COMLEX Level 1 & COMSAE-
Style Pharmacology Practice
Questions | Original MCQs
with Rationales
Question 1
A 62-year-old man with chronic heart failure is started on a medication that decreases mortality
by reducing angiotensin II production. Which medication has this mechanism?
A. Losartan
B. Lisinopril
C. Furosemide
D. Hydralazine
Answer: B. Lisinopril
Rationale: ACE inhibitors such as lisinopril inhibit the conversion of angiotensin I to angiotensin
II, reducing afterload and aldosterone secretion while improving survival in heart failure.
Losartan blocks the AT1 receptor rather than ACE. Furosemide is a loop diuretic that improves
symptoms but not mortality. Hydralazine is an arterial vasodilator.
Question 2
A patient receiving gentamicin develops hearing loss and worsening renal function. Which
adverse effect best explains these findings?
A. Hepatotoxicity
B. Bone marrow suppression
C. Ototoxicity and nephrotoxicity
, D. QT prolongation
Answer: C. Ototoxicity and nephrotoxicity
Rationale: Aminoglycosides cause dose-dependent nephrotoxicity and irreversible ototoxicity.
Monitoring renal function and drug levels is important during therapy.
Question 3
A patient develops severe diarrhea after prolonged clindamycin therapy. Which organism is most
likely responsible?
A. Salmonella enterica
B. Escherichia coli
C. Clostridioides difficile
D. Campylobacter jejuni
Answer: C. Clostridioides difficile
Rationale: Clindamycin is strongly associated with C. difficile colitis due to disruption of normal
intestinal flora.
Question 4
Warfarin therapy is initiated in a patient with atrial fibrillation. Which laboratory test should be
monitored?
A. Bleeding time
B. aPTT
C. Thrombin time
D. PT/INR
Answer: D. PT/INR
Rationale: Warfarin inhibits vitamin K-dependent clotting factors II, VII, IX, and X. Its
anticoagulant effect is monitored using the PT/INR.
Style Pharmacology Practice
Questions | Original MCQs
with Rationales
Question 1
A 62-year-old man with chronic heart failure is started on a medication that decreases mortality
by reducing angiotensin II production. Which medication has this mechanism?
A. Losartan
B. Lisinopril
C. Furosemide
D. Hydralazine
Answer: B. Lisinopril
Rationale: ACE inhibitors such as lisinopril inhibit the conversion of angiotensin I to angiotensin
II, reducing afterload and aldosterone secretion while improving survival in heart failure.
Losartan blocks the AT1 receptor rather than ACE. Furosemide is a loop diuretic that improves
symptoms but not mortality. Hydralazine is an arterial vasodilator.
Question 2
A patient receiving gentamicin develops hearing loss and worsening renal function. Which
adverse effect best explains these findings?
A. Hepatotoxicity
B. Bone marrow suppression
C. Ototoxicity and nephrotoxicity
, D. QT prolongation
Answer: C. Ototoxicity and nephrotoxicity
Rationale: Aminoglycosides cause dose-dependent nephrotoxicity and irreversible ototoxicity.
Monitoring renal function and drug levels is important during therapy.
Question 3
A patient develops severe diarrhea after prolonged clindamycin therapy. Which organism is most
likely responsible?
A. Salmonella enterica
B. Escherichia coli
C. Clostridioides difficile
D. Campylobacter jejuni
Answer: C. Clostridioides difficile
Rationale: Clindamycin is strongly associated with C. difficile colitis due to disruption of normal
intestinal flora.
Question 4
Warfarin therapy is initiated in a patient with atrial fibrillation. Which laboratory test should be
monitored?
A. Bleeding time
B. aPTT
C. Thrombin time
D. PT/INR
Answer: D. PT/INR
Rationale: Warfarin inhibits vitamin K-dependent clotting factors II, VII, IX, and X. Its
anticoagulant effect is monitored using the PT/INR.
