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Q1. Which adverse effect is most characteristic of ACE inhibitors (e.g., lisinopril)?
A) Dilated pupils
B) Hypoglycemia
C) Dry cough
D) Constipation
Answer: C
Rationale: ACE inhibitors increase bradykinin, causing a persistent dry cough.
Q2. Which medication is the antidote for warfarin toxicity when INR is dangerously high?
A) Protamine sulfate
B) Naloxone
C) Flumazenil
D) Vitamin K (phytonadione)
Answer: D
Rationale: Vitamin K reverses warfarin; protamine reverses heparin.
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, A+
Q3. Which finding requires holding a beta■blocker (e.g., metoprolol) and notifying the provider?
A) Capillary glucose 110 mg/dL
B) Apical heart rate 48/min
C) Temperature 37.2°C
D) BP 138/84 mmHg
Answer: B
Rationale: Beta■blockers can cause bradycardia; hold if HR < 60/min per protocol.
Q4. A client on spironolactone is at most risk for which electrolyte imbalance?
A) Hypomagnesemia
B) Hypocalcemia
C) Hyperkalemia
D) Hyponatremia
Answer: C
Rationale: Spironolactone is potassium■sparing, increasing risk of hyperkalemia.
Q5. Which antibiotic can discolor developing teeth and should be avoided in pregnancy/children <8?
A) Azithromycin
B) Tetracycline
C) Amoxicillin
D) Ceftriaxone
Answer: B
Rationale: Tetracyclines bind calcium and can cause permanent tooth discoloration.
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, A+
Q6. Which insulin has no pronounced peak and is given once daily?
A) NPH insulin
B) Regular insulin
C) Insulin glargine
D) Insulin lispro
Answer: C
Rationale: Glargine is long■acting with a relatively flat profile and no peak.
Q7. Before starting a statin (e.g., atorvastatin), which baseline lab is most important?
A) Serum amylase
B) Serum lipase
C) Serum uric acid
D) Liver function tests (AST/ALT)
Answer: D
Rationale: Statins can cause hepatotoxicity; monitor LFTs.
Q8. Which teaching is correct for nitroglycerin transdermal patches?
A) Use patches for acute chest pain relief
B) Remove the patch at night for 10–12 hours
C) Apply over hairy skin for better adhesion
D) Cut patches to adjust dose
Answer: B
Rationale: A daily nitrate■free interval prevents tolerance; patches are not for acute pain.
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, A+
Q9. A patient on digoxin has nausea, vision changes, and HR 54/min. What is the priority action?
A) Administer dose with food
B) Give IV calcium gluconate
C) Hold the dose and check digoxin level
D) Increase potassium restriction
Answer: C
Rationale: Toxicity signs: GI upset, visual halos, bradycardia; hold and assess level.
Q10. Which antibiotic is associated with tendon rupture risk, especially in older adults?
A) Amoxicillin
B) Vancomycin
C) Doxycycline
D) Ciprofloxacin
Answer: D
Rationale: Fluoroquinolones carry a boxed warning for tendonitis/tendon rupture.
Q11. Which TB drug commonly causes orange discoloration of body fluids?
A) Pyrazinamide
B) Rifampin
C) Isoniazid
D) Ethambutol
Answer: B
Rationale: Rifampin turns urine/tears/sweat orange; this is expected.
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