PHMY 771 EXAM READY - VERIFIED QUESTIONS AND
ANSWERS - COMPREHENSIVE LATEST VERSION (2026/2027)
PHMY 771 – Drug Quiz Review
300 Questions & Answers for Nursing Students
Comprehensive Pharmacology Review
Q1. What is the mechanism of action of digoxin?
ANSWER Digoxin inhibits the Na+/K+ ATPase pump, increasing
intracellular calcium, which strengthens myocardial contraction (positive
inotrope) and decreases heart rate (negative chronotrope).
Q2. What are the signs and symptoms of digoxin toxicity?
ANSWER Nausea, vomiting, visual disturbances (yellow-green halos),
bradycardia, arrhythmias, and hyperkalemia. The therapeutic range is 0.5–2
ng/mL.
Q3. What electrolyte imbalance increases the risk of digoxin toxicity?
ANSWER Hypokalemia increases the risk of digoxin toxicity because
potassium and digoxin compete for the same receptor site on the Na+/K+
ATPase pump.
Q4. What is the antidote for digoxin toxicity?
ANSWER Digoxin immune Fab (Digibind or DigiFab) is the antidote for
severe digoxin toxicity.
Q5. What is the mechanism of action of beta-blockers?
ANSWER Beta-blockers competitively block beta-adrenergic receptors,
reducing heart rate, myocardial contractility, and blood pressure.
Q6. Name a non-selective beta-blocker and its clinical use.
ANSWER Propranolol (Inderal) is non-selective (blocks β1 and β2). Used for
hypertension, angina, arrhythmias, and migraine prophylaxis.
PHMY 771 Drug Quiz Review – Page 1
,Q7. Why are non-selective beta-blockers contraindicated in asthma?
ANSWER Beta-2 blockade causes bronchoconstriction, which can precipitate
or worsen bronchospasm in patients with asthma or COPD.
Q8. What is the mechanism of ACE inhibitors?
ANSWER ACE inhibitors block angiotensin-converting enzyme, preventing
conversion of angiotensin I to angiotensin II, reducing vasoconstriction and
aldosterone secretion.
Q9. What is the most common side effect of ACE inhibitors?
ANSWER Dry, persistent, non-productive cough due to accumulation of
bradykinin. If intolerable, switch to an ARB.
Q10. What is the dangerous adverse effect of ACE inhibitors that requires
immediate discontinuation?
ANSWER Angioedema — swelling of the face, lips, tongue, and throat — is
a rare but life-threatening adverse effect.
Q11. What are ARBs (Angiotensin Receptor Blockers) and give two examples.
ANSWER ARBs block angiotensin II type 1 receptors. Examples: losartan
(Cozaar) and valsartan (Diovan). They do not cause cough.
Q12. What is the mechanism of calcium channel blockers?
ANSWER They block L-type voltage-gated calcium channels, causing
smooth muscle relaxation (vasodilation) and in cardiac tissue, reduce heart rate
and contractility.
Q13. Differentiate dihydropyridine vs. non-dihydropyridine calcium channel
blockers.
ANSWER Dihydropyridines (e.g., amlodipine, nifedipine) primarily
vasodilate. Non-dihydropyridines (diltiazem, verapamil) also slow AV
conduction and reduce heart rate.
Q14. What is the nursing priority when administering IV nitroglycerin?
ANSWER Monitor blood pressure continuously because nitroglycerin causes
vasodilation and can cause severe hypotension.
Q15. Why must nitroglycerin be stored in a dark glass bottle?
ANSWER Nitroglycerin is sensitive to light and air, which degrade it. An
amber glass bottle protects its potency.
PHMY 771 Drug Quiz Review – Page 2
,Q16. What is the mechanism of loop diuretics?
ANSWER Loop diuretics (e.g., furosemide) inhibit the Na+/K+/2Cl-
cotransporter in the thick ascending loop of Henle, producing diuresis.
Q17. What electrolyte imbalances are associated with loop diuretics?
ANSWER Hypokalemia, hyponatremia, hypomagnesemia, hypocalcemia, and
metabolic alkalosis.
Q18. What is the ototoxicity risk with furosemide?
ANSWER High doses or rapid IV administration of furosemide can cause
reversible or permanent hearing loss (ototoxicity), especially when combined
with aminoglycosides.
Q19. What is the mechanism of thiazide diuretics?
ANSWER Thiazides inhibit the Na+/Cl- cotransporter in the distal convoluted
tubule, reducing sodium reabsorption and increasing urinary excretion.
Q20. How do potassium-sparing diuretics work? Give two examples.
ANSWER Spironolactone antagonizes aldosterone; amiloride and triamterene
directly block epithelial sodium channels in the collecting duct, retaining
potassium.
Q21. What is the most dangerous adverse effect of potassium-sparing
diuretics?
ANSWER Hyperkalemia, which can cause fatal cardiac arrhythmias. Avoid
combining with ACE inhibitors or ARBs.
Q22. What is heparin's mechanism of action?
ANSWER Heparin binds antithrombin III, potentiating its inhibition of
thrombin (factor IIa) and factor Xa, thus preventing clot formation.
Q23. What lab test monitors unfractionated heparin therapy?
ANSWER aPTT (activated partial thromboplastin time), with a therapeutic
range of 1.5–2.5 times the control value.
Q24. What is the antidote for heparin overdose?
ANSWER Protamine sulfate reverses heparin anticoagulation. 1 mg
neutralizes approximately 100 units of heparin.
Q25. What is the mechanism of warfarin?
PHMY 771 Drug Quiz Review – Page 3
, ANSWER Warfarin inhibits vitamin K epoxide reductase, blocking activation
of vitamin K-dependent clotting factors II, VII, IX, X, and proteins C and S.
Q26. What lab monitors warfarin therapy and what is the therapeutic INR
range?
ANSWER PT/INR monitors warfarin. Typical therapeutic range is INR 2–3;
2.5–3.5 for mechanical heart valves.
Q27. What is the antidote for warfarin overdose?
ANSWER Vitamin K (phytonadione) and, for severe bleeding, fresh frozen
plasma (FFP) or 4-factor prothrombin complex concentrate (PCC).
Q28. What foods interact with warfarin?
ANSWER Foods high in vitamin K (leafy greens like spinach, kale, broccoli)
can reduce warfarin's anticoagulant effect. Patients should maintain consistent
intake.
Q29. What is the mechanism of direct oral anticoagulants (DOACs)?
ANSWER Rivaroxaban and apixaban directly inhibit factor Xa; dabigatran
directly inhibits thrombin (factor IIa). No routine monitoring required.
Q30. What is the reversal agent for dabigatran?
ANSWER Idarucizumab (Praxbind) is the specific reversal agent for
dabigatran.
Pain & Analgesics
Q31. What is the reversal agent for apixaban and rivaroxaban?
ANSWER Andexanet alfa (Andexxa) reverses apixaban and rivaroxaban by
binding and sequestering the drugs.
Q32. What is the mechanism of acetaminophen (Tylenol)?
ANSWER Acetaminophen inhibits prostaglandin synthesis in the CNS,
providing analgesia and antipyresis, but lacks anti-inflammatory effects.
Q33. What is the maximum daily dose of acetaminophen for a healthy adult?
ANSWER 4,000 mg/day for healthy adults; 2,000 mg/day for patients who
drink alcohol regularly or have liver disease.
Q34. What is the antidote for acetaminophen overdose?
PHMY 771 Drug Quiz Review – Page 4
ANSWERS - COMPREHENSIVE LATEST VERSION (2026/2027)
PHMY 771 – Drug Quiz Review
300 Questions & Answers for Nursing Students
Comprehensive Pharmacology Review
Q1. What is the mechanism of action of digoxin?
ANSWER Digoxin inhibits the Na+/K+ ATPase pump, increasing
intracellular calcium, which strengthens myocardial contraction (positive
inotrope) and decreases heart rate (negative chronotrope).
Q2. What are the signs and symptoms of digoxin toxicity?
ANSWER Nausea, vomiting, visual disturbances (yellow-green halos),
bradycardia, arrhythmias, and hyperkalemia. The therapeutic range is 0.5–2
ng/mL.
Q3. What electrolyte imbalance increases the risk of digoxin toxicity?
ANSWER Hypokalemia increases the risk of digoxin toxicity because
potassium and digoxin compete for the same receptor site on the Na+/K+
ATPase pump.
Q4. What is the antidote for digoxin toxicity?
ANSWER Digoxin immune Fab (Digibind or DigiFab) is the antidote for
severe digoxin toxicity.
Q5. What is the mechanism of action of beta-blockers?
ANSWER Beta-blockers competitively block beta-adrenergic receptors,
reducing heart rate, myocardial contractility, and blood pressure.
Q6. Name a non-selective beta-blocker and its clinical use.
ANSWER Propranolol (Inderal) is non-selective (blocks β1 and β2). Used for
hypertension, angina, arrhythmias, and migraine prophylaxis.
PHMY 771 Drug Quiz Review – Page 1
,Q7. Why are non-selective beta-blockers contraindicated in asthma?
ANSWER Beta-2 blockade causes bronchoconstriction, which can precipitate
or worsen bronchospasm in patients with asthma or COPD.
Q8. What is the mechanism of ACE inhibitors?
ANSWER ACE inhibitors block angiotensin-converting enzyme, preventing
conversion of angiotensin I to angiotensin II, reducing vasoconstriction and
aldosterone secretion.
Q9. What is the most common side effect of ACE inhibitors?
ANSWER Dry, persistent, non-productive cough due to accumulation of
bradykinin. If intolerable, switch to an ARB.
Q10. What is the dangerous adverse effect of ACE inhibitors that requires
immediate discontinuation?
ANSWER Angioedema — swelling of the face, lips, tongue, and throat — is
a rare but life-threatening adverse effect.
Q11. What are ARBs (Angiotensin Receptor Blockers) and give two examples.
ANSWER ARBs block angiotensin II type 1 receptors. Examples: losartan
(Cozaar) and valsartan (Diovan). They do not cause cough.
Q12. What is the mechanism of calcium channel blockers?
ANSWER They block L-type voltage-gated calcium channels, causing
smooth muscle relaxation (vasodilation) and in cardiac tissue, reduce heart rate
and contractility.
Q13. Differentiate dihydropyridine vs. non-dihydropyridine calcium channel
blockers.
ANSWER Dihydropyridines (e.g., amlodipine, nifedipine) primarily
vasodilate. Non-dihydropyridines (diltiazem, verapamil) also slow AV
conduction and reduce heart rate.
Q14. What is the nursing priority when administering IV nitroglycerin?
ANSWER Monitor blood pressure continuously because nitroglycerin causes
vasodilation and can cause severe hypotension.
Q15. Why must nitroglycerin be stored in a dark glass bottle?
ANSWER Nitroglycerin is sensitive to light and air, which degrade it. An
amber glass bottle protects its potency.
PHMY 771 Drug Quiz Review – Page 2
,Q16. What is the mechanism of loop diuretics?
ANSWER Loop diuretics (e.g., furosemide) inhibit the Na+/K+/2Cl-
cotransporter in the thick ascending loop of Henle, producing diuresis.
Q17. What electrolyte imbalances are associated with loop diuretics?
ANSWER Hypokalemia, hyponatremia, hypomagnesemia, hypocalcemia, and
metabolic alkalosis.
Q18. What is the ototoxicity risk with furosemide?
ANSWER High doses or rapid IV administration of furosemide can cause
reversible or permanent hearing loss (ototoxicity), especially when combined
with aminoglycosides.
Q19. What is the mechanism of thiazide diuretics?
ANSWER Thiazides inhibit the Na+/Cl- cotransporter in the distal convoluted
tubule, reducing sodium reabsorption and increasing urinary excretion.
Q20. How do potassium-sparing diuretics work? Give two examples.
ANSWER Spironolactone antagonizes aldosterone; amiloride and triamterene
directly block epithelial sodium channels in the collecting duct, retaining
potassium.
Q21. What is the most dangerous adverse effect of potassium-sparing
diuretics?
ANSWER Hyperkalemia, which can cause fatal cardiac arrhythmias. Avoid
combining with ACE inhibitors or ARBs.
Q22. What is heparin's mechanism of action?
ANSWER Heparin binds antithrombin III, potentiating its inhibition of
thrombin (factor IIa) and factor Xa, thus preventing clot formation.
Q23. What lab test monitors unfractionated heparin therapy?
ANSWER aPTT (activated partial thromboplastin time), with a therapeutic
range of 1.5–2.5 times the control value.
Q24. What is the antidote for heparin overdose?
ANSWER Protamine sulfate reverses heparin anticoagulation. 1 mg
neutralizes approximately 100 units of heparin.
Q25. What is the mechanism of warfarin?
PHMY 771 Drug Quiz Review – Page 3
, ANSWER Warfarin inhibits vitamin K epoxide reductase, blocking activation
of vitamin K-dependent clotting factors II, VII, IX, X, and proteins C and S.
Q26. What lab monitors warfarin therapy and what is the therapeutic INR
range?
ANSWER PT/INR monitors warfarin. Typical therapeutic range is INR 2–3;
2.5–3.5 for mechanical heart valves.
Q27. What is the antidote for warfarin overdose?
ANSWER Vitamin K (phytonadione) and, for severe bleeding, fresh frozen
plasma (FFP) or 4-factor prothrombin complex concentrate (PCC).
Q28. What foods interact with warfarin?
ANSWER Foods high in vitamin K (leafy greens like spinach, kale, broccoli)
can reduce warfarin's anticoagulant effect. Patients should maintain consistent
intake.
Q29. What is the mechanism of direct oral anticoagulants (DOACs)?
ANSWER Rivaroxaban and apixaban directly inhibit factor Xa; dabigatran
directly inhibits thrombin (factor IIa). No routine monitoring required.
Q30. What is the reversal agent for dabigatran?
ANSWER Idarucizumab (Praxbind) is the specific reversal agent for
dabigatran.
Pain & Analgesics
Q31. What is the reversal agent for apixaban and rivaroxaban?
ANSWER Andexanet alfa (Andexxa) reverses apixaban and rivaroxaban by
binding and sequestering the drugs.
Q32. What is the mechanism of acetaminophen (Tylenol)?
ANSWER Acetaminophen inhibits prostaglandin synthesis in the CNS,
providing analgesia and antipyresis, but lacks anti-inflammatory effects.
Q33. What is the maximum daily dose of acetaminophen for a healthy adult?
ANSWER 4,000 mg/day for healthy adults; 2,000 mg/day for patients who
drink alcohol regularly or have liver disease.
Q34. What is the antidote for acetaminophen overdose?
PHMY 771 Drug Quiz Review – Page 4
