KAPLAN PHARM INTEGRATED EXAM 2025-2026 ACTUAL EXAM ALL
150 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+
Q1. A patient with type 2 diabetes is started on metformin. Which is the most common adverse
effect?
A. Hypoglycemia
B. Weight gain
C. Gastrointestinal upset
D. Lactic acidosis
Rationale: Metformin commonly causes GI upset but rarely lactic acidosis unless renal function
is impaired.
Q2. Which drug is first-line for treating an acute myocardial infarction?
A. Atorvastatin
B. Aspirin
C. Lisinopril
D. Metoprolol
Rationale: Aspirin inhibits platelet aggregation, reducing mortality in acute MI.
Q3. A 6-year-old dog presents with hookworm infection. Which is the drug of choice?
A. Praziquantel
B. Fenbendazole
C. Ivermectin
D. Metronidazole
Rationale: Fenbendazole is effective against Ancylostoma caninum in dogs.
Q4. Which CNS drug is most likely to cause sedation as a side effect?
A. Fluoxetine
B. Diazepam
C. Lithium
D. Citalopram
Rationale: Diazepam, a benzodiazepine, enhances GABAergic activity, causing sedation.
,Q5. A patient presents with asthma exacerbation. Which is the most appropriate first-line
treatment?
A. Fluticasone
B. Montelukast
C. Albuterol
D. Salmeterol
Rationale: Albuterol is a short-acting β2-agonist providing rapid bronchodilation.
Q6. A patient taking warfarin begins taking ciprofloxacin. What is the likely effect on INR?
A. Decreases INR
B. No change
C. Increases INR
D. Fluctuates randomly
Rationale: Ciprofloxacin inhibits CYP450 metabolism of warfarin, increasing anticoagulant
effect.
Q7. Which antihypertensive drug is contraindicated in pregnancy?
A. Labetalol
B. Methyldopa
C. ACE inhibitors
D. Nifedipine
Rationale: ACE inhibitors can cause fetal renal dysgenesis; contraindicated in pregnancy.
Q8. Which antibiotic class inhibits bacterial cell wall synthesis?
A. Aminoglycosides
B. Tetracyclines
C. Beta-lactams
D. Macrolides
Rationale: Beta-lactams (penicillins, cephalosporins) inhibit bacterial cell wall synthesis.
Q9. A patient is poisoned with acetaminophen. Which antidote is indicated?
A. Atropine
B. N-acetylcysteine
,C. Naloxone
D. Flumazenil
Rationale: N-acetylcysteine replenishes glutathione to prevent hepatic damage from
acetaminophen.
Q10. Which diuretic is most appropriate for a patient with edema and heart failure?
A. Spironolactone
B. Furosemide
C. Furosemide
D. Hydrochlorothiazide
Rationale: Furosemide, a loop diuretic, rapidly mobilizes fluid in heart failure.
Q11. Which drug is used as a first-line treatment for hypothyroidism?
A. Propylthiouracil
B. Methimazole
C. Levothyroxine
D. Liothyronine
Rationale: Levothyroxine is synthetic T4, the standard treatment for hypothyroidism.
Q12. A patient presents with generalized tonic-clonic seizures. Which is the drug of choice?
A. Valproic acid
B. Phenytoin
C. Carbamazepine
D. Ethosuximide
Rationale: Phenytoin stabilizes neuronal membranes and is effective for tonic-clonic seizures.
Q13. Which drug is most likely to cause hyperkalemia?
A. Hydrochlorothiazide
B. Furosemide
C. Spironolactone
D. Mannitol
Rationale: Spironolactone is a potassium-sparing diuretic, which can increase serum potassium.
, Q14. Which antibiotic is contraindicated in pregnancy due to risk of teeth discoloration in the
fetus?
A. Penicillin
B. Tetracyclines
C. Cephalosporins
D. Macrolides
Rationale: Tetracyclines bind calcium in developing teeth, causing permanent discoloration.
Q15. Which drug is used for rapid reversal of opioid overdose?
A. Flumazenil
B. Atropine
C. Naloxone
D. Physostigmine
Rationale: Naloxone is a competitive opioid receptor antagonist.
Q16. A patient with hypertension and tachyarrhythmia is prescribed a non-selective β-blocker.
Which drug is this?
A. Metoprolol
B. Atenolol
C. Propranolol
D. Nebivolol
Rationale: Propranolol blocks both β1 and β2 receptors.
Q17. Which drug is first-line for hyperthyroidism?
A. Levothyroxine
B. Methimazole
C. Propylthiouracil
D. Liothyronine
Rationale: Methimazole inhibits thyroid hormone synthesis and is preferred for non-pregnant
adults.
Q18. A patient with chronic pain is started on an NSAID. Which organ is most at risk for toxicity?
A. Liver
B. Heart
150 QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES|ALREADY GRADED A+
Q1. A patient with type 2 diabetes is started on metformin. Which is the most common adverse
effect?
A. Hypoglycemia
B. Weight gain
C. Gastrointestinal upset
D. Lactic acidosis
Rationale: Metformin commonly causes GI upset but rarely lactic acidosis unless renal function
is impaired.
Q2. Which drug is first-line for treating an acute myocardial infarction?
A. Atorvastatin
B. Aspirin
C. Lisinopril
D. Metoprolol
Rationale: Aspirin inhibits platelet aggregation, reducing mortality in acute MI.
Q3. A 6-year-old dog presents with hookworm infection. Which is the drug of choice?
A. Praziquantel
B. Fenbendazole
C. Ivermectin
D. Metronidazole
Rationale: Fenbendazole is effective against Ancylostoma caninum in dogs.
Q4. Which CNS drug is most likely to cause sedation as a side effect?
A. Fluoxetine
B. Diazepam
C. Lithium
D. Citalopram
Rationale: Diazepam, a benzodiazepine, enhances GABAergic activity, causing sedation.
,Q5. A patient presents with asthma exacerbation. Which is the most appropriate first-line
treatment?
A. Fluticasone
B. Montelukast
C. Albuterol
D. Salmeterol
Rationale: Albuterol is a short-acting β2-agonist providing rapid bronchodilation.
Q6. A patient taking warfarin begins taking ciprofloxacin. What is the likely effect on INR?
A. Decreases INR
B. No change
C. Increases INR
D. Fluctuates randomly
Rationale: Ciprofloxacin inhibits CYP450 metabolism of warfarin, increasing anticoagulant
effect.
Q7. Which antihypertensive drug is contraindicated in pregnancy?
A. Labetalol
B. Methyldopa
C. ACE inhibitors
D. Nifedipine
Rationale: ACE inhibitors can cause fetal renal dysgenesis; contraindicated in pregnancy.
Q8. Which antibiotic class inhibits bacterial cell wall synthesis?
A. Aminoglycosides
B. Tetracyclines
C. Beta-lactams
D. Macrolides
Rationale: Beta-lactams (penicillins, cephalosporins) inhibit bacterial cell wall synthesis.
Q9. A patient is poisoned with acetaminophen. Which antidote is indicated?
A. Atropine
B. N-acetylcysteine
,C. Naloxone
D. Flumazenil
Rationale: N-acetylcysteine replenishes glutathione to prevent hepatic damage from
acetaminophen.
Q10. Which diuretic is most appropriate for a patient with edema and heart failure?
A. Spironolactone
B. Furosemide
C. Furosemide
D. Hydrochlorothiazide
Rationale: Furosemide, a loop diuretic, rapidly mobilizes fluid in heart failure.
Q11. Which drug is used as a first-line treatment for hypothyroidism?
A. Propylthiouracil
B. Methimazole
C. Levothyroxine
D. Liothyronine
Rationale: Levothyroxine is synthetic T4, the standard treatment for hypothyroidism.
Q12. A patient presents with generalized tonic-clonic seizures. Which is the drug of choice?
A. Valproic acid
B. Phenytoin
C. Carbamazepine
D. Ethosuximide
Rationale: Phenytoin stabilizes neuronal membranes and is effective for tonic-clonic seizures.
Q13. Which drug is most likely to cause hyperkalemia?
A. Hydrochlorothiazide
B. Furosemide
C. Spironolactone
D. Mannitol
Rationale: Spironolactone is a potassium-sparing diuretic, which can increase serum potassium.
, Q14. Which antibiotic is contraindicated in pregnancy due to risk of teeth discoloration in the
fetus?
A. Penicillin
B. Tetracyclines
C. Cephalosporins
D. Macrolides
Rationale: Tetracyclines bind calcium in developing teeth, causing permanent discoloration.
Q15. Which drug is used for rapid reversal of opioid overdose?
A. Flumazenil
B. Atropine
C. Naloxone
D. Physostigmine
Rationale: Naloxone is a competitive opioid receptor antagonist.
Q16. A patient with hypertension and tachyarrhythmia is prescribed a non-selective β-blocker.
Which drug is this?
A. Metoprolol
B. Atenolol
C. Propranolol
D. Nebivolol
Rationale: Propranolol blocks both β1 and β2 receptors.
Q17. Which drug is first-line for hyperthyroidism?
A. Levothyroxine
B. Methimazole
C. Propylthiouracil
D. Liothyronine
Rationale: Methimazole inhibits thyroid hormone synthesis and is preferred for non-pregnant
adults.
Q18. A patient with chronic pain is started on an NSAID. Which organ is most at risk for toxicity?
A. Liver
B. Heart
