,NSG 533 Exam 1 Advanced Pharmacology Questions And Answers
2026/2027 Wilkes University
Q1. Proton pump inhibitors suppress gastric acid secretion through
which mechanism?
A) Competitive blockade of histamine H1 receptors
B) Irreversible inhibition of the gastric H+/K+-ATPase
C) Neutralization of existing gastric acid within the lumen
D) Stimulation of prostaglandin degradation
Correct Answer: B) Irreversible inhibition of the gastric H+/K+-ATPase
Rationale: Proton pump inhibitors irreversibly inhibit the hydrogen-
potassium ATPase in gastric parietal cells, blocking the final step of acid
secretion. This produces more potent and sustained acid suppression than
histamine H2-receptor antagonists.
Q2. A person taking omeprazole for gastroesophageal reflux asks
when to take the medication for maximum effect. Which instruction
is most appropriate?
A) Take it only after symptoms begin
B) Take it immediately after the evening meal
C) Take it simultaneously with an antacid after every meal
D) Take it before a meal, preferably before breakfast
Correct Answer: D) Take it before a meal, preferably before breakfast
Rationale: Proton pumps become active in response to food. Administering
a PPI approximately 30–60 minutes before a meal allows adequate drug
absorption before maximal pump activation, improving acid suppression.
Q3. Which pharmacologic property best explains why famotidine
reduces gastric acid production?
A) It blocks histamine H2 receptors on parietal cells
B) It forms a physical coating over the entire stomach
C) It irreversibly inhibits proton pumps
D) It inhibits muscarinic receptors throughout the gastrointestinal tract
, Correct Answer: A) It blocks histamine H2 receptors on parietal cells
Rationale: Histamine stimulates gastric acid secretion through H2 receptors
on parietal cells. Famotidine competitively blocks these receptors, reducing
basal and stimulated acid secretion.
Q4. Long-term or high-intensity proton pump inhibitor therapy
warrants periodic reassessment primarily because prolonged acid
suppression has been associated with which concern?
A) Severe hyperglycemia
B) Irreversible adrenal suppression
C) Increased susceptibility to selected enteric infections and nutrient
abnormalities
D) Persistent bronchoconstriction
Correct Answer: C) Increased susceptibility to selected enteric infections
and nutrient abnormalities
Rationale: Sustained gastric acid suppression can alter gastrointestinal
microbial defenses and affect absorption of nutrients such as magnesium or
vitamin B12 in susceptible individuals. Long-term therapy should therefore
have a continuing clinical indication.
Q5. Which medication is most appropriate for protecting the gastric
mucosa in a high-risk patient who must continue long-term NSAID
therapy?
A) Diphenhydramine
B) Loperamide
C) A proton pump inhibitor
D) Metoclopramide
Correct Answer: C) A proton pump inhibitor
Rationale: NSAIDs inhibit prostaglandin synthesis and weaken mucosal
protection. PPIs substantially reduce gastric acid exposure and decrease the
risk of NSAID-associated ulcer formation and complications in high-risk
patients.
Q6. Misoprostol prevents NSAID-associated gastric injury through
which pharmacologic action?
2026/2027 Wilkes University
Q1. Proton pump inhibitors suppress gastric acid secretion through
which mechanism?
A) Competitive blockade of histamine H1 receptors
B) Irreversible inhibition of the gastric H+/K+-ATPase
C) Neutralization of existing gastric acid within the lumen
D) Stimulation of prostaglandin degradation
Correct Answer: B) Irreversible inhibition of the gastric H+/K+-ATPase
Rationale: Proton pump inhibitors irreversibly inhibit the hydrogen-
potassium ATPase in gastric parietal cells, blocking the final step of acid
secretion. This produces more potent and sustained acid suppression than
histamine H2-receptor antagonists.
Q2. A person taking omeprazole for gastroesophageal reflux asks
when to take the medication for maximum effect. Which instruction
is most appropriate?
A) Take it only after symptoms begin
B) Take it immediately after the evening meal
C) Take it simultaneously with an antacid after every meal
D) Take it before a meal, preferably before breakfast
Correct Answer: D) Take it before a meal, preferably before breakfast
Rationale: Proton pumps become active in response to food. Administering
a PPI approximately 30–60 minutes before a meal allows adequate drug
absorption before maximal pump activation, improving acid suppression.
Q3. Which pharmacologic property best explains why famotidine
reduces gastric acid production?
A) It blocks histamine H2 receptors on parietal cells
B) It forms a physical coating over the entire stomach
C) It irreversibly inhibits proton pumps
D) It inhibits muscarinic receptors throughout the gastrointestinal tract
, Correct Answer: A) It blocks histamine H2 receptors on parietal cells
Rationale: Histamine stimulates gastric acid secretion through H2 receptors
on parietal cells. Famotidine competitively blocks these receptors, reducing
basal and stimulated acid secretion.
Q4. Long-term or high-intensity proton pump inhibitor therapy
warrants periodic reassessment primarily because prolonged acid
suppression has been associated with which concern?
A) Severe hyperglycemia
B) Irreversible adrenal suppression
C) Increased susceptibility to selected enteric infections and nutrient
abnormalities
D) Persistent bronchoconstriction
Correct Answer: C) Increased susceptibility to selected enteric infections
and nutrient abnormalities
Rationale: Sustained gastric acid suppression can alter gastrointestinal
microbial defenses and affect absorption of nutrients such as magnesium or
vitamin B12 in susceptible individuals. Long-term therapy should therefore
have a continuing clinical indication.
Q5. Which medication is most appropriate for protecting the gastric
mucosa in a high-risk patient who must continue long-term NSAID
therapy?
A) Diphenhydramine
B) Loperamide
C) A proton pump inhibitor
D) Metoclopramide
Correct Answer: C) A proton pump inhibitor
Rationale: NSAIDs inhibit prostaglandin synthesis and weaken mucosal
protection. PPIs substantially reduce gastric acid exposure and decrease the
risk of NSAID-associated ulcer formation and complications in high-risk
patients.
Q6. Misoprostol prevents NSAID-associated gastric injury through
which pharmacologic action?
