PHARMACOLOGY
60 Updated Actual Exam Questions and Correct Answers • Verified Solutions
1. A client is prescribed naloxone for an acute opioid overdose. What is the primary
mechanism of action of this drug?
A) Agonist at central alpha-2 adrenergic receptors
B) Competitive antagonist at opioid mu receptors
C) Partial agonist at GABA-A receptors
D) Irreversible inhibitor of acetylcholinesterase
Rationale: Naloxone competitively displaces opioids from mu, kappa, and delta receptors in the
central nervous system to reverse respiratory depression. It acts as a pure antagonist without intrinsic
agonist activity.
2. A patient taking digoxin develops nausea, vomiting, blurred vision, and halo visual
disturbances. Which electrolyte imbalance significantly elevates the risk of this
condition?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
Rationale: Hypokalemia enhances myocardial tissue binding of digoxin, leading to increased drug
sensitivity and clinical toxicity even at normal blood concentrations.
3. Which medication is considered the antidote for severe heparin-induced
anticoagulation toxicity?
A) Protamine sulfate
B) Phytonadione (Vitamin K1)
C) Aminocaproic acid
D) Idarucizumab
Rationale: Protamine sulfate is a strongly basic protein that binds strongly to acidic heparin molecules
to form an inactive neutral salt complex, rapidly neutralizing heparin's anticoagulant effects.
,4. A patient is starting lisinopril for hypertension. The nurse educates the patient to
monitor for which common side effect caused by bradykinin accumulation?
A) Peripheral edema
B) Dry persistent cough
C) Reflex tachycardia
D) Urinary retention
Rationale: ACE inhibitors prevent the metabolic breakdown of bradykinin and substance P in the
respiratory tract, frequently causing a dry, non-productive cough.
5. Which drug is classified as a short-acting beta-2 adrenergic agonist (SABA) used as a
rescue inhaler in acute asthma attacks?
A) Albuterol
B) Salmeterol
C) Tiotropium
D) Fluticasone
Rationale: Albuterol rapidly relaxes bronchial smooth muscle by stimulating beta-2 receptors,
providing fast relief during acute bronchospasm. Salmeterol is long-acting and unsuitable for
emergency rescue.
6. A patient is prescribed vancomycin IV for MRSA bacteremia. The nurse administers
the infusion over at least 60 minutes to prevent which adverse reaction?
A) Stevens-Johnson syndrome
B) Red Man Syndrome
C) Gray baby syndrome
D) Hemolytic anemia
Rationale: Rapid intravenous infusion of vancomycin triggers non-immunologic mast cell
degranulation and systemic histamine release, causing flushing, pruritus, and hypotension known as
Red Man Syndrome.
7. What is the specific therapeutic mechanism of action of spironolactone?
A) Blocks sodium-potassium-chloride cotransporters in the loop of Henle
B) Antagonizes aldosterone receptors in the distal renal tubule
C) Inhibits carbonic anhydrase in proximal convoluted tubules
D) Blocks epithelial sodium channels directly in the collecting duct
, Rationale: Spironolactone competitively inhibits aldosterone binding, promoting sodium and water
excretion while retaining potassium ions, classifying it as a potassium-sparing diuretic.
8. A client on chronic warfarin therapy has an INR of 7.2 without active hemorrhage.
Which medication should the nurse anticipate administering?
A) Oral Phytonadione (Vitamin K1)
B) Protamine sulfate IV
C) Desmopressin
D) Fresh frozen plasma bolus
Rationale: Oral Vitamin K1 bypasses warfarin inhibition to promote hepatic synthesis of clotting
factors II, VII, IX, and X, safely lowering supratherapeutic INR values when bleeding is absent.
9. What primary laboratory test is monitored to evaluate the therapeutic efficacy and
safety of unfractionated heparin infusions?
A) Prothrombin Time (PT)
B) Activated Partial Thromboplastin Time (aPTT)
C) International Normalized Ratio (INR)
D) Bleeding Time
Rationale: Unfractionated heparin enhances antithrombin III activity against intrinsic coagulation
pathway factors, making aPTT the appropriate assay for titration. Warfarin is monitored via PT/INR.
10. Which medication is a direct thrombin inhibitor used as an oral anticoagulant for
atrial fibrillation?
A) Rivaroxaban
B) Dabigatran
C) Apixaban
D) Clopidogrel
Rationale: Dabigatran directly binds to and inactivates both free and clot-bound thrombin (Factor IIa).
Rivaroxaban and apixaban inhibit Factor Xa directly.
11. A client with Parkinson's disease receives carbidopa-levodopa. What is the role of
carbidopa in this combination formulation?
A) Inhibits peripheral dopa decarboxylase to prevent peripheral breakdown of
60 Updated Actual Exam Questions and Correct Answers • Verified Solutions
1. A client is prescribed naloxone for an acute opioid overdose. What is the primary
mechanism of action of this drug?
A) Agonist at central alpha-2 adrenergic receptors
B) Competitive antagonist at opioid mu receptors
C) Partial agonist at GABA-A receptors
D) Irreversible inhibitor of acetylcholinesterase
Rationale: Naloxone competitively displaces opioids from mu, kappa, and delta receptors in the
central nervous system to reverse respiratory depression. It acts as a pure antagonist without intrinsic
agonist activity.
2. A patient taking digoxin develops nausea, vomiting, blurred vision, and halo visual
disturbances. Which electrolyte imbalance significantly elevates the risk of this
condition?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
Rationale: Hypokalemia enhances myocardial tissue binding of digoxin, leading to increased drug
sensitivity and clinical toxicity even at normal blood concentrations.
3. Which medication is considered the antidote for severe heparin-induced
anticoagulation toxicity?
A) Protamine sulfate
B) Phytonadione (Vitamin K1)
C) Aminocaproic acid
D) Idarucizumab
Rationale: Protamine sulfate is a strongly basic protein that binds strongly to acidic heparin molecules
to form an inactive neutral salt complex, rapidly neutralizing heparin's anticoagulant effects.
,4. A patient is starting lisinopril for hypertension. The nurse educates the patient to
monitor for which common side effect caused by bradykinin accumulation?
A) Peripheral edema
B) Dry persistent cough
C) Reflex tachycardia
D) Urinary retention
Rationale: ACE inhibitors prevent the metabolic breakdown of bradykinin and substance P in the
respiratory tract, frequently causing a dry, non-productive cough.
5. Which drug is classified as a short-acting beta-2 adrenergic agonist (SABA) used as a
rescue inhaler in acute asthma attacks?
A) Albuterol
B) Salmeterol
C) Tiotropium
D) Fluticasone
Rationale: Albuterol rapidly relaxes bronchial smooth muscle by stimulating beta-2 receptors,
providing fast relief during acute bronchospasm. Salmeterol is long-acting and unsuitable for
emergency rescue.
6. A patient is prescribed vancomycin IV for MRSA bacteremia. The nurse administers
the infusion over at least 60 minutes to prevent which adverse reaction?
A) Stevens-Johnson syndrome
B) Red Man Syndrome
C) Gray baby syndrome
D) Hemolytic anemia
Rationale: Rapid intravenous infusion of vancomycin triggers non-immunologic mast cell
degranulation and systemic histamine release, causing flushing, pruritus, and hypotension known as
Red Man Syndrome.
7. What is the specific therapeutic mechanism of action of spironolactone?
A) Blocks sodium-potassium-chloride cotransporters in the loop of Henle
B) Antagonizes aldosterone receptors in the distal renal tubule
C) Inhibits carbonic anhydrase in proximal convoluted tubules
D) Blocks epithelial sodium channels directly in the collecting duct
, Rationale: Spironolactone competitively inhibits aldosterone binding, promoting sodium and water
excretion while retaining potassium ions, classifying it as a potassium-sparing diuretic.
8. A client on chronic warfarin therapy has an INR of 7.2 without active hemorrhage.
Which medication should the nurse anticipate administering?
A) Oral Phytonadione (Vitamin K1)
B) Protamine sulfate IV
C) Desmopressin
D) Fresh frozen plasma bolus
Rationale: Oral Vitamin K1 bypasses warfarin inhibition to promote hepatic synthesis of clotting
factors II, VII, IX, and X, safely lowering supratherapeutic INR values when bleeding is absent.
9. What primary laboratory test is monitored to evaluate the therapeutic efficacy and
safety of unfractionated heparin infusions?
A) Prothrombin Time (PT)
B) Activated Partial Thromboplastin Time (aPTT)
C) International Normalized Ratio (INR)
D) Bleeding Time
Rationale: Unfractionated heparin enhances antithrombin III activity against intrinsic coagulation
pathway factors, making aPTT the appropriate assay for titration. Warfarin is monitored via PT/INR.
10. Which medication is a direct thrombin inhibitor used as an oral anticoagulant for
atrial fibrillation?
A) Rivaroxaban
B) Dabigatran
C) Apixaban
D) Clopidogrel
Rationale: Dabigatran directly binds to and inactivates both free and clot-bound thrombin (Factor IIa).
Rivaroxaban and apixaban inhibit Factor Xa directly.
11. A client with Parkinson's disease receives carbidopa-levodopa. What is the role of
carbidopa in this combination formulation?
A) Inhibits peripheral dopa decarboxylase to prevent peripheral breakdown of
