Maryville NR 565 Advanced
Pharmacology Exam 1 Exam With
Actual 120 Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/ 2025/2026 /Latest Update/Instant
Download Pdf
1. Which receptor subtype is primarily responsible for bronchoconstriction when
stimulated?
A. Alpha-1
B. Beta-1
C. M3
D. Beta-2
Answer: C. M3
Rationale: M3 muscarinic receptors on airway smooth muscle mediate
bronchoconstriction via parasympathetic cholinergic stimulation.
2. A patient on warfarin begins taking trimethoprim-sulfamethoxazole. What is the
most likely interaction?
A. Decreased INR due to induction of warfarin metabolism
B. Increased INR due to inhibition of warfarin metabolism
C. No interaction
D. Decreased warfarin absorption in the gut
Answer: B. Increased INR due to inhibition of warfarin metabolism
Rationale: TMP-SMX inhibits CYP enzymes (and displaces warfarin) increasing
warfarin levels and INR, raising bleeding risk.
3. Which of the following drugs is the antidote for acetaminophen overdose?
A. Naloxone
B. Flumazenil
C. N-acetylcysteine
, D. Deferoxamine
Answer: C. N-acetylcysteine
Rationale: N-acetylcysteine replenishes glutathione to detoxify NAPQI, preventing
liver injury.
4. Which antibiotic class is most associated with ototoxicity and nephrotoxicity?
A. Macrolides
B. Fluoroquinolones
C. Aminoglycosides
D. Tetracyclines
Answer: C. Aminoglycosides
Rationale: Aminoglycosides (e.g., gentamicin) cause dose-dependent
nephrotoxicity and ototoxicity; monitoring levels reduces risk.
5. A patient develops a dry mouth, urinary retention, and constipation after receiving a
new medication. Which mechanism best explains these effects?
A. Beta-2 agonism
B. Anticholinergic (muscarinic) blockade
C. Dopamine blockade
D. Alpha-1 agonism
Answer: B. Anticholinergic (muscarinic) blockade
Rationale: Antimuscarinic drugs block parasympathetic muscarinic receptors
causing reduced secretions, bladder retention, and decreased GI motility.
6. Which class of antihypertensive drugs can cause a persistent dry cough in some
patients?
A. Beta-blockers
B. ACE inhibitors
C. Calcium channel blockers
D. Alpha-1 blockers
Answer: B. ACE inhibitors
Rationale: ACE inhibitors increase bradykinin levels which can cause a dry,
persistent cough in susceptible patients.
7. Which insulin has the fastest onset of action?
A. Insulin lispro
B. NPH insulin
C. Insulin glargine
D. Regular insulin (human)
Answer: A. Insulin lispro
Rationale: Rapid-acting analogs (lispro, aspart) have very fast onset useful for
prandial glucose control; regular insulin is slower.
, 8. A patient taking digoxin becomes hyperkalemic. Which statement is true regarding
digoxin toxicity?
A. Hypokalemia protects against digoxin toxicity
B. Hyperkalemia indicates severe digoxin toxicity
C. Digoxin toxicity is unrelated to potassium
D. Hyperkalemia reduces digoxin effects
Answer: B. Hyperkalemia indicates severe digoxin toxicity
Rationale: In acute overdose, digoxin inhibition of Na+/K+ ATPase causes
extracellular K+ rise; hyperkalemia signals severe toxicity.
9. Which drug is first-line for anaphylaxis?
A. Diphenhydramine
B. Albuterol
C. Intramuscular epinephrine
D. IV corticosteroids
Answer: C. Intramuscular epinephrine
Rationale: IM epinephrine provides alpha and beta stimulation (vasoconstriction,
bronchodilation) and reverses anaphylactic shock quickly.
10. Which anticonvulsant is associated with fetal neural tube defects when used in
pregnancy?
A. Levetiracetam
B. Gabapentin
C. Valproic acid
D. Lamotrigine
Answer: C. Valproic acid
Rationale: Valproate increases the risk of neural tube defects and cognitive
impairment in exposed fetuses; avoid in pregnancy when possible.
11. Which antihyperlipidemic drug is most potent at lowering LDL cholesterol?
A. Ezetimibe
B. Bile acid sequestrants
C. High-intensity statin (e.g., atorvastatin 40–80 mg)
D. Niacin
Answer: C. High-intensity statin (e.g., atorvastatin 40–80 mg)
Rationale: Statins inhibit HMG-CoA reductase and are the most effective agents for
LDL reduction and CVD risk reduction.
12. A 70-year-old patient on multiple meds starts a selective serotonin reuptake inhibitor
(SSRI). They later present with agitation, hyperreflexia, and fever. What is the likely
diagnosis?
A. Neuroleptic malignant syndrome
B. Anticholinergic toxicity
Pharmacology Exam 1 Exam With
Actual 120 Questions & Verified
Answers,Plus Rationales/Expert
Verified For Guaranteed Pass Graded
A+/ 2025/2026 /Latest Update/Instant
Download Pdf
1. Which receptor subtype is primarily responsible for bronchoconstriction when
stimulated?
A. Alpha-1
B. Beta-1
C. M3
D. Beta-2
Answer: C. M3
Rationale: M3 muscarinic receptors on airway smooth muscle mediate
bronchoconstriction via parasympathetic cholinergic stimulation.
2. A patient on warfarin begins taking trimethoprim-sulfamethoxazole. What is the
most likely interaction?
A. Decreased INR due to induction of warfarin metabolism
B. Increased INR due to inhibition of warfarin metabolism
C. No interaction
D. Decreased warfarin absorption in the gut
Answer: B. Increased INR due to inhibition of warfarin metabolism
Rationale: TMP-SMX inhibits CYP enzymes (and displaces warfarin) increasing
warfarin levels and INR, raising bleeding risk.
3. Which of the following drugs is the antidote for acetaminophen overdose?
A. Naloxone
B. Flumazenil
C. N-acetylcysteine
, D. Deferoxamine
Answer: C. N-acetylcysteine
Rationale: N-acetylcysteine replenishes glutathione to detoxify NAPQI, preventing
liver injury.
4. Which antibiotic class is most associated with ototoxicity and nephrotoxicity?
A. Macrolides
B. Fluoroquinolones
C. Aminoglycosides
D. Tetracyclines
Answer: C. Aminoglycosides
Rationale: Aminoglycosides (e.g., gentamicin) cause dose-dependent
nephrotoxicity and ototoxicity; monitoring levels reduces risk.
5. A patient develops a dry mouth, urinary retention, and constipation after receiving a
new medication. Which mechanism best explains these effects?
A. Beta-2 agonism
B. Anticholinergic (muscarinic) blockade
C. Dopamine blockade
D. Alpha-1 agonism
Answer: B. Anticholinergic (muscarinic) blockade
Rationale: Antimuscarinic drugs block parasympathetic muscarinic receptors
causing reduced secretions, bladder retention, and decreased GI motility.
6. Which class of antihypertensive drugs can cause a persistent dry cough in some
patients?
A. Beta-blockers
B. ACE inhibitors
C. Calcium channel blockers
D. Alpha-1 blockers
Answer: B. ACE inhibitors
Rationale: ACE inhibitors increase bradykinin levels which can cause a dry,
persistent cough in susceptible patients.
7. Which insulin has the fastest onset of action?
A. Insulin lispro
B. NPH insulin
C. Insulin glargine
D. Regular insulin (human)
Answer: A. Insulin lispro
Rationale: Rapid-acting analogs (lispro, aspart) have very fast onset useful for
prandial glucose control; regular insulin is slower.
, 8. A patient taking digoxin becomes hyperkalemic. Which statement is true regarding
digoxin toxicity?
A. Hypokalemia protects against digoxin toxicity
B. Hyperkalemia indicates severe digoxin toxicity
C. Digoxin toxicity is unrelated to potassium
D. Hyperkalemia reduces digoxin effects
Answer: B. Hyperkalemia indicates severe digoxin toxicity
Rationale: In acute overdose, digoxin inhibition of Na+/K+ ATPase causes
extracellular K+ rise; hyperkalemia signals severe toxicity.
9. Which drug is first-line for anaphylaxis?
A. Diphenhydramine
B. Albuterol
C. Intramuscular epinephrine
D. IV corticosteroids
Answer: C. Intramuscular epinephrine
Rationale: IM epinephrine provides alpha and beta stimulation (vasoconstriction,
bronchodilation) and reverses anaphylactic shock quickly.
10. Which anticonvulsant is associated with fetal neural tube defects when used in
pregnancy?
A. Levetiracetam
B. Gabapentin
C. Valproic acid
D. Lamotrigine
Answer: C. Valproic acid
Rationale: Valproate increases the risk of neural tube defects and cognitive
impairment in exposed fetuses; avoid in pregnancy when possible.
11. Which antihyperlipidemic drug is most potent at lowering LDL cholesterol?
A. Ezetimibe
B. Bile acid sequestrants
C. High-intensity statin (e.g., atorvastatin 40–80 mg)
D. Niacin
Answer: C. High-intensity statin (e.g., atorvastatin 40–80 mg)
Rationale: Statins inhibit HMG-CoA reductase and are the most effective agents for
LDL reduction and CVD risk reduction.
12. A 70-year-old patient on multiple meds starts a selective serotonin reuptake inhibitor
(SSRI). They later present with agitation, hyperreflexia, and fever. What is the likely
diagnosis?
A. Neuroleptic malignant syndrome
B. Anticholinergic toxicity
