PHARMACOLOGY HIGH-YIELD
DRUG STUDY EXAM (2026 Edition)||
Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Total Questions: 80
Time Limit: 90 minutes
Directions: Choose the single best answer. Correct answers are bolded and
highlighted.
SECTION A: Cardiovascular & Anticoagulation (Q1–15)
Q1. A patient on warfarin has an INR of 4.5 with minor bleeding. Which reversal
agent is most appropriate?
A. Vitamin K (phytonadione) – IV
B. Protamine sulfate
C. Fresh frozen plasma (FFP)
D. Andexanet alfa
Correct Answer: A – Rationale: For INR 4.5 with minor bleeding, IV vitamin
K (1–2.5 mg) is indicated. Protamine (B) reverses heparin. FFP (C) is for major
bleeding. Andexanet (D) reverses factor Xa inhibitors.
Q2. Which DOAC has a specific FDA-approved reversal agent (andexanet alfa)
for life-threatening bleeding?
A. Dabigatran
B. Apixaban
,C. Rivaroxaban
D. Edoxaban
Correct Answer: B – Rationale: Andexanet alfa is approved for apixaban and
rivaroxaban reversal. Dabigatran reversal is idarucizumab (Praxbind).
Q3. First-line medication for stable angina with prior MI (post-MI patient) –
reduces mortality?
A. Nitroglycerin sublingual
B. Metoprolol succinate
C. Amlodipine
D. Ranolazine
Correct Answer: B – Rationale: Beta-blockers (metoprolol) reduce post-MI
mortality. Nitroglycerin treats acute symptoms but doesn’t reduce mortality.
Q4. Statin with the greatest LDL-lowering potency (≥50% reduction) at high
doses?
A. Pravastatin
B. Simvastatin
C. Rosuvastatin
D. Lovastatin
Correct Answer: C – Rationale: Rosuvastatin (Crestor) 40 mg lowers LDL by
~55%. Atorvastatin is second (~50%). Pravastatin is low-intensity.
Q5. Patient with acute HF with reduced ejection fraction (HFrEF) presents with
pulmonary edema. First-line IV agent?
A. Metoprolol
B. Spironolactone
C. Furosemide
D. Digoxin
Correct Answer: C – Rationale: Loop diuretic (furosemide) rapidly removes
volume in pulmonary edema. Beta-blockers are long-term, not acute.
Q6. Which antihypertensive is absolutely contraindicated in pregnancy
(teratogenic, especially in 2nd/3rd trimester)?
A. Labetalol
B. Nifedipine
, C. Lisinopril
D. Methyldopa
Correct Answer: C – Rationale: ACE inhibitors (lisinopril) cause fetal renal
agenesis and oligohydramnios. Methyldopa and nifedipine are pregnancy-safe.
Q7. Patient on amiodarone develops pulmonary fibrosis and blue-gray skin
discoloration. What is the half-life (days)?
A. 20 hours
B. 5 days
C. 40 days
D. 100 days
Correct Answer: C – Rationale: Amiodarone has a very long half-life (~40–
60 days), causing delayed toxicity.
Q8. Reversal agent for dabigatran in emergent surgery (2026 protocol)?
A. Protamine
B. Idarucizumab
C. Vitamin K
D. Four-factor PCC
Correct Answer: B – Rationale: Idarucizumab (Praxbind) is a monoclonal
antibody that specifically binds dabigatran.
Q9. Which agent is a P2Y12 inhibitor used with aspirin after PCI, with less
bleeding risk than clopidogrel in certain genotypes?
A. Prasugrel
B. Ticagrelor
C. Ticlopidine
D. Cilostazol
Correct Answer: B – Rationale: Ticagrelor is reversible, no CYP2C19
metabolism issue. Prasugrel (A) is more potent but higher bleeding.
Q10. ARNI (sacubitril/valsartan) is indicated for HFrEF. What is its primary
mechanism?
A. Aldosterone antagonist
B. Neprilysin inhibitor + ARB
C. Beta-1 selective blocker
D. Calcium sensitizer
DRUG STUDY EXAM (2026 Edition)||
Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
Total Questions: 80
Time Limit: 90 minutes
Directions: Choose the single best answer. Correct answers are bolded and
highlighted.
SECTION A: Cardiovascular & Anticoagulation (Q1–15)
Q1. A patient on warfarin has an INR of 4.5 with minor bleeding. Which reversal
agent is most appropriate?
A. Vitamin K (phytonadione) – IV
B. Protamine sulfate
C. Fresh frozen plasma (FFP)
D. Andexanet alfa
Correct Answer: A – Rationale: For INR 4.5 with minor bleeding, IV vitamin
K (1–2.5 mg) is indicated. Protamine (B) reverses heparin. FFP (C) is for major
bleeding. Andexanet (D) reverses factor Xa inhibitors.
Q2. Which DOAC has a specific FDA-approved reversal agent (andexanet alfa)
for life-threatening bleeding?
A. Dabigatran
B. Apixaban
,C. Rivaroxaban
D. Edoxaban
Correct Answer: B – Rationale: Andexanet alfa is approved for apixaban and
rivaroxaban reversal. Dabigatran reversal is idarucizumab (Praxbind).
Q3. First-line medication for stable angina with prior MI (post-MI patient) –
reduces mortality?
A. Nitroglycerin sublingual
B. Metoprolol succinate
C. Amlodipine
D. Ranolazine
Correct Answer: B – Rationale: Beta-blockers (metoprolol) reduce post-MI
mortality. Nitroglycerin treats acute symptoms but doesn’t reduce mortality.
Q4. Statin with the greatest LDL-lowering potency (≥50% reduction) at high
doses?
A. Pravastatin
B. Simvastatin
C. Rosuvastatin
D. Lovastatin
Correct Answer: C – Rationale: Rosuvastatin (Crestor) 40 mg lowers LDL by
~55%. Atorvastatin is second (~50%). Pravastatin is low-intensity.
Q5. Patient with acute HF with reduced ejection fraction (HFrEF) presents with
pulmonary edema. First-line IV agent?
A. Metoprolol
B. Spironolactone
C. Furosemide
D. Digoxin
Correct Answer: C – Rationale: Loop diuretic (furosemide) rapidly removes
volume in pulmonary edema. Beta-blockers are long-term, not acute.
Q6. Which antihypertensive is absolutely contraindicated in pregnancy
(teratogenic, especially in 2nd/3rd trimester)?
A. Labetalol
B. Nifedipine
, C. Lisinopril
D. Methyldopa
Correct Answer: C – Rationale: ACE inhibitors (lisinopril) cause fetal renal
agenesis and oligohydramnios. Methyldopa and nifedipine are pregnancy-safe.
Q7. Patient on amiodarone develops pulmonary fibrosis and blue-gray skin
discoloration. What is the half-life (days)?
A. 20 hours
B. 5 days
C. 40 days
D. 100 days
Correct Answer: C – Rationale: Amiodarone has a very long half-life (~40–
60 days), causing delayed toxicity.
Q8. Reversal agent for dabigatran in emergent surgery (2026 protocol)?
A. Protamine
B. Idarucizumab
C. Vitamin K
D. Four-factor PCC
Correct Answer: B – Rationale: Idarucizumab (Praxbind) is a monoclonal
antibody that specifically binds dabigatran.
Q9. Which agent is a P2Y12 inhibitor used with aspirin after PCI, with less
bleeding risk than clopidogrel in certain genotypes?
A. Prasugrel
B. Ticagrelor
C. Ticlopidine
D. Cilostazol
Correct Answer: B – Rationale: Ticagrelor is reversible, no CYP2C19
metabolism issue. Prasugrel (A) is more potent but higher bleeding.
Q10. ARNI (sacubitril/valsartan) is indicated for HFrEF. What is its primary
mechanism?
A. Aldosterone antagonist
B. Neprilysin inhibitor + ARB
C. Beta-1 selective blocker
D. Calcium sensitizer
