.

The nurse recognizes that endometrial cancer is a common complication in patients receiving which hormonal therapy?

  • Tamoxifen
  • Leuprolide
  • Cetuximab
  • Anastrozole

Explanation

Explanation
Correct Answer:
A. Tamoxifen

Explanation

A. Tamoxifen
Tamoxifen is a selective estrogen receptor modulator (SERM) commonly used in the treatment and prevention of breast cancer, particularly in estrogen receptor-positive (ER+) cases. One of the known side effects of tamoxifen is an increased risk of endometrial cancer, as it has estrogen-like effects on the endometrium (lining of the uterus). These estrogenic effects can stimulate the growth of endometrial tissue, which can lead to hyperplasia or cancer over time, especially in postmenopausal women. Patients on tamoxifen should be monitored regularly for signs of uterine cancer, including abnormal bleeding.

5.

A patient is ordered to receive regular insulin at mealtimes. The nurse will instruct this patient to administer the medication at which time?

  • 15 minutes after eating
  • 30 minutes before eating
  • 10 minutes after eating
  • 5 minutes before eating

Explanation

Explanation
Correct Answer:
D. 5 minutes before eating

Explanation

D. 5 minutes before eating
Regular insulin, a short-acting insulin, typically starts working within 30 minutes of injection and peaks around 2 to 3 hours. To ensure that insulin is active when blood sugar rises after eating, it should be administered approximately 30 minutes before meals. However, it is most effective when injected 5 to 15 minutes prior to the meal to match the onset of action with the increase in blood glucose after eating.

6.

A nurse is preparing to administer insulin to a patient. The nurse knows which insulin should not be mixed with any other insulin?

  • Isophane Insulin
  • Insulin Glargine
  • Insulin Lispro
  • Regular Insulin

Explanation

Explanation
Correct Answer:
B. Insulin Glargine

Explanation

B. Insulin Glargine
Insulin glargine is a long-acting insulin that should not be mixed with any other insulin. This is because insulin glargine has a unique formulation and a prolonged, steady release, which could be altered if mixed with other insulins. Mixing it with rapid-acting or intermediate-acting insulins could affect its effectiveness and potentially lead to unpredictable blood glucose control. Therefore, insulin glargine is typically administered alone, either in a separate injection or as a stand-alone dose.

7.

A nurse is preparing to administer insulin to a patient with diabetes. A vial of lispro insulin is labeled U 100. What does this label mean?

  • There is 100 units of insulin in the bottle
  • There is 1 milliliter of insulin per unit
  • There is 100 units of insulin per milliliter
  • There is 100 units of insulin per dose

Explanation

Explanation
Correct Answer:
C. There is 100 units of insulin per milliliter

Explanation

C. There is 100 units of insulin per milliliter
The label "U 100" on a vial of insulin indicates that the concentration of the insulin is 100 units per milliliter (mL). This means that for every milliliter of insulin in the vial, there are 100 units of insulin. This is a standard concentration for most insulin vials, and it is important for the nurse to know this when drawing the correct amount of insulin for the patient’s prescribed dose.

8.

A patient is being discharged on glipizide. Which statement should the nurse include when teaching about this medication?

  • Glipizide is a substitute for insulin and acts by directly stimulating glucose uptake into the cell.
  • Glipizide and other sulfonylureas lower blood sugar by slowing the rate of carbohydrate absorption in the small intestine.
  • Glipizide stimulates insulin release from the pancreas.
  • Glipizide is safer than insulin because it does not cause the hypoglycemic reactions that may occur with insulin use.

Explanation

Explanation
Correct Answer:
C. Glipizide stimulates insulin release from the pancreas.

Explanation
C. Glipizide stimulates insulin release from the pancreas
Glipizide is a sulfonylurea, and its primary mechanism of action is stimulating the pancreas to release more insulin. This helps lower blood glucose levels, especially in patients with type 2 diabetes who still have some insulin-producing capability in the pancreas. Unlike insulin injections, glipizide works by enhancing the body's own insulin secretion in response to rising blood glucose levels.

9.

A nurse is preparing to administer metformin 500 mg PO BID to a patient. Which factor would contraindicate the administration of metformin to this patient?

  • A history of hypertension
  • Allergy to sulfonamides
  • A history of renal disease
  • The ingestion of carbohydrates

Explanation

Explanation
Correct Answer:
C. A history of renal disease

Explanation:
Metformin is contraindicated in patients with a history of renal disease, particularly those with impaired kidney function, as it is primarily excreted through the kidneys. Renal dysfunction can lead to the accumulation of metformin in the body, increasing the risk of lactic acidosis, a rare but serious side effect. Kidney function should be assessed before initiating metformin, and it should be avoided in patients with a glomerular filtration rate (GFR) below 30 mL/min.

10.

Which complication should a patient immediately report to their provider when taking metoclopramide, a Dopamine antagonist?

  • Involuntary movements of the face and neck
  • Elevated blood pressure
  • Dizziness when standing
  • Diarrhea

Explanation

Explanation
Correct Answer:
A. Involuntary movements of the face and neck

Explanation

A. Involuntary movements of the face and neck
Metoclopramide, a dopamine antagonist, can cause extrapyramidal side effects, including tardive dyskinesia, which presents as involuntary movements, especially of the face and neck. These movements may include grimacing, lip smacking, and tongue protrusion. Tardive dyskinesia is a serious, potentially irreversible condition, and patients taking metoclopramide should immediately report any signs of these involuntary movements to their provider for prompt evaluation and possible adjustment of therapy.

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