NR 566 ADVANCED PHARMACOLOGY FOR FAMILY
CARE | QUESTIONS AND 100% CORRECT ANSWERS
WITH RATIONALES | LATEST UPDATE GRADED A+
1. Which of the following is the primary mechanism of action of ACE inhibitors?
A. Beta-adrenergic blockade
B. Inhibition of angiotensin-converting enzyme
C. Calcium channel blockade
D. Sodium-potassium exchange inhibition
Answer: B
Rationale: ACE inhibitors prevent conversion of angiotensin I to angiotensin II, leading to
vasodilation and reduced blood pressure.
2. A patient on digoxin shows nausea, vomiting, and visual disturbances. What is the
most likely cause?
A. Hypokalemia
B. Digoxin toxicity
C. Dehydration
D. Hypotension
Answer: B
Rationale: Nausea, vomiting, and visual disturbances (yellow halos) are classic signs of
digoxin toxicity.
3. Which class of drugs is first-line treatment for type 2 diabetes?
A. Sulfonylureas
B. Insulin
C. Metformin
D. Thiazolidinediones
Answer: C
Rationale: Metformin improves insulin sensitivity and reduces hepatic glucose production; it
is first-line therapy for type 2 diabetes.
4. A patient is prescribed warfarin. Which lab test is essential to monitor therapy?
A. aPTT
B. INR
C. CBC
D. Serum potassium
Answer: B
Rationale: INR (International Normalized Ratio) measures the effectiveness of warfarin and
guides dose adjustments.
, 5. Which of the following antibiotics inhibits bacterial cell wall synthesis?
A. Gentamicin
B. Vancomycin
C. Ciprofloxacin
D. Tetracycline
Answer: B
Rationale: Vancomycin binds to cell wall precursors, preventing bacterial cell wall synthesis.
6. A patient taking albuterol reports tremors and palpitations. This is likely due to:
A. Beta-1 adrenergic stimulation
B. Beta-2 adrenergic stimulation
C. Muscarinic receptor blockade
D. Alpha-1 adrenergic stimulation
Answer: B
Rationale: Albuterol is a beta-2 agonist; systemic absorption can stimulate beta-2 receptors
causing tremors and palpitations.
7. Which of the following medications is used as a reversal agent for opioid overdose?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Atropine
Answer: A
Rationale: Naloxone is an opioid antagonist that rapidly reverses opioid-induced respiratory
depression.
8. Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hypercalcemia
B. Hypokalemia
C. Hypermagnesemia
D. Hyponatremia
Answer: B
Rationale: Low potassium levels enhance digoxin binding to myocardial cells, increasing
toxicity risk.
9. Which antihypertensive class is contraindicated in pregnancy?
A. Methyldopa
B. Labetalol
C. ACE inhibitors
D. Nifedipine
Answer: C
Rationale: ACE inhibitors can cause fetal renal damage and are contraindicated in
pregnancy.
, 10. Which of the following drugs is classified as a loop diuretic?
A. Hydrochlorothiazide
B. Furosemide
C. Spironolactone
D. Amiloride
Answer: B
Rationale: Furosemide inhibits the Na-K-2Cl symporter in the loop of Henle, promoting
diuresis.
11. Which of the following medications is preferred for treating hyperthyroidism in
pregnancy?
A. Methimazole
B. Propylthiouracil (PTU)
C. Levothyroxine
D. Radioactive iodine
Answer: B
Rationale: PTU is preferred in the first trimester due to lower risk of teratogenicity compared
to methimazole.
12. Which drug class decreases LDL cholesterol most effectively?
A. Statins
B. Fibrates
C. Bile acid sequestrants
D. Niacin
Answer: A
Rationale: Statins inhibit HMG-CoA reductase, reducing cholesterol synthesis and lowering
LDL levels.
13. A patient develops a cough after starting an ACE inhibitor. What is the recommended
action?
A. Continue therapy
B. Switch to ARB
C. Add beta-blocker
D. Increase ACE inhibitor dose
Answer: B
Rationale: ACE inhibitor-induced cough is common; switching to an ARB avoids this side
effect while providing similar benefits.
14. Which antibiotic inhibits bacterial protein synthesis by binding to the 30S ribosomal
subunit?
A. Gentamicin
B. Erythromycin
, C. Penicillin
D. Ciprofloxacin
Answer: A
Rationale: Aminoglycosides like gentamicin bind the 30S subunit, inhibiting bacterial protein
synthesis.
15. A patient receiving heparin develops a platelet count drop. This is suggestive of:
A. Heparin-induced thrombocytopenia (HIT)
B. Vitamin K deficiency
C. Leukopenia
D. Pancytopenia
Answer: A
Rationale: HIT is an immune-mediated reaction causing platelet destruction and increased
thrombosis risk.
16. Which medication is used for acute asthma exacerbations?
A. Salmeterol
B. Albuterol
C. Montelukast
D. Fluticasone
Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist used for rapid relief of bronchospasm.
17. Which of the following drugs is used to treat heart failure by decreasing afterload and
preload?
A. Digoxin
B. Lisinopril
C. Metoprolol
D. Furosemide
Answer: B
Rationale: ACE inhibitors like lisinopril reduce vascular resistance (afterload) and venous
return (preload), improving cardiac output.
18. A patient with atrial fibrillation is prescribed dabigatran. This medication:
A. Inhibits vitamin K-dependent clotting factors
B. Directly inhibits thrombin
C. Activates antithrombin III
D. Blocks platelet aggregation
Answer: B
Rationale: Dabigatran is a direct thrombin inhibitor used for stroke prevention in atrial
fibrillation.
CARE | QUESTIONS AND 100% CORRECT ANSWERS
WITH RATIONALES | LATEST UPDATE GRADED A+
1. Which of the following is the primary mechanism of action of ACE inhibitors?
A. Beta-adrenergic blockade
B. Inhibition of angiotensin-converting enzyme
C. Calcium channel blockade
D. Sodium-potassium exchange inhibition
Answer: B
Rationale: ACE inhibitors prevent conversion of angiotensin I to angiotensin II, leading to
vasodilation and reduced blood pressure.
2. A patient on digoxin shows nausea, vomiting, and visual disturbances. What is the
most likely cause?
A. Hypokalemia
B. Digoxin toxicity
C. Dehydration
D. Hypotension
Answer: B
Rationale: Nausea, vomiting, and visual disturbances (yellow halos) are classic signs of
digoxin toxicity.
3. Which class of drugs is first-line treatment for type 2 diabetes?
A. Sulfonylureas
B. Insulin
C. Metformin
D. Thiazolidinediones
Answer: C
Rationale: Metformin improves insulin sensitivity and reduces hepatic glucose production; it
is first-line therapy for type 2 diabetes.
4. A patient is prescribed warfarin. Which lab test is essential to monitor therapy?
A. aPTT
B. INR
C. CBC
D. Serum potassium
Answer: B
Rationale: INR (International Normalized Ratio) measures the effectiveness of warfarin and
guides dose adjustments.
, 5. Which of the following antibiotics inhibits bacterial cell wall synthesis?
A. Gentamicin
B. Vancomycin
C. Ciprofloxacin
D. Tetracycline
Answer: B
Rationale: Vancomycin binds to cell wall precursors, preventing bacterial cell wall synthesis.
6. A patient taking albuterol reports tremors and palpitations. This is likely due to:
A. Beta-1 adrenergic stimulation
B. Beta-2 adrenergic stimulation
C. Muscarinic receptor blockade
D. Alpha-1 adrenergic stimulation
Answer: B
Rationale: Albuterol is a beta-2 agonist; systemic absorption can stimulate beta-2 receptors
causing tremors and palpitations.
7. Which of the following medications is used as a reversal agent for opioid overdose?
A. Naloxone
B. Flumazenil
C. Protamine sulfate
D. Atropine
Answer: A
Rationale: Naloxone is an opioid antagonist that rapidly reverses opioid-induced respiratory
depression.
8. Which electrolyte imbalance increases the risk of digoxin toxicity?
A. Hypercalcemia
B. Hypokalemia
C. Hypermagnesemia
D. Hyponatremia
Answer: B
Rationale: Low potassium levels enhance digoxin binding to myocardial cells, increasing
toxicity risk.
9. Which antihypertensive class is contraindicated in pregnancy?
A. Methyldopa
B. Labetalol
C. ACE inhibitors
D. Nifedipine
Answer: C
Rationale: ACE inhibitors can cause fetal renal damage and are contraindicated in
pregnancy.
, 10. Which of the following drugs is classified as a loop diuretic?
A. Hydrochlorothiazide
B. Furosemide
C. Spironolactone
D. Amiloride
Answer: B
Rationale: Furosemide inhibits the Na-K-2Cl symporter in the loop of Henle, promoting
diuresis.
11. Which of the following medications is preferred for treating hyperthyroidism in
pregnancy?
A. Methimazole
B. Propylthiouracil (PTU)
C. Levothyroxine
D. Radioactive iodine
Answer: B
Rationale: PTU is preferred in the first trimester due to lower risk of teratogenicity compared
to methimazole.
12. Which drug class decreases LDL cholesterol most effectively?
A. Statins
B. Fibrates
C. Bile acid sequestrants
D. Niacin
Answer: A
Rationale: Statins inhibit HMG-CoA reductase, reducing cholesterol synthesis and lowering
LDL levels.
13. A patient develops a cough after starting an ACE inhibitor. What is the recommended
action?
A. Continue therapy
B. Switch to ARB
C. Add beta-blocker
D. Increase ACE inhibitor dose
Answer: B
Rationale: ACE inhibitor-induced cough is common; switching to an ARB avoids this side
effect while providing similar benefits.
14. Which antibiotic inhibits bacterial protein synthesis by binding to the 30S ribosomal
subunit?
A. Gentamicin
B. Erythromycin
, C. Penicillin
D. Ciprofloxacin
Answer: A
Rationale: Aminoglycosides like gentamicin bind the 30S subunit, inhibiting bacterial protein
synthesis.
15. A patient receiving heparin develops a platelet count drop. This is suggestive of:
A. Heparin-induced thrombocytopenia (HIT)
B. Vitamin K deficiency
C. Leukopenia
D. Pancytopenia
Answer: A
Rationale: HIT is an immune-mediated reaction causing platelet destruction and increased
thrombosis risk.
16. Which medication is used for acute asthma exacerbations?
A. Salmeterol
B. Albuterol
C. Montelukast
D. Fluticasone
Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist used for rapid relief of bronchospasm.
17. Which of the following drugs is used to treat heart failure by decreasing afterload and
preload?
A. Digoxin
B. Lisinopril
C. Metoprolol
D. Furosemide
Answer: B
Rationale: ACE inhibitors like lisinopril reduce vascular resistance (afterload) and venous
return (preload), improving cardiac output.
18. A patient with atrial fibrillation is prescribed dabigatran. This medication:
A. Inhibits vitamin K-dependent clotting factors
B. Directly inhibits thrombin
C. Activates antithrombin III
D. Blocks platelet aggregation
Answer: B
Rationale: Dabigatran is a direct thrombin inhibitor used for stroke prevention in atrial
fibrillation.
