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1. Which of the following drug classes is most effective in treating
hypertension in African American patients?
A. ACE inhibitors
B. Beta-blockers
C. Calcium channel blockers
D. Alpha-1 antagonists
Calcium channel blockers are more effective in African American patients due to
lower renin levels, which makes them less responsive to ACE inhibitors and beta-
blockers.
2. Which antibiotic is contraindicated in pregnancy due to its effect on fetal
bone growth?
A. Amoxicillin
B. Doxycycline
C. Erythromycin
D. Cephalexin
,Doxycycline, a tetracycline, can impair fetal bone growth and discolor teeth,
making it unsafe during pregnancy.
3. Which of the following insulins has the shortest onset of action?
A. Regular insulin
B. NPH insulin
C. Lispro (Humalog)
D. Detemir (Levemir)
Lispro is a rapid-acting insulin with onset in about 15 minutes, ideal for
controlling postprandial glucose spikes.
4. A patient taking warfarin has an INR of 5.2 without bleeding. What is the
appropriate action?
A. Continue warfarin at the same dose
B. Increase warfarin dose
C. Hold 1–2 doses of warfarin
D. Administer vitamin K immediately
An INR of 5.2 without bleeding is treated by holding warfarin until INR
decreases. Vitamin K is reserved for higher INR or active bleeding.
5. Which drug is used as first-line therapy in a newly diagnosed type 2 diabetic
with normal renal function?
,A. Insulin
B. Sulfonylurea
C. Metformin
D. DPP-4 inhibitor
Metformin is the first-line treatment unless contraindicated, as it improves
insulin sensitivity and helps with weight loss.
6. Which class of drugs is contraindicated in patients with bilateral renal
artery stenosis?
A. ACE inhibitors
B. Beta-blockers
C. Thiazide diuretics
D. Calcium channel blockers
ACE inhibitors can severely decrease GFR in patients with bilateral renal artery
stenosis, leading to renal failure.
7. Which of the following medications should be avoided in older adults due
to anticholinergic effects?
A. Furosemide
B. Amlodipine
C. Ranitidine
D. Diphenhydramine
, Diphenhydramine has strong anticholinergic properties, increasing risk of
confusion, falls, and urinary retention in older adults.
8. What lab value must be monitored with statin therapy?
A. BUN
B. Hemoglobin
C. INR
D. Liver enzymes
Statins can cause hepatotoxicity; liver enzymes (ALT, AST) should be monitored
at baseline and if symptoms arise.
9. Which of the following is a potential side effect of spironolactone?
A. Hypokalemia
B. Hypernatremia
C. Gynecomastia
D. Tachycardia
Spironolactone is a potassium-sparing diuretic and an aldosterone antagonist,
which can cause gynecomastia due to hormonal effects.
10.A 30-year-old female on isotretinoin must be monitored for:
A. Renal failure
B. Pregnancy