Pharmacology CMS Exam 2025/2026 |
Actual Comprehensive Medication
Safety (CMS) Pharmacology Exam
Exam
This document provides comprehensive preparation for the Comprehensive Medication
Safety Pharmacology Examination, featuring actual exam questions with 100% verified
correct ,,,answer,,,s already graded A+ for the 2025/2026 testing cycle. It covers high-
alert medications, error prevention strategies, therapeutic monitoring, adverse drug
reactions, and safe administration practices according to current medication safety
standards and accreditation requirements. This essential tool offers authentic exam
simulation and systematic pharmacology review to ensure mastery of medication safety
principles and success on your CMS assessment.
1. Which class of antihypertensive drugs is MOST likely to cause a dry
cough?
,,,answer,,,: ACE inhibitors (e.g., lisinopril).
Rationale: Increased bradykinin from ACE inhibition causes a
persistent dry cough.
2. A patient on warfarin starts trimethoprim–sulfamethoxazole (TMP–
SMX). What happens to INR?
,,,answer,,,: INR usually increases (bleeding risk ↑).
Rationale: TMP–SMX inhibits warfarin metabolism and displaces
protein binding, increasing INR.
3. Which antiplatelet medication irreversibly inhibits the P2Y12
receptor?
,,,answer,,,: Clopidogrel (and prasugrel, ticlopidine).
Rationale: These drugs block platelet aggregation by irreversible
P2Y12 receptor antagonism.
,4. Which antibiotic class is contraindicated in pregnant women due to
teratogenicity (teeth discoloration and bone effects)?
,,,answer,,,: Tetracyclines (e.g., doxycycline).
Rationale: Tetracyclines deposit in bone/teeth; avoid in
pregnancy/young children.
5. What is the antidote for acetaminophen (paracetamol) overdose?
,,,answer,,,: N-acetylcysteine (NAC).
Rationale: NAC replenishes glutathione and detoxifies NAPQI
metabolite.
6. Which statin has the highest risk of CYP3A4-mediated interactions?
,,,answer,,,: Simvastatin (also atorvastatin).
Rationale: These are metabolized by CYP3A4 and interact with
CYP3A4 inhibitors.
7. A patient with asthma needs a beta-blocker. Which is the safest
option?
,,,answer,,,: Cardioselective beta-1 blocker (e.g., metoprolol) used
cautiously.
Rationale: Beta-1 selective agents have less bronchospasm risk
than nonselective agents.
8. Which class of drugs can cause torsades de pointes by prolonging
QT interval?
,,,answer,,,: Class III antiarrhythmics, some macrolides,
fluoroquinolones, antipsychotics.
Rationale: They prolong cardiac repolarization (QT prolongation),
predisposing to torsades.
9. What is the major adverse effect limiting aminoglycoside use?
,,,answer,,,: Nephrotoxicity and ototoxicity.
Rationale: Accumulation in renal cortex and inner ear causes
toxicity—monitor levels.
10. Which oral hypoglycemic is associated with lactic acidosis in
renal impairment?
,,,answer,,,: Metformin.
, Rationale: Metformin accumulation can cause lactic acidosis; avoid
in severe renal dysfunction.
11. What should be monitored when initiating ACE inhibitors?
,,,answer,,,: Serum potassium and creatinine.
Rationale: ACE inhibitors can raise potassium and reduce GFR
initially.
12. Which drug class is FIRST-LINE for treating anaphylaxis?
,,,answer,,,: Intramuscular epinephrine.
Rationale: Epinephrine reverses bronchospasm, vasodilation, and
airway edema rapidly.
13. A patient on simvastatin develops muscle pain and elevated
CK after starting a macrolide. Why?
,,,answer,,,: Macrolide inhibits CYP3A4 → increased statin levels →
myopathy/rhabdomyolysis risk.
Rationale: Drug–drug interaction increases statin concentrations.
14. Which anticoagulant does NOT require routine INR
monitoring?
,,,answer,,,: Direct oral anticoagulants (DOACs) like apixaban,
rivaroxaban.
Rationale: DOACs have predictable pharmacokinetics and fixed
dosing for many indications.
15. Which medication class is associated with C. difficile infection
risk when overused?
,,,answer,,,: Broad-spectrum antibiotics (e.g., clindamycin,
fluoroquinolones, cephalosporins).
Rationale: They disrupt normal gut flora, allowing C. difficile
overgrowth.
16. Which medication requires genetic testing for HLA-B1502 in
some Asian populations due to severe rash risk?
,,,answer,,,: Carbamazepine.
Rationale: HLA-B1502 is associated with Stevens–Johnson
syndrome/toxic epidermal necrolysis.
Actual Comprehensive Medication
Safety (CMS) Pharmacology Exam
Exam
This document provides comprehensive preparation for the Comprehensive Medication
Safety Pharmacology Examination, featuring actual exam questions with 100% verified
correct ,,,answer,,,s already graded A+ for the 2025/2026 testing cycle. It covers high-
alert medications, error prevention strategies, therapeutic monitoring, adverse drug
reactions, and safe administration practices according to current medication safety
standards and accreditation requirements. This essential tool offers authentic exam
simulation and systematic pharmacology review to ensure mastery of medication safety
principles and success on your CMS assessment.
1. Which class of antihypertensive drugs is MOST likely to cause a dry
cough?
,,,answer,,,: ACE inhibitors (e.g., lisinopril).
Rationale: Increased bradykinin from ACE inhibition causes a
persistent dry cough.
2. A patient on warfarin starts trimethoprim–sulfamethoxazole (TMP–
SMX). What happens to INR?
,,,answer,,,: INR usually increases (bleeding risk ↑).
Rationale: TMP–SMX inhibits warfarin metabolism and displaces
protein binding, increasing INR.
3. Which antiplatelet medication irreversibly inhibits the P2Y12
receptor?
,,,answer,,,: Clopidogrel (and prasugrel, ticlopidine).
Rationale: These drugs block platelet aggregation by irreversible
P2Y12 receptor antagonism.
,4. Which antibiotic class is contraindicated in pregnant women due to
teratogenicity (teeth discoloration and bone effects)?
,,,answer,,,: Tetracyclines (e.g., doxycycline).
Rationale: Tetracyclines deposit in bone/teeth; avoid in
pregnancy/young children.
5. What is the antidote for acetaminophen (paracetamol) overdose?
,,,answer,,,: N-acetylcysteine (NAC).
Rationale: NAC replenishes glutathione and detoxifies NAPQI
metabolite.
6. Which statin has the highest risk of CYP3A4-mediated interactions?
,,,answer,,,: Simvastatin (also atorvastatin).
Rationale: These are metabolized by CYP3A4 and interact with
CYP3A4 inhibitors.
7. A patient with asthma needs a beta-blocker. Which is the safest
option?
,,,answer,,,: Cardioselective beta-1 blocker (e.g., metoprolol) used
cautiously.
Rationale: Beta-1 selective agents have less bronchospasm risk
than nonselective agents.
8. Which class of drugs can cause torsades de pointes by prolonging
QT interval?
,,,answer,,,: Class III antiarrhythmics, some macrolides,
fluoroquinolones, antipsychotics.
Rationale: They prolong cardiac repolarization (QT prolongation),
predisposing to torsades.
9. What is the major adverse effect limiting aminoglycoside use?
,,,answer,,,: Nephrotoxicity and ototoxicity.
Rationale: Accumulation in renal cortex and inner ear causes
toxicity—monitor levels.
10. Which oral hypoglycemic is associated with lactic acidosis in
renal impairment?
,,,answer,,,: Metformin.
, Rationale: Metformin accumulation can cause lactic acidosis; avoid
in severe renal dysfunction.
11. What should be monitored when initiating ACE inhibitors?
,,,answer,,,: Serum potassium and creatinine.
Rationale: ACE inhibitors can raise potassium and reduce GFR
initially.
12. Which drug class is FIRST-LINE for treating anaphylaxis?
,,,answer,,,: Intramuscular epinephrine.
Rationale: Epinephrine reverses bronchospasm, vasodilation, and
airway edema rapidly.
13. A patient on simvastatin develops muscle pain and elevated
CK after starting a macrolide. Why?
,,,answer,,,: Macrolide inhibits CYP3A4 → increased statin levels →
myopathy/rhabdomyolysis risk.
Rationale: Drug–drug interaction increases statin concentrations.
14. Which anticoagulant does NOT require routine INR
monitoring?
,,,answer,,,: Direct oral anticoagulants (DOACs) like apixaban,
rivaroxaban.
Rationale: DOACs have predictable pharmacokinetics and fixed
dosing for many indications.
15. Which medication class is associated with C. difficile infection
risk when overused?
,,,answer,,,: Broad-spectrum antibiotics (e.g., clindamycin,
fluoroquinolones, cephalosporins).
Rationale: They disrupt normal gut flora, allowing C. difficile
overgrowth.
16. Which medication requires genetic testing for HLA-B1502 in
some Asian populations due to severe rash risk?
,,,answer,,,: Carbamazepine.
Rationale: HLA-B1502 is associated with Stevens–Johnson
syndrome/toxic epidermal necrolysis.
