Medication Case Studies Practice Exam

Case Study 1: Metformin for Type 2 Diabetes

Patient: 55-year-old female with newly diagnosed type 2 diabetes, started on metformin 500 mg PO BID.

Q1. Highlight the assessment findings that are most concerning for a patient on metformin:

Q2. Which order should the nurse question?

Q3. Select all teaching points for metformin:

Q4. Place the following nursing actions in order of priority if the patient develops rapid breathing and confusion:

1. --Select--Stop metforminNotify the providerAssess airway and vital signsDocument findings
2. --Select--Stop metforminNotify the providerAssess airway and vital signsDocument findings
3. --Select--Stop metforminNotify the providerAssess airway and vital signsDocument findings
4. --Select--Stop metforminNotify the providerAssess airway and vital signsDocument findings

Q5. Matrix: Indicate if each is a common or serious side effect of metformin:

Side Effect	Common	Serious
GI upset (nausea, diarrhea)
Lactic acidosis
Vitamin B12 deficiency

Q6. Which finding requires immediate provider notification?

Case Study 2: Glipizide for Type 2 Diabetes

Patient: 62-year-old male with poorly controlled type 2 diabetes, started on glipizide 5 mg PO daily.

Q7. Highlight the assessment findings that are most concerning for a patient on glipizide:

Q8. Which order should the nurse question?

Q9. Select all teaching points for glipizide:

Q10. Place the following nursing actions in order of priority if the patient develops confusion and diaphoresis:

1. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings
2. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings
3. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings
4. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings

Q11. Matrix: Indicate if each is a common or serious side effect of glipizide:

Side Effect	Common	Serious
Hypoglycemia
Weight gain
Rash

Q12. Which finding requires immediate provider notification?

Case Study 3: Zepbound (GLP-1 Agonist) for Type 2 Diabetes/Obesity

Patient: 48-year-old female with type 2 diabetes and obesity, started on Zepbound (tirzepatide) 2.5 mg SC weekly.

Q13. Highlight the assessment findings that are most concerning for a patient on Zepbound:

Q14. Which order should the nurse question?

Q15. Select all teaching points for Zepbound:

Q16. Place the following nursing actions in order of priority if the patient develops severe abdominal pain and vomiting:

1. --Select--Hold medicationNotify the providerAssess airway and vital signsDocument findings
2. --Select--Hold medicationNotify the providerAssess airway and vital signsDocument findings
3. --Select--Hold medicationNotify the providerAssess airway and vital signsDocument findings
4. --Select--Hold medicationNotify the providerAssess airway and vital signsDocument findings

Q17. Matrix: Indicate if each is a common or serious side effect of Zepbound:

Side Effect	Common	Serious
Nausea
Pancreatitis
Injection site reaction

Q18. Which finding requires immediate provider notification?

Case Study 4: Jardiance (empagliflozin) for Type 2 Diabetes

Patient: 60-year-old male with type 2 diabetes and heart failure, started on Jardiance 10 mg PO daily.

Q19. Highlight the assessment findings that are most concerning for a patient on Jardiance:

Q20. Which order should the nurse question?

Q21. Select all teaching points for Jardiance:

Q22. Place the following nursing actions in order of priority if the patient develops confusion, abdominal pain, and rapid breathing:

1. --Select--Assess airway and vital signsHold JardianceNotify the providerDocument findings
2. --Select--Assess airway and vital signsHold JardianceNotify the providerDocument findings
3. --Select--Assess airway and vital signsHold JardianceNotify the providerDocument findings
4. --Select--Assess airway and vital signsHold JardianceNotify the providerDocument findings

Q23. Matrix: Indicate if each is a common or serious side effect of Jardiance:

Side Effect	Common	Serious
Genital yeast infection
Euglycemic diabetic ketoacidosis
Urinary tract infection

Q24. Which finding requires immediate provider notification?

Case Study 5: Lantus (insulin glargine) for Diabetes

Patient: 54-year-old female with type 2 diabetes, started on Lantus 20 units SC at bedtime.

Q25. Highlight the assessment findings that are most concerning for a patient on Lantus:

Q26. Which order should the nurse question?

Q27. Select all teaching points for Lantus:

Q28. Place the following nursing actions in order of priority if the patient develops confusion, diaphoresis, and tremors:

1. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings
2. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings
3. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings
4. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings

Q29. Matrix: Indicate if each is a common or serious side effect of Lantus:

Side Effect	Common	Serious
Hypoglycemia
Injection site reaction
Allergic reaction

Q30. Which finding requires immediate provider notification?

Case Study 6: Humalog (insulin lispro) Sliding Scale

Patient: 45-year-old male with type 2 diabetes, receiving Humalog regular insulin per sliding scale before meals.

Q31. Highlight the assessment findings that are most concerning for a patient on Humalog sliding scale:

Q32. Which order should the nurse question?

Q33. Select all teaching points for Humalog sliding scale:

Q34. Place the following nursing actions in order of priority if the patient develops confusion, sweating, and palpitations:

1. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings
2. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings
3. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings
4. --Select--Check blood glucoseGive fast-acting carbohydrate if lowNotify the providerDocument findings

Q35. Matrix: Indicate if each is a common or serious side effect of Humalog:

Side Effect	Common	Serious
Hypoglycemia
Injection site reaction
Hypokalemia

Q36. Which finding requires immediate provider notification?