N332 - Chronic Illness Midterm

Medications on Midterm

A patient with type 2 diabetes is prescribed metformin. Which explanation by the nurse is most appropriate?
A. “This medication increases insulin secretion.”
B. “This medication lowers blood glucose by reducing liver glucose production.”
C. “This medication replaces insulin.”
D. “This medication treats hypoglycemia.”

This medication lowers blood glucose by reducing liver glucose production

Which statement by a patient taking metformin indicates correct understanding?
A. “I may experience low blood sugar if I skip meals.”
B. “I should take this medication with meals.”
C. “I can stop this medication before lab tests.”
D. “I don’t need kidney monitoring.”

I should take this medication with meals

Which side effect should the nurse tell a patient taking metformin to report immediately?
A. Mild diarrhea
B. Abdominal cramping
C. Muscle pain and rapid breathing
D. Decreased appetite

Muscle pain and rapid breathing

A patient scheduled for a CT scan with contrast is taking metformin. What is the nurse’s priority action?
A. Administer metformin as scheduled
B. Hold metformin before the procedure
C. Increase the metformin dose
D. Monitor blood pressure

Hold metformin before the procedure

Why is renal function monitored regularly in patients taking metformin?
A. Risk of hypertension
B. Risk of hypoglycemia
C. Risk of lactic acidosis
D. Risk of bleeding

Risk of lactic acidosis

A nurse is teaching a patient about insulin glargine. Which statement is correct?
A. “This insulin works quickly after injection.”
B. “This insulin provides steady glucose control over 24 hours.”
C. “This insulin should be mixed with short-acting insulin.”
D. “This insulin is taken only with meals.”

This insulin provides steady glucose control over 24 hours

Which instruction is essential for insulin glargine administration?
A. Take it at varying times daily
B. Rotate injection sites
C. Mix with regular insulin
D. Skip doses if not eating

Rotate injection sites

Which symptom should a patient receiving insulin glargine recognize as hypoglycemia?
A. Increased thirst
B. Sweating and shakiness
C. Frequent urination
D. Weight gain

Sweating and shakiness

A nurse should emphasize which self-management teaching for a patient on insulin glargine?
A. Administer only during hyperglycemia
B. Take once daily at the same time
C. Avoid blood glucose monitoring
D. Stop insulin during illness

Take once daily at the same time

A patient with diabetes and hypertension is prescribed ramipril. Why is this medication beneficial?
A. It increases heart rate
B. It protects kidney function
C. It lowers blood glucose directly
D. It treats hypoglycemia

It protects kidney function

Which adverse effect of ramipril should the nurse monitor closely?
A. Constipation
B. Dry, persistent cough
C. Bradycardia
D. Hypoglycemia

Dry, persistent cough

A patient taking ramipril develops swelling of the lips and tongue. What should the nurse suspect?
A. Allergic rash
B. Angioedema
C. Dehydration
D. Hypotension

Angioedema

Which teaching is most important for a patient taking ramipril?
A. Increase potassium intake
B. Rise slowly from sitting
C. Stop medication if dizzy
D. Take with grapefruit juice

Rise slowly from sitting

A patient is prescribed metoprolol. Which vital sign requires holding the medication?
A. BP 128/76
B. HR 58
C. RR 18
D. SpO₂ 96%

HR 58

Which statement by a patient taking metoprolol indicates understanding?
A. “I can stop this medication suddenly.”
B. “This medication may hide signs of low blood sugar.”
C. “This medication increases my heart rate.”
D. “I only take it when my BP is high.”

This medication may hide signs of low blood sugar

Why should metoprolol not be stopped abruptly?
A. Risk of kidney failure
B. Risk of rebound hypertension
C. Risk of hypoglycemia
D. Risk of infection

Risk of rebound hypertension

Which side effect is commonly associated with metoprolol?
A. Weight gain
B. Fatigue and dizziness
C. Muscle pain
D. GI bleeding

Fatigue and dizziness

A nurse is teaching a patient prescribed atorvastatin. Which statement is correct?
A. “Take this medication in the morning.”
B. “Avoid grapefruit while taking this medication.”
C. “This medication treats acute chest pain.”
D. “You do not need lab monitoring.”

Avoid grapefruit while taking this medication

Which symptom should be reported immediately by a patient taking atorvastatin?
A. Mild nausea
B. Severe muscle pain
C. Occasional headache
D. Increased appetite

Severe muscle pain

Why are liver enzymes monitored in patients taking atorvastatin?
A. Risk of kidney failure
B. Risk of liver injury
C. Risk of bleeding
D. Risk of hypoglycemia

Risk of liver injury

Which instruction supports effective self-management for a patient on atorvastatin?
A. Rely on medication alone
B. Emphasize lifestyle changes
C. Stop exercise
D. Avoid cholesterol monitoring

Emphasize lifestyle changes

A patient is prescribed aspirin for secondary prevention after a stroke. What is the primary purpose?
A. Pain control
B. Blood pressure reduction
C. Prevention of clot formation
D. Blood glucose control

Prevention of clot formation

Which side effect of aspirin should the nurse teach the patient to monitor for?
A. Constipation
B. Easy bruising
C. Bradycardia
D. Weight gain

Easy bruising

Which instruction is appropriate for aspirin administration?
A. Take on an empty stomach
B. Take with food
C. Combine with other NSAIDs
D. Use in children

Take with food

Which finding should be reported by a patient taking aspirin?
A. Dry cough
B. Black stools
C. Fatigue
D. Mild headache

Black stools

Why is aspirin contraindicated in children?
A. Risk of hypoglycemia
B. Risk of Reye’s syndrome
C. Risk of kidney failure
D. Risk of infection

Reye’s syndrome

A patient takes calcium carbonate for osteoporosis prevention. Which teaching is correct?
A. Take on an empty stomach
B. Increase fluid intake
C. Avoid vitamin D
D. Expect diarrhea

Increase fluid intake

Which side effect is most common with calcium carbonate?
A. Constipation
B. Hypotension
C. Hypoglycemia
D. Muscle weakness

Constipation

Which instruction improves calcium absorption?
A. Take at bedtime
B. Take with food
C. Avoid vitamin D
D. Limit fluids

Take with food

Calcium carbonate is also commonly used to treat which condition?
A. Hypertension
B. GERD
C. Hypoglycemia
D. Infection

GERD

A patient with asthma is prescribed IV corticosteroids during an acute exacerbation. What is the primary purpose?
A. Long-term disease cure
B. Reduce inflammation
C. Increase immunity
D. Control blood pressure

Reduce inflammation

Which side effect is associated with IV corticosteroids?
A. Hypoglycemia
B. Immunosuppression
C. Weight loss
D. Dehydration

Immunosuppression

Which nursing intervention is essential for a diabetic patient receiving IV corticosteroids?
A. Restrict fluids
B. Monitor blood glucose
C. Avoid infection screening
D. Hold insulin

Monitor blood glucose

Why should IV corticosteroids not be stopped abruptly?
A. Risk of renal crisis
B. Risk of bleeding
C. Risk of hypoglycemia
D. Risk of hypotension

Risk of renal crisis

Long-term corticosteroid use increases the risk for which condition?
A. Osteoporosis
B. Hypotension
C. Anemia
D. Dehydration

Osteoporosis

Which patient teaching is appropriate for corticosteroid therapy?
A. Stop medication when symptoms improve
B. Report signs of infection
C. Avoid blood glucose monitoring
D. Limit calcium intake

Report signs of infection

A nurse reviews medication education with a patient. Which statement shows understanding of insulin safety?
A. “I can inject in the same site daily.”
B. “I will rotate injection sites.”
C. “I will mix long-acting insulin with others.”
D. “I will skip insulin if I’m sick.”

I will rotate injection sites

Which medication masks symptoms of hypoglycemia?
A. Metformin
B. Metoprolol
C. Aspirin
D. Calcium carbonate

Metoprolol

Which medication requires avoiding potassium supplements?
A. Metformin
B. Ramipril
C. Atorvastatin
D. Aspirin

Ramipril

Which medication requires monitoring heart rate before administration?
A. Ramipril
B. Metoprolol
C. Atorvastatin
D. Metformin

Metoprolol

Which medication is first-line treatment for type 2 diabetes?
A. Insulin glargine
B. Metformin
C. Aspirin
D. Ramipril

Metformin

Which medication provides basal insulin coverage?
A. Metformin
B. Insulin glargine
C. Aspirin
D. Atorvastatin

Insulin glargine

Which medication is cardioprotective post-MI?
A. Calcium carbonate
B. Metoprolol
C. Metformin
D. Corticosteroids

Metoprolol

Which medication reduces LDL cholesterol?
A. Aspirin
B. Atorvastatin
C. Ramipril
D. Metoprolol

Atorvastatin

Which medication increases bleeding risk?
A. Calcium carbonate
B. Aspirin
C. Insulin glargine
D. Metformin

Aspirin

Which teaching improves medication safety for chronic illness management?
A. Skipping doses when busy
B. Understanding side effects
C. Avoiding follow-up labs
D. Relying on memory

Understanding side effects

Which medication requires consistent daily timing?
A. Aspirin
B. Insulin glargine
C. Calcium carbonate
D. Metformin

Insulin glargine

Which medication should be taken at bedtime for best effect?
A. Aspirin
B. Atorvastatin
C. Metoprolol
D. Ramipril

Atorvastatin

Which medication requires monitoring for cough as a side effect?
A. Ramipril
B. Atorvastatin
C. Aspirin
D. Insulin glargine

Ramipril

Which nursing priority applies to all chronic illness medications?
A. Cure the disease
B. Support safe self-management
C. Avoid patient education
D. Limit caregiver involvement

Support safe self-management