NU 578 Exam 1-5 Review Questions and
Answers
Pharmacology Foundations
A patient with severe liver disease is prescribed a drug with high first-pass
metabolism. What happens to oral bioavailability?
A. Decreased
B. Increased
C. No change
D. Increased renal clearance
Answer: B. Rationale: Impaired liver metabolism increases systemic drug levels.
Which drug characteristic indicates the safest medication?
A. Narrow therapeutic index
B. Wide therapeutic index
C. High potency
D. Low efficacy
Answer: B. Rationale: Wide therapeutic index = lower risk of toxicity.
Anti-Infectives
Which drug is first-line for latent TB?
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide
Answer: B. Rationale: Isoniazid is standard for latent TB therapy.
Which combination is recommended for initial HIV treatment?
A. Two NRTIs + one integrase inhibitor
B. One NNRTI + one PI
C. Monotherapy with AZT
D. Two PIs + one booster
Answer: A. Rationale: Current guidelines recommend dual NRTIs plus integrase
inhibitor.
Cardiovascular & Renal
Which beta-blocker improves survival in heart failure?
A. Atenolol
B. Metoprolol succinate
C. Propranolol
D. Nadolol
Answer: B. Rationale: Metoprolol succinate is evidence-based for HF.
Which diuretic is most effective for pulmonary edema?
A. Hydrochlorothiazide
,B. Furosemide
C. Spironolactone
D. Amiloride
Answer: B. Rationale: Loop diuretics rapidly reduce fluid overload.
Endocrine & Psychiatric
Which insulin has the fastest onset?
A. Regular insulin
B. Lispro
C. NPH
D. Glargine
Answer: B. Rationale: Lispro is rapid-acting, onset within 15 minutes.
Which SSRI is first-line for major depression?
A. Fluoxetine
B. Amitriptyline
C. Bupropion
D. Lithium
Answer: A. Rationale: SSRIs are safer and effective compared to TCAs.
Oncology & Immunology
Which chemotherapy drug causes cardiotoxicity?
A. Doxorubicin
B. Cisplatin
C. Vincristine
D. Methotrexate
Answer: A. Rationale: Doxorubicin is linked to dose-dependent cardiomyopathy.
Which drug prevents organ rejection by calcineurin inhibition?
A. Cyclosporine
B. Azathioprine
C. Methotrexate
D. Prednisone
Answer: A. Rationale: Cyclosporine inhibits T-cell activation.
Pharmacology Foundations
Which route avoids first-pass metabolism?
A. Oral
B. Sublingual
C. Rectal
D. Intramuscular
Answer: B. Rationale: Sublingual administration bypasses hepatic metabolism.
Which factor increases drug half-life?
A. Increased clearance
B. Decreased clearance
C. Increased metabolism
, D. Increased renal excretion
Answer: B. Rationale: Reduced clearance prolongs half-life.
Which receptor type produces the fastest response?
A. G-protein coupled
B. Ion channel
C. Nuclear receptor
D. Enzyme-linked
Answer: B. Rationale: Ion channels act within milliseconds.
Which drug is a partial agonist?
A. Morphine
B. Buprenorphine
C. Naloxone
D. Fentanyl
Answer: B. Rationale: Buprenorphine activates opioid receptors but with limited
efficacy.
Which factor increases volume of distribution?
A. High protein binding
B. Lipid solubility
C. Hydrophilicity
D. Renal clearance
Answer: B. Rationale: Lipophilic drugs distribute widely into tissues.
Anti-Infectives
Which antibiotic causes tendon rupture?
A. Ciprofloxacin
B. Amoxicillin
C. Azithromycin
D. Vancomycin
Answer: A. Rationale: Fluoroquinolones are linked to tendon injury.
Which drug treats MRSA?
A. Penicillin
B. Vancomycin
C. Amoxicillin
D. Ceftriaxone
Answer: B. Rationale: Vancomycin is standard for MRSA infections.
Which antifungal requires monitoring for nephrotoxicity?
A. Amphotericin B
B. Fluconazole
C. Ketoconazole
D. Terbinafine
Answer: A. Rationale: Amphotericin B is nephrotoxic.
Answers
Pharmacology Foundations
A patient with severe liver disease is prescribed a drug with high first-pass
metabolism. What happens to oral bioavailability?
A. Decreased
B. Increased
C. No change
D. Increased renal clearance
Answer: B. Rationale: Impaired liver metabolism increases systemic drug levels.
Which drug characteristic indicates the safest medication?
A. Narrow therapeutic index
B. Wide therapeutic index
C. High potency
D. Low efficacy
Answer: B. Rationale: Wide therapeutic index = lower risk of toxicity.
Anti-Infectives
Which drug is first-line for latent TB?
A. Rifampin
B. Isoniazid
C. Ethambutol
D. Pyrazinamide
Answer: B. Rationale: Isoniazid is standard for latent TB therapy.
Which combination is recommended for initial HIV treatment?
A. Two NRTIs + one integrase inhibitor
B. One NNRTI + one PI
C. Monotherapy with AZT
D. Two PIs + one booster
Answer: A. Rationale: Current guidelines recommend dual NRTIs plus integrase
inhibitor.
Cardiovascular & Renal
Which beta-blocker improves survival in heart failure?
A. Atenolol
B. Metoprolol succinate
C. Propranolol
D. Nadolol
Answer: B. Rationale: Metoprolol succinate is evidence-based for HF.
Which diuretic is most effective for pulmonary edema?
A. Hydrochlorothiazide
,B. Furosemide
C. Spironolactone
D. Amiloride
Answer: B. Rationale: Loop diuretics rapidly reduce fluid overload.
Endocrine & Psychiatric
Which insulin has the fastest onset?
A. Regular insulin
B. Lispro
C. NPH
D. Glargine
Answer: B. Rationale: Lispro is rapid-acting, onset within 15 minutes.
Which SSRI is first-line for major depression?
A. Fluoxetine
B. Amitriptyline
C. Bupropion
D. Lithium
Answer: A. Rationale: SSRIs are safer and effective compared to TCAs.
Oncology & Immunology
Which chemotherapy drug causes cardiotoxicity?
A. Doxorubicin
B. Cisplatin
C. Vincristine
D. Methotrexate
Answer: A. Rationale: Doxorubicin is linked to dose-dependent cardiomyopathy.
Which drug prevents organ rejection by calcineurin inhibition?
A. Cyclosporine
B. Azathioprine
C. Methotrexate
D. Prednisone
Answer: A. Rationale: Cyclosporine inhibits T-cell activation.
Pharmacology Foundations
Which route avoids first-pass metabolism?
A. Oral
B. Sublingual
C. Rectal
D. Intramuscular
Answer: B. Rationale: Sublingual administration bypasses hepatic metabolism.
Which factor increases drug half-life?
A. Increased clearance
B. Decreased clearance
C. Increased metabolism
, D. Increased renal excretion
Answer: B. Rationale: Reduced clearance prolongs half-life.
Which receptor type produces the fastest response?
A. G-protein coupled
B. Ion channel
C. Nuclear receptor
D. Enzyme-linked
Answer: B. Rationale: Ion channels act within milliseconds.
Which drug is a partial agonist?
A. Morphine
B. Buprenorphine
C. Naloxone
D. Fentanyl
Answer: B. Rationale: Buprenorphine activates opioid receptors but with limited
efficacy.
Which factor increases volume of distribution?
A. High protein binding
B. Lipid solubility
C. Hydrophilicity
D. Renal clearance
Answer: B. Rationale: Lipophilic drugs distribute widely into tissues.
Anti-Infectives
Which antibiotic causes tendon rupture?
A. Ciprofloxacin
B. Amoxicillin
C. Azithromycin
D. Vancomycin
Answer: A. Rationale: Fluoroquinolones are linked to tendon injury.
Which drug treats MRSA?
A. Penicillin
B. Vancomycin
C. Amoxicillin
D. Ceftriaxone
Answer: B. Rationale: Vancomycin is standard for MRSA infections.
Which antifungal requires monitoring for nephrotoxicity?
A. Amphotericin B
B. Fluconazole
C. Ketoconazole
D. Terbinafine
Answer: A. Rationale: Amphotericin B is nephrotoxic.
