NP Pharmacology practice exam with answers and rationales formatted
as requested. I can continue in multiple parts if needed.
1. Which of the following drugs is considered a beta-1 selective
blocker?
a) Propranolol
b) Metoprolol
c) Labetalol
d) Carvedilol
Rationale: Metoprolol selectively blocks beta-1 adrenergic receptors,
primarily affecting the heart with minimal effect on the lungs, unlike
non-selective beta-blockers such as propranolol.
2. A patient is prescribed warfarin. Which lab test is most important
for monitoring its effect?
a) PT/INR
b) aPTT
c) PT/INR
d) Platelet count
Rationale: Warfarin affects the vitamin K-dependent clotting factors,
making prothrombin time (PT) and INR the standard monitoring
parameters.
3. Which of the following antibiotics is contraindicated in
pregnancy?
a) Amoxicillin
b) Azithromycin
c) Tetracycline
d) Cephalexin
,Rationale: Tetracyclines can cause fetal teeth discoloration and bone
growth inhibition, making them contraindicated during pregnancy.
4. Which opioid has a ceiling effect for analgesia?
a) Morphine
b) Buprenorphine
c) Fentanyl
d) Hydromorphone
Rationale: Buprenorphine is a partial agonist at mu-opioid receptors
and exhibits a ceiling effect for analgesia and respiratory depression.
5. A patient with heart failure is prescribed spironolactone. Which
electrolyte abnormality should be monitored?
a) Hypokalemia
b) Hyperkalemia
c) Hyponatremia
d) Hypocalcemia
Rationale: Spironolactone is a potassium-sparing diuretic, which
increases the risk of hyperkalemia.
6. Which antiepileptic drug is associated with gingival hyperplasia?
a) Valproic acid
b) Carbamazepine
c) Phenytoin
d) Levetiracetam
Rationale: Phenytoin commonly causes gingival hyperplasia,
particularly in children and patients with poor oral hygiene.
7. A patient develops angioedema after starting an ACE inhibitor.
What is the next best step?
a) Continue ACE inhibitor
b) Switch to ARB
, c) Discontinue ACE inhibitor immediately
d) Prescribe antihistamine only
Rationale: ACE inhibitors can cause life-threatening angioedema; the
drug should be stopped immediately. ARBs can be considered
cautiously in some cases.
8. Which of the following is a common side effect of amiodarone?
a) Hypoglycemia
b) Pulmonary fibrosis
c) Hyperkalemia
d) Bradycardia
Rationale: Amiodarone can cause pulmonary toxicity, including
fibrosis, along with thyroid and hepatic abnormalities.
9. A patient taking furosemide presents with muscle cramps and
weakness. Which lab abnormality is most likely?
a) Hyperkalemia
b) Hypokalemia
c) Hypernatremia
d) Hypocalcemia
Rationale: Loop diuretics like furosemide increase renal potassium
excretion, which can cause hypokalemia and muscle cramps.
10. Which medication is first-line therapy for type 2 diabetes?
a) Glyburide
b) Pioglitazone
c) Metformin
d) Insulin
Rationale: Metformin improves insulin sensitivity and decreases
hepatic glucose production; it is the preferred first-line agent in type 2
diabetes unless contraindicated.
, 11. Which drug is classified as a proton pump inhibitor?
a) Ranitidine
b) Famotidine
c) Omeprazole
d) Sucralfate
Rationale: Omeprazole irreversibly inhibits the H+/K+ ATPase
pump in gastric parietal cells, reducing acid secretion.
12. Which medication can cause a dry cough as a side effect?
a) Losartan
b) Lisinopril
c) Amlodipine
d) Hydrochlorothiazide
Rationale: ACE inhibitors increase bradykinin levels, which can
lead to a persistent dry cough.
13. Which drug is used to reverse opioid overdose?
a) Naloxone
b) Naltrexone
c) Buprenorphine
d) Methadone
Rationale: Naloxone is a rapid-acting opioid antagonist used to
reverse respiratory depression in opioid overdose.
14. A common side effect of atropine is:
a) Diarrhea
b) Dry mouth
c) Miosis
d) Bronchoconstriction
Rationale: Atropine is an anticholinergic agent that commonly
causes dry mouth, urinary retention, and blurred vision.
as requested. I can continue in multiple parts if needed.
1. Which of the following drugs is considered a beta-1 selective
blocker?
a) Propranolol
b) Metoprolol
c) Labetalol
d) Carvedilol
Rationale: Metoprolol selectively blocks beta-1 adrenergic receptors,
primarily affecting the heart with minimal effect on the lungs, unlike
non-selective beta-blockers such as propranolol.
2. A patient is prescribed warfarin. Which lab test is most important
for monitoring its effect?
a) PT/INR
b) aPTT
c) PT/INR
d) Platelet count
Rationale: Warfarin affects the vitamin K-dependent clotting factors,
making prothrombin time (PT) and INR the standard monitoring
parameters.
3. Which of the following antibiotics is contraindicated in
pregnancy?
a) Amoxicillin
b) Azithromycin
c) Tetracycline
d) Cephalexin
,Rationale: Tetracyclines can cause fetal teeth discoloration and bone
growth inhibition, making them contraindicated during pregnancy.
4. Which opioid has a ceiling effect for analgesia?
a) Morphine
b) Buprenorphine
c) Fentanyl
d) Hydromorphone
Rationale: Buprenorphine is a partial agonist at mu-opioid receptors
and exhibits a ceiling effect for analgesia and respiratory depression.
5. A patient with heart failure is prescribed spironolactone. Which
electrolyte abnormality should be monitored?
a) Hypokalemia
b) Hyperkalemia
c) Hyponatremia
d) Hypocalcemia
Rationale: Spironolactone is a potassium-sparing diuretic, which
increases the risk of hyperkalemia.
6. Which antiepileptic drug is associated with gingival hyperplasia?
a) Valproic acid
b) Carbamazepine
c) Phenytoin
d) Levetiracetam
Rationale: Phenytoin commonly causes gingival hyperplasia,
particularly in children and patients with poor oral hygiene.
7. A patient develops angioedema after starting an ACE inhibitor.
What is the next best step?
a) Continue ACE inhibitor
b) Switch to ARB
, c) Discontinue ACE inhibitor immediately
d) Prescribe antihistamine only
Rationale: ACE inhibitors can cause life-threatening angioedema; the
drug should be stopped immediately. ARBs can be considered
cautiously in some cases.
8. Which of the following is a common side effect of amiodarone?
a) Hypoglycemia
b) Pulmonary fibrosis
c) Hyperkalemia
d) Bradycardia
Rationale: Amiodarone can cause pulmonary toxicity, including
fibrosis, along with thyroid and hepatic abnormalities.
9. A patient taking furosemide presents with muscle cramps and
weakness. Which lab abnormality is most likely?
a) Hyperkalemia
b) Hypokalemia
c) Hypernatremia
d) Hypocalcemia
Rationale: Loop diuretics like furosemide increase renal potassium
excretion, which can cause hypokalemia and muscle cramps.
10. Which medication is first-line therapy for type 2 diabetes?
a) Glyburide
b) Pioglitazone
c) Metformin
d) Insulin
Rationale: Metformin improves insulin sensitivity and decreases
hepatic glucose production; it is the preferred first-line agent in type 2
diabetes unless contraindicated.
, 11. Which drug is classified as a proton pump inhibitor?
a) Ranitidine
b) Famotidine
c) Omeprazole
d) Sucralfate
Rationale: Omeprazole irreversibly inhibits the H+/K+ ATPase
pump in gastric parietal cells, reducing acid secretion.
12. Which medication can cause a dry cough as a side effect?
a) Losartan
b) Lisinopril
c) Amlodipine
d) Hydrochlorothiazide
Rationale: ACE inhibitors increase bradykinin levels, which can
lead to a persistent dry cough.
13. Which drug is used to reverse opioid overdose?
a) Naloxone
b) Naltrexone
c) Buprenorphine
d) Methadone
Rationale: Naloxone is a rapid-acting opioid antagonist used to
reverse respiratory depression in opioid overdose.
14. A common side effect of atropine is:
a) Diarrhea
b) Dry mouth
c) Miosis
d) Bronchoconstriction
Rationale: Atropine is an anticholinergic agent that commonly
causes dry mouth, urinary retention, and blurred vision.
