NP Pharmacology – 150-Question Practice Exam
(From the 300-Item Mega Pack) | Fully Verified &
Updated( Answers And Rationale Included)
2025/2026
Instructions: 150 multiple-choice questions. Do not bold questions.
Bold the correct answer only. Rationale should be in bold italics
immediately following each answer.
1. Which drug is a selective beta-1 adrenergic blocker commonly
used for hypertension and ischemic heart disease?
A. Propranolol
B. Metoprolol
C. Carvedilol
D. Labetalol
Answer: B
Rationale: Metoprolol is a selective beta-1 blocker at typical doses,
reducing heart rate and contractility with less bronchoconstriction
than nonselective beta-blockers.
2. Which antibiotic is most appropriate for empiric outpatient
therapy of uncomplicated community-acquired pneumonia in an
otherwise healthy adult?
A. Doxycycline
B. Azithromycin
C. Ciprofloxacin
D. Vancomycin
Answer: B
,Rationale: Azithromycin provides coverage against common atypical
and typical pathogens in outpatient community-acquired pneumonia
and has convenient dosing.
3. A patient on warfarin begins taking trimethoprim-
sulfamethoxazole (TMP-SMX). What is the expected interaction?
A. Decreased INR
B. No change
C. Increased INR
D. Increased warfarin clearance
Answer: C
Rationale: TMP-SMX inhibits warfarin metabolism and can displace
protein-bound warfarin, both increasing INR and bleeding risk.
4. Which insulin has the fastest onset when given subcutaneously?
A. Regular insulin
B. NPH insulin
C. Insulin lispro
D. Insulin glargine
Answer: C
Rationale: Rapid-acting analogs like insulin lispro have onset within 15
minutes and are used for mealtime glucose control.
5. Which medication is the first-line therapy for type 2 diabetes that
also reduces hepatic glucose production?
A. Sulfonylureas
B. DPP-4 inhibitors
C. Metformin
D. Thiazolidinediones
Answer: C
,Rationale: Metformin decreases hepatic gluconeogenesis and
improves insulin sensitivity; it is first-line unless contraindicated.
6. A drug that blocks HMG-CoA reductase will primarily affect which
process?
A. Glycolysis
B. Gluconeogenesis
C. Cholesterol synthesis
D. Triglyceride absorption
Answer: C
Rationale: HMG-CoA reductase inhibitors (statins) inhibit the rate-
limiting step of cholesterol biosynthesis, lowering LDL.
7. Which opioid is associated with serotonin syndrome risk when
combined with SSRIs?
A. Morphine
B. Tramadol
C. Fentanyl
D. Methadone
Answer: B
Rationale: Tramadol inhibits serotonin reuptake and can precipitate
serotonin syndrome when combined with serotonergic agents.
8. For an acute asthma exacerbation in clinic, which inhaled
medication provides the fastest bronchodilation?
A. Inhaled corticosteroid
B. Long-acting beta agonist
C. Short-acting beta-2 agonist (albuterol)
D. Leukotriene receptor antagonist
Answer: C
, Rationale: Short-acting beta-2 agonists like albuterol act quickly to
relax bronchial smooth muscle and are first-line for acute relief.
9. Which class of antihypertensives is contraindicated in pregnancy
due to teratogenicity?
A. Methyldopa
B. Labetalol
C. ACE inhibitors
D. Calcium channel blockers
Answer: C
Rationale: ACE inhibitors cause fetal renal dysplasia and are
contraindicated in pregnancy, especially in the second and third
trimesters.
10. A patient has an allergy to penicillin with anaphylaxis
history. Which antibiotic is safest for group A strep pharyngitis?
A. Amoxicillin
B. Cefalexin
C. Azithromycin
D. Augmentin
Answer: C
Rationale: In severe penicillin allergy, macrolides like azithromycin are
alternatives for streptococcal pharyngitis.
11. Which drug is most appropriate for acute management of
anaphylaxis?
A. Diphenhydramine
B. Hydrocortisone
C. Intramuscular epinephrine
D. Albuterol inhalation
(From the 300-Item Mega Pack) | Fully Verified &
Updated( Answers And Rationale Included)
2025/2026
Instructions: 150 multiple-choice questions. Do not bold questions.
Bold the correct answer only. Rationale should be in bold italics
immediately following each answer.
1. Which drug is a selective beta-1 adrenergic blocker commonly
used for hypertension and ischemic heart disease?
A. Propranolol
B. Metoprolol
C. Carvedilol
D. Labetalol
Answer: B
Rationale: Metoprolol is a selective beta-1 blocker at typical doses,
reducing heart rate and contractility with less bronchoconstriction
than nonselective beta-blockers.
2. Which antibiotic is most appropriate for empiric outpatient
therapy of uncomplicated community-acquired pneumonia in an
otherwise healthy adult?
A. Doxycycline
B. Azithromycin
C. Ciprofloxacin
D. Vancomycin
Answer: B
,Rationale: Azithromycin provides coverage against common atypical
and typical pathogens in outpatient community-acquired pneumonia
and has convenient dosing.
3. A patient on warfarin begins taking trimethoprim-
sulfamethoxazole (TMP-SMX). What is the expected interaction?
A. Decreased INR
B. No change
C. Increased INR
D. Increased warfarin clearance
Answer: C
Rationale: TMP-SMX inhibits warfarin metabolism and can displace
protein-bound warfarin, both increasing INR and bleeding risk.
4. Which insulin has the fastest onset when given subcutaneously?
A. Regular insulin
B. NPH insulin
C. Insulin lispro
D. Insulin glargine
Answer: C
Rationale: Rapid-acting analogs like insulin lispro have onset within 15
minutes and are used for mealtime glucose control.
5. Which medication is the first-line therapy for type 2 diabetes that
also reduces hepatic glucose production?
A. Sulfonylureas
B. DPP-4 inhibitors
C. Metformin
D. Thiazolidinediones
Answer: C
,Rationale: Metformin decreases hepatic gluconeogenesis and
improves insulin sensitivity; it is first-line unless contraindicated.
6. A drug that blocks HMG-CoA reductase will primarily affect which
process?
A. Glycolysis
B. Gluconeogenesis
C. Cholesterol synthesis
D. Triglyceride absorption
Answer: C
Rationale: HMG-CoA reductase inhibitors (statins) inhibit the rate-
limiting step of cholesterol biosynthesis, lowering LDL.
7. Which opioid is associated with serotonin syndrome risk when
combined with SSRIs?
A. Morphine
B. Tramadol
C. Fentanyl
D. Methadone
Answer: B
Rationale: Tramadol inhibits serotonin reuptake and can precipitate
serotonin syndrome when combined with serotonergic agents.
8. For an acute asthma exacerbation in clinic, which inhaled
medication provides the fastest bronchodilation?
A. Inhaled corticosteroid
B. Long-acting beta agonist
C. Short-acting beta-2 agonist (albuterol)
D. Leukotriene receptor antagonist
Answer: C
, Rationale: Short-acting beta-2 agonists like albuterol act quickly to
relax bronchial smooth muscle and are first-line for acute relief.
9. Which class of antihypertensives is contraindicated in pregnancy
due to teratogenicity?
A. Methyldopa
B. Labetalol
C. ACE inhibitors
D. Calcium channel blockers
Answer: C
Rationale: ACE inhibitors cause fetal renal dysplasia and are
contraindicated in pregnancy, especially in the second and third
trimesters.
10. A patient has an allergy to penicillin with anaphylaxis
history. Which antibiotic is safest for group A strep pharyngitis?
A. Amoxicillin
B. Cefalexin
C. Azithromycin
D. Augmentin
Answer: C
Rationale: In severe penicillin allergy, macrolides like azithromycin are
alternatives for streptococcal pharyngitis.
11. Which drug is most appropriate for acute management of
anaphylaxis?
A. Diphenhydramine
B. Hydrocortisone
C. Intramuscular epinephrine
D. Albuterol inhalation
