Question 1

Inhibit the growth of micro organisms

Accepted Answer

Answer reason: a- Bacteriostatic These agents prevent bacterial proliferation by inhibiting replication and metabolic processes rather than directly killing organisms. This distinction contrasts with bactericidal drugs, which kill bacteria, and fungicidal agents, which kill fungi. “Germicidal” is a broader term implying killing of microorganisms, not merely growth inhibition.
Category reason: This item tests the pharmacologic/microbiologic definition of how antimicrobial agents act (inhibiting growth vs killing), which is core Pharmacology knowledge rather than a nursing-care decision.

Question 2

Mechanism of action of penicillin:

Accepted Answer

Answer reason: Penicillins are beta-lactam antibiotics that bind penicillin-binding proteins (transpeptidases), preventing the cross-linking step in bacterial cell wall peptidoglycan. This weakens the cell wall and leads to osmotic lysis, making them bactericidal, especially against actively dividing bacteria. Inhibiting folate metabolism is typical of sulfonamides/trimethoprim, and inhibiting protein synthesis is typical of ribosomal-targeting antibiotics (e.g., macrolides, tetracyclines, aminoglycosides).
Category reason: This asks about the drug mechanism of penicillin, which is a core concept in Pharmacology rather than a nursing intervention or prioritization scenario.

Question 3

Sulfonamides:

Accepted Answer

Answer reason: Sulfonamides are antimetabolites that competitively inhibit dihydropteroate synthase, blocking bacterial synthesis of dihydrofolic acid from PABA. Because humans obtain folate from the diet and do not use this enzyme, the pathway is selectively targeted in bacteria. This reduces thymidine and purine production, impairing nucleic acid formation and leading to bacteriostatic activity.
Category reason: This question tests the mechanism of action of an antimicrobial drug class, which is a core Pharmacology concept rather than a nursing care decision-making scenario.

Question 4

A client with diabetes mellitus is prescribed Humulin N (NPH insulin). When is the greatest risk for hypoglycemia?

Accepted Answer

Answer reason: Hypoglycemia risk is highest at an insulin’s peak effect. NPH (Humulin N) is an intermediate-acting insulin with a peak typically occurring several hours after administration, commonly around 6–14 hours. During this peak window, glucose utilization increases and hepatic glucose output is more suppressed, so blood glucose can drop if intake is insufficient or activity is increased. Therefore monitoring and meal/snack timing are especially important during this period.
Category reason: This question tests pharmacokinetics of an insulin formulation (onset/peak/duration) to identify when adverse effects are most likely, which is primarily Pharmacology rather than nursing prioritization or care management.

Question 5

A pregnant woman with HIV is receiving zidovudine therapy. What is the primary goal of this medication?

Accepted Answer

Answer reason: Zidovudine is an antiretroviral (NRTI) used in pregnancy to lower the risk of vertical HIV transmission during pregnancy, labor, and to the newborn. While suppressing maternal viral replication is part of how it works, the tested primary clinical objective in this setting is protecting the infant from acquiring HIV. CD4 count may improve with effective ART but is not the main purpose of zidovudine given specifically for perinatal prophylaxis. Nutritional status is unrelated to the drug’s direct therapeutic goal.
Category reason: This question tests the therapeutic purpose of a specific antiretroviral medication (zidovudine) in pregnancy, which is pharmacology-focused rather than a nursing prioritization or care-management decision.

Question 6

A patient with Graves' disease is receiving propranolol. What is the intended effect of this medication?

Accepted Answer

Answer reason: Propranolol is a nonselective beta-adrenergic blocker used in Graves’ disease for symptomatic control of adrenergic manifestations such as tachycardia, palpitations, anxiety, and tremor. It provides relatively rapid relief of these symptoms while definitive therapy (e.g., antithyroid drugs, radioactive iodine, or surgery) addresses the underlying excess thyroid hormone. It does not directly cure hyperthyroidism or primarily lower T3/T4 levels as its main intended effect in routine use.
Category reason: This item tests the therapeutic intent of a specific medication (propranolol) in Graves’ disease, which is core pharmacology knowledge rather than a nursing prioritization or care-management decision.

Question 7

Lactated Ringer’s solution is contraindicated in?

Accepted Answer

Answer reason: LR contains sodium lactate, which is metabolized (primarily in the liver) to bicarbonate and is intended to help buffer metabolic acidosis due to bicarbonate loss. In lactic acidosis, impaired lactate clearance and ongoing lactate production mean adding an exogenous lactate load is generally avoided, and resuscitation is typically done with isotonic crystalloids without lactate (e.g., normal saline or balanced solutions without lactate depending on context). LR is commonly used in hypovolemia, burns, and gastrointestinal fluid losses where extracellular volume replacement is needed.
Category reason: This question tests properties and contraindications of an IV crystalloid solution (composition and clinical use), which is primarily pharmacology/IV fluids knowledge rather than nursing prioritization or care management.

Question 8

Naproxen has the following action?

Accepted Answer

Answer reason: It is an NSAID that inhibits COX enzymes, reducing prostaglandin synthesis. This produces pain relief and decreases inflammation in tissues. Reduced prostaglandins in the hypothalamus also lowers fever. Therefore it has analgesic, antipyretic, and anti-inflammatory effects.
Category reason: This question tests the pharmacologic actions/effects of a specific drug (naproxen), which is core Pharmacology knowledge rather than a nursing care decision.

Question 9

Telmisartan tablet is used for ?

Accepted Answer

Answer reason: Telmisartan is an angiotensin II receptor blocker (ARB) that lowers blood pressure by blocking AT1 receptors, leading to decreased vasoconstriction and reduced aldosterone-mediated sodium and water retention. Its primary clinical indication is treatment of high blood pressure and, in some patients, reduction of cardiovascular risk. It is not used to treat hypotension and is not an analgesic for headache; while it may be used in some patients with diabetes for renal/cardiovascular protection, the direct therapeutic use here is blood pressure control.
Category reason: This question tests the indication/therapeutic use of a specific medication (telmisartan), which is core Pharmacology knowledge rather than a nursing judgment or care prioritization scenario.

Question 10

Which the following best describes describes Isapgol?

Accepted Answer

Answer reason: Isapgol is the common name for ispaghula/psyllium, a bulk-forming laxative derived from Plantago ovata seed husk. It absorbs water in the gut to increase stool bulk and promote peristalsis, so it is used for constipation and to improve stool consistency. The other options are different herbal drugs: aloe latex and senna are stimulant laxatives, while datura contains anticholinergic alkaloids and is not used as a bulk laxative.
Category reason: This is a drug-identification question about a commonly used laxative preparation and its source, which is tested under Pharmacology rather than nursing care decision-making.

Question 11

A 45-year-old woman with hypothyroidism starts levothyroxine. What is the best time to take it?

Accepted Answer

Answer reason: Levothyroxine absorption is reduced by food, so taking it fasting improves bioavailability and helps maintain stable thyroid hormone levels. The standard recommendation is to take it consistently 30–60 minutes before breakfast with water. Bedtime dosing can be acceptable only if it is taken several hours after the last meal, but the question asks for the best time. Taking it with meals or after breakfast increases variability and can lead to under-replacement.
Category reason: This item tests medication administration timing based on drug absorption and interactions, which is a core Pharmacology concept rather than a nursing-prioritization scenario.

Question 12

What is the key ingredient in Paracetamol syrups?

Accepted Answer

Answer reason: Paracetamol is the international nonproprietary name for acetaminophen, so the active ingredient in paracetamol syrup formulations is acetaminophen. The other choices are different drug classes and indications: ibuprofen is an NSAID, salbutamol is a beta-2 agonist bronchodilator, and chlorpheniramine is an antihistamine. Therefore, only one option matches the generic drug identity of paracetamol.
Category reason: This item tests knowledge of drug names and active ingredients (paracetamol vs acetaminophen), which is a core Pharmacology concept rather than a nursing care decision.

Question 13

Which medication is given to treat anemia with chronic renal failure?

Accepted Answer

Answer reason: In chronic renal failure, decreased renal production of endogenous erythropoietin leads to reduced red blood cell production and a normocytic, normochromic anemia. Epoetin alfa is an erythropoiesis-stimulating agent that replaces the deficient hormone signal and increases bone marrow RBC production. Iron or folate may be needed as adjuncts if deficiencies exist, but they do not address the primary mechanism of anemia of CKD. Treatment requires monitoring hemoglobin response and blood pressure due to thrombosis and hypertension risk.
Category reason: This question tests the drug of choice and mechanism-based pharmacologic management of anemia due to chronic kidney disease, which is primarily a Pharmacology concept rather than a nursing-intervention prioritization scenario.

Question 14

Metronidazole Tablet is used for -?

Accepted Answer

Answer reason: Metronidazole is an antimicrobial active against anaerobic bacteria and several protozoa (e.g., Giardia, Entamoeba histolytica), which are common infectious causes of diarrhea/dysentery. It is not a primary treatment for malaria (antimalarials like artemisinins/chloroquine are used), smallpox (a viral infection), or AIDS (managed with antiretroviral therapy). Therefore, among the given choices, infectious diarrhea is the best match.
Category reason: This question tests the therapeutic use of a specific drug (metronidazole), which is a core Pharmacology concept rather than a nursing-care judgment scenario.

Question 15

Azithromycin Tablet is used for -?

Accepted Answer

Answer reason: Azithromycin is a macrolide antibiotic commonly used to treat respiratory tract infections, including community-acquired pneumonia, especially when atypical pathogens (e.g., Mycoplasma, Chlamydophila, Legionella) are possible. It is not a standard treatment for uncomplicated UTI, and it has no role in treating myocardial infarction. While azithromycin can be used in some malaria-related contexts (e.g., certain combination regimens or prophylaxis in limited settings), this is not its typical primary indication compared with respiratory infections.
Category reason: This is a medication-indication question focusing on what condition an antibiotic treats, which is core Pharmacology content rather than nursing care prioritization or interventions.

Question 16

A pregnant woman at 30 weeks gestation presents with Hb 7,5 g/L and poor tolerance to oral iron. What is the most appropriate next?

Accepted Answer

Answer reason: In late pregnancy with significant anemia and inability to tolerate oral iron, intravenous iron is the preferred way to rapidly replenish iron stores and raise hemoglobin without the risks associated with transfusion. Ferric carboxymaltose is an established IV iron preparation used when oral therapy fails or is not tolerated. Transfusion is generally reserved for hemodynamic instability, ongoing bleeding, or severe symptomatic anemia requiring immediate oxygen-carrying support rather than iron repletion. Deferring treatment risks worsening maternal and fetal outcomes, including preterm birth and poor peripartum reserve.
Category reason: The stem tests choice of iron formulation and route (oral vs IV vs blood transfusion) for anemia in pregnancy, which is primarily pharmacologic/therapeutic management rather than nursing prioritization or safety actions.

Question 17

A 70-year-old patient develops diarrhoea after a prolonged course of clindamycin for a dental infection. Stool testing confirms Clostridium difficile. What is the recommended first-line treatment?

Accepted Answer

Answer reason: This presentation is classic antibiotic-associated C. difficile infection after clindamycin exposure. Current first-line therapy for an initial episode is an anti–C. difficile agent given orally to achieve high intraluminal colonic concentrations; oral vancomycin is an accepted first-line option (with fidaxomicin also used when available). Metronidazole is no longer preferred as first-line for adults due to lower efficacy and concerns in more severe disease. IV ceftriaxone and IV ciprofloxacin would not treat CDI and additional broad-spectrum antibiotics can worsen colitis by further disrupting gut flora.
Category reason: The question tests selection of the appropriate antimicrobial regimen for a specific infection (C. difficile), which is primarily pharmacotherapy knowledge rather than nursing process or prioritization.

Question 18

Paracetamol belongs to which class of drug?

Accepted Answer

Answer reason: It is used to relieve mild-to-moderate pain and reduce fever primarily through central inhibition of prostaglandin synthesis. It has minimal anti-inflammatory activity compared with NSAIDs and is not an antibiotic, antacid, or antihypertensive. Clinically, key safety knowledge is dose-related hepatotoxicity risk, especially with alcohol use or liver disease.
Category reason: This is a medication classification question testing drug class and therapeutic effects, which is core Pharmacology knowledge rather than a nursing care decision.

Question 19

Which of the following is the current preferred antimicrobial treatment of cutaneous anthrax?

Accepted Answer

Answer reason: B. Ciprofloxacin Bacillus anthracis can produce severe systemic disease, and current preferred first-line therapy for cutaneous anthrax (especially when bioterrorism exposure is possible) is a fluoroquinolone due to reliable activity and concern for resistance. Ciprofloxacin is recommended for treatment and post-exposure prophylaxis in many guidelines because it covers potential engineered resistance patterns and has good tissue penetration. Penicillin may be effective for susceptible strains but is not the preferred empiric choice in this context. Tetracyclines are alternatives (e.g., doxycycline) but are generally listed as alternative options rather than the single preferred agent.
Category reason: This item tests drug selection for a specific infectious disease (anthrax), focusing on antimicrobial choice rather than nursing interventions, so it fits Pharmacology under NursingScience.

Question 20

A woman with a history of epilepsy becomes pregnant. Which drug is safest?

Accepted Answer

Answer reason: B) Lamotrigine Lamotrigine is among the preferred anti-seizure medications in pregnancy because it has a comparatively lower teratogenic risk than several older agents. Valproic acid is strongly associated with major congenital malformations (notably neural tube defects) and adverse neurodevelopmental outcomes, making it the least safe choice here. Phenytoin and carbamazepine also carry teratogenic risks (e.g., fetal hydantoin features with phenytoin; increased malformation risk with carbamazepine), generally higher than lamotrigine. Ongoing pregnancy can increase lamotrigine clearance, so dose/level monitoring is often needed to maintain seizure control.
Category reason: This question tests comparative safety/teratogenicity of anticonvulsant medications during pregnancy, which is primarily a pharmacology concept rather than a nursing intervention or prioritization scenario.

Question 21

Odd One Out NSAIDs: Identify the odd one out.

Accepted Answer

Answer reason: It is an opioid analgesic (mu-receptor agonist) and not a nonsteroidal anti-inflammatory drug. The other listed medications are NSAIDs that inhibit cyclooxygenase (COX) enzymes, reducing prostaglandin synthesis to provide analgesic, antipyretic, and anti-inflammatory effects. Opioids do not have primary anti-inflammatory activity and carry different key risks such as respiratory depression, constipation, and dependence.
Category reason: This item tests drug classification and mechanism (distinguishing NSAIDs from an opioid), which is a foundational pharmacology concept rather than a nursing intervention/prioritization scenario.

Question 22

Which the following best describes Asafoetida? (SSC Pharmacist 2022)?

Accepted Answer

Answer reason: Asafoetida is an oleo-gum-resin obtained as a dried exudate (latex) from the roots/rhizomes of Ferula species, classically Ferula foetida (and related Ferula asafoetida). This crude drug is used in traditional medicine and pharmacognosy for its carminative and antispasmodic properties. The other options refer to different plant products: acacia yields gum arabic, boswellia yields frankincense, and aloe provides aloe latex/gel extracts.
Category reason: This is a pharmacognosy identification question about the botanical source and nature of a crude drug, which fits Pharmacology rather than nursing care decision-making.

Question 23

The drug to relieve malaria for a 6-month pregnant mother is?

Accepted Answer

Answer reason: In the 2nd and 3rd trimesters, mefloquine is generally considered safe for treatment/prophylaxis of malaria when indicated and is commonly recommended in pregnancy. Doxycycline is contraindicated in pregnancy due to fetal effects (e.g., teeth discoloration and impaired bone growth). Artemether (usually as an artemisinin-based combination) is used for malaria but many exam keys still prefer mefloquine over artemisinin derivatives for non-severe cases in pregnancy in older curricula, while quinine is more associated with adverse effects and is typically reserved for specific regimens/availability.
Category reason: This is primarily a medication-safety/selection question about antimalarial drugs in pregnancy, which is tested as Pharmacology rather than nursing-care prioritization.

Question 24

A 45-year-old HIV-positive woman is diagnosed with pulmonary TB. Her sputum smear remains positive for acid-fast bacilli after 2 months of treatment. Which of the following is the best course of action?

Accepted Answer

Answer reason: Persistent smear (or culture) positivity at 2 months increases concern for delayed response and relapse risk, which is higher in patients with HIV. Standard guidance is to prolong total therapy duration by extending the continuation phase (INH + rifampin) so that total treatment is longer (commonly 9 months when 2-month results are still positive and/or cavitation is present). Simply continuing without adjusting duration under-treats relapse risk, while stopping therapy or empirically swapping drugs is inappropriate without clear evidence of drug resistance and proper susceptibility/culture evaluation.
Category reason: This item tests tuberculosis drug regimen duration adjustment (INH/RIF continuation-phase extension) based on treatment response, which is primarily pharmacologic regimen knowledge rather than a nursing action/priority decision.

Question 25

Q-1) Which nasal spray relieves blocked nose and congestion?

Accepted Answer

Answer reason: C) Oxymetazoline It is a topical alpha-adrenergic agonist that causes vasoconstriction of nasal mucosal blood vessels, reducing edema and quickly improving airflow in nasal congestion. The other options are not nasal decongestant sprays: loratadine is an oral antihistamine, metformin is an antidiabetic drug, and aspirin is an analgesic/antiplatelet. A key safety point is to limit use to about 3 days to avoid rebound congestion (rhinitis medicamentosa).
Category reason: This question tests identification of a medication by its therapeutic use (nasal decongestant action), which is primarily Pharmacology rather than nursing care prioritization.

Question 26

A patient on chronic beta-blocker therapy is undergoing elective surgery. What is the risk of abruptly stopping beta-blockers pre-op?

Accepted Answer

Answer reason: Abrupt discontinuation after chronic therapy can cause sympathetic overactivity due to upregulated beta receptors, leading to rebound tachycardia and hypertension. This increases myocardial oxygen demand while potentially reducing coronary perfusion time, precipitating angina, ischemia, and myocardial infarction. For elective surgery, chronic beta-blockers are generally continued perioperatively to avoid withdrawal-related cardiovascular events.
Category reason: This tests the pharmacologic consequence of abruptly stopping a chronic beta-blocker (withdrawal/rebound physiology and cardiac ischemic risk), which is a medication mechanism/adverse effect concept under Pharmacology rather than a nursing prioritization/intervention scenario.

Question 27

Which diuretic reduces calcium excretion and prevents kidney stones?

Accepted Answer

Answer reason: Thiazide diuretics increase calcium reabsorption in the distal convoluted tubule, leading to decreased urinary calcium excretion. Lower urinary calcium reduces supersaturation of calcium salts, helping prevent calcium-containing nephrolithiasis. In contrast, loop diuretics like furosemide increase urinary calcium loss, and mannitol does not have a calcium-sparing effect. Amiloride is potassium-sparing and is not the standard agent used to reduce calcium stone risk.
Category reason: This is primarily a question about diuretic class effects and mechanisms, which is pharmacology-focused rather than a nursing care or prioritization scenario.

Question 28

Which drug causes a disulfiram-like reaction with alcohol?

Accepted Answer

Answer reason: This medication can inhibit aldehyde dehydrogenase activity when alcohol is ingested, leading to acetaldehyde accumulation. The result is a predictable adverse reaction characterized by flushing, throbbing headache, nausea/vomiting, tachycardia, and hypotension. Patients should be instructed to avoid alcohol during therapy and for at least 48–72 hours after the last dose to prevent this reaction.
Category reason: This is a drug adverse-effect/toxic interaction question (alcohol interaction causing a disulfiram-like reaction), which is primarily tested under Pharmacology rather than nursing care prioritization.

Question 29

Which of the following medication is NOT effective against Typhoid?

Accepted Answer

Answer reason: Typhoid fever is caused by Salmonella enterica serovar Typhi, an intracellular Gram-negative pathogen where effective therapy requires agents with reliable systemic and intracellular activity. Ceftriaxone, azithromycin, and fluoroquinolones (e.g., ciprofloxacin, depending on resistance) are established treatments for typhoid. Gentamicin (an aminoglycoside) has poor intracellular penetration and is not a standard or reliably effective agent for typhoid fever despite some Gram-negative coverage. Therefore it is the best choice for “NOT effective” among the options.
Category reason: This item tests knowledge of which antibiotics are effective for a specific bacterial infection (typhoid), which is primarily pharmacology (antimicrobial spectrum/clinical use) rather than nursing care prioritization or interventions.

Question 30

Case: A 23-year-old male with exercise-induced asthma is prescribed albuterol as a rescue inhaler. He asks how it works. What is the mechanism of action of albuterol?

Accepted Answer

Answer reason: Albuterol is a short-acting beta-2 agonist that stimulates beta-2 receptors on bronchial smooth muscle, increasing intracellular cAMP and producing bronchodilation. This provides rapid relief of acute bronchospasm and is why it is used as a rescue inhaler, including before exercise in exercise-induced bronchoconstriction. The other options describe different drug classes (e.g., antimuscarinics like ipratropium, leukotriene modifiers like montelukast/zileuton, and methylxanthine-related phosphodiesterase inhibition).
Category reason: This question tests the drug mechanism of action of a bronchodilator (albuterol), which is a core Pharmacology concept rather than a nursing care prioritization or intervention decision.

Question 31

The drug Aceclofenac is use for?

Accepted Answer

Answer reason: Aceclofenac is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain and inflammation in musculoskeletal conditions such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis. It works mainly by inhibiting cyclooxygenase (COX) enzymes, lowering prostaglandin synthesis and thereby decreasing inflammatory pain. It is not an antimicrobial/antiparasitic agent and does not treat infections like malaria or viral hepatitis, and it can worsen peptic ulcer disease due to GI mucosal irritation.
Category reason: This question tests knowledge of a medication’s therapeutic use/indication (aceclofenac as an NSAID), which is a core Pharmacology concept rather than a nursing care prioritization scenario.

Question 32

What is the main function of a binder in tablets?

Accepted Answer

Answer reason: B. To bind the ingredients of the tablet Binders are excipients added to promote cohesion of powder particles so the granules and final tablet hold together after compression. They improve mechanical strength, reduce friability, and help ensure uniformity during manufacturing and handling. Color, taste, and odor are typically addressed by other excipients such as colorants, flavoring agents, and perfumes/sweeteners.
Category reason: This is a pharmaceutics/pharmacology question about the role of a dosage-form excipient (binder) in tablet formulation rather than nursing care decisions.

Question 33

Severe allergic reaction to a drug is known as?

Accepted Answer

Answer reason: This refers to an acute, severe, potentially life-threatening hypersensitivity reaction that can occur after exposure to a medication. It is typically IgE-mediated and can cause airway edema/bronchospasm, hypotension, and shock within minutes. The other options describe different medication-related problems: predictable side effects, interactions between drugs, or dose-related poisoning rather than an immediate severe allergy.
Category reason: This item tests recognition of a medication-related immunologic emergency term, which is a core concept in Pharmacology rather than a nursing-priority decision scenario.

Question 34

A patient in the clinic has been diagnosed with acute gastritis by a doctor. For this patient, which of the following drugs would be contraindicated?

Accepted Answer

Answer reason: NSAIDs inhibit prostaglandin synthesis, which reduces gastric mucosal protection and can worsen inflammation and bleeding risk in acute gastritis. In a patient with active gastric irritation, this increases the likelihood of pain, ulceration, and GI hemorrhage. Antacids like calcium carbonate may provide symptomatic relief, while clarithromycin may be used when H. pylori eradication is indicated. Furosemide is not specifically contraindicated by gastritis, though it has its own separate risks and indications.
Category reason: This item tests medication contraindications and adverse GI effects of NSAIDs, which is a foundational drug-knowledge question in Pharmacology rather than a nursing process/prioritization scenario.

Question 35

Which of the following drugs is a loop diuretic?

Accepted Answer

Answer reason: It is a classic loop diuretic that inhibits the Na+-K+-2Cl− cotransporter in the thick ascending limb of the loop of Henle, producing potent natriuresis and diuresis. Spironolactone is a potassium-sparing aldosterone antagonist, hydrochlorothiazide is a thiazide diuretic acting in the distal convoluted tubule, and acetazolamide is a carbonic anhydrase inhibitor acting mainly in the proximal tubule. Loop diuretics are commonly used for rapid fluid removal in edema and heart failure and can cause hypokalemia and ototoxicity.
Category reason: This question tests identification of a diuretic drug class and its mechanism/classification, which is a core Pharmacology concept rather than a nursing judgment/intervention scenario.

Question 36

Which of the following is most likely to exacerbate asthma in a patient with a history of nasal polyps?

Accepted Answer

Answer reason: In patients with asthma and nasal polyps, NSAIDs (especially aspirin) can trigger aspirin-exacerbated respiratory disease due to COX-1 inhibition shifting arachidonic acid metabolism toward increased leukotriene production. This raises bronchoconstriction and airway inflammation, precipitating wheeze and asthma attacks. In contrast, beta-2 agonists, anticholinergics, and corticosteroids are typically bronchodilating and/or anti-inflammatory therapies used to treat asthma rather than worsen it.
Category reason: This question tests a drug-class adverse effect and contraindication pattern (aspirin/NSAID sensitivity in asthma with nasal polyps), which is primarily pharmacologic knowledge rather than a nursing management decision.

Question 37

Which of these is an antibiotic?

Accepted Answer

Answer reason: Azithromycin is a macrolide antimicrobial used to treat susceptible bacterial infections by inhibiting bacterial protein synthesis (50S ribosomal subunit). Prednisone is a corticosteroid used for anti-inflammatory and immunosuppressive effects, not for treating bacteria. Paracetamol (acetaminophen) is an analgesic/antipyretic that reduces pain and fever but has no antibacterial activity.
Category reason: This question tests recognition of drug classes (antibiotic vs steroid vs analgesic), which is core Pharmacology knowledge rather than a nursing care decision.

Question 38

Which of the following drug is a thrombolytic agent?

Accepted Answer

Answer reason: Thrombolytics (fibrinolytics) actively dissolve an existing clot by converting plasminogen to plasmin, which breaks down fibrin. Heparin and warfarin are anticoagulants that prevent clot formation/extension rather than lysing established thrombi. Clopidogrel is an antiplatelet (P2Y12 inhibitor) that reduces platelet aggregation and also does not dissolve formed clots.
Category reason: This question tests drug class identification (thrombolytic vs anticoagulant vs antiplatelet), which is foundational medication knowledge in Pharmacology rather than a nursing management decision.

Question 39

If someone has chest burning after eating, which medicine works best?

Accepted Answer

Answer reason: Burning chest pain after eating is most consistent with gastroesophageal reflux/heartburn due to gastric acid refluxing into the esophagus. Proton pump inhibitors reduce gastric acid secretion by inhibiting the H+/K+ ATPase, providing the most effective symptom relief and healing for frequent reflux compared with non–acid-targeting drugs. Loratadine treats allergic symptoms, paracetamol treats pain/fever without addressing acid reflux, and salbutamol treats bronchospasm/asthma.
Category reason: This question tests which drug class is appropriate for heartburn/GERD symptoms and requires knowledge of medication indications and mechanism, which falls under Pharmacology.

Question 40

Use of lactose in hepatic encephalopathy is to?

Accepted Answer

Answer reason: Lactulose (often misspelled as lactose) is used in hepatic encephalopathy to lower ammonia by acidifying the colon and trapping ammonia as ammonium, reducing its absorption into portal circulation. It also works as an osmotic laxative to increase stool frequency, promoting fecal excretion of nitrogenous waste. Lower systemic ammonia reduces neurotoxicity and improves mental status in hepatic encephalopathy.
Category reason: This item tests the therapeutic purpose and mechanism of an agent used to treat hepatic encephalopathy, which is primarily medication-focused knowledge within Pharmacology rather than nursing prioritization or safety actions.

Question 41

Which of these is not antibiotics?

Accepted Answer

Answer reason: Azithromycin (a macrolide) and amoxicillin (an aminopenicillin) are antibacterial antibiotics used to treat susceptible bacterial infections. Digoxin is a cardiac glycoside used primarily for heart failure and rate control in certain atrial arrhythmias, not for treating infections. Therefore, it is the only option that is not an antibiotic.
Category reason: This item tests drug classification and therapeutic use (distinguishing an antibiotic from a cardiac medication), which is core Pharmacology rather than nursing-care decision making.

Question 42

Which excipient is mainly used in tablet formulation?

Accepted Answer

Answer reason: Tablet formulations commonly include multiple excipients with different roles: binders help particles adhere and form a coherent tablet, while coloring agents improve identification and appearance. Flavoring agents may also be used (especially in chewable or orally disintegrating tablets) to improve palatability and adherence. Since all listed excipient types can be used in tablets depending on the dosage form design, the best choice is the inclusive option.
Category reason: This question tests knowledge of pharmaceutical dosage-form excipients and their functions in tablet formulation, which is a core Pharmacology topic rather than a nursing care decision.

Question 43

A 26-year-old man presents with a productive cough producing greenish-yellow sputum. The physician suspects a viral infection and opts not to prescribe antibiotics. Instead, he advises the patient to visit a pharmacist for a suitable cough mixture. Which of the following active ingredients would be most appropriate in this case?

Accepted Answer

Answer reason: A productive cough benefits from an expectorant that helps loosen and thin bronchial secretions, making sputum easier to clear and improving airway clearance. Antitussives (e.g., dextromethorphan, codeine) suppress the cough reflex and are generally less appropriate when secretions need to be expelled. Diphenhydramine is an antihistamine that can dry secretions and is mainly used for allergic symptoms or nighttime cough due to postnasal drip rather than facilitating mucus clearance. Since the clinician suspects a viral illness, symptomatic relief while supporting effective expectoration is the best approach.
Category reason: This question tests knowledge of OTC cough medication mechanisms and appropriate selection (expectorant vs antitussive vs antihistamine), which is primarily Pharmacology.

Question 44

A 48-year-old diabetic female presents with BP 174/102 mmHg, retinopathy, and LV hypertrophy on ECG. She is started on amlodipine. One month later, BP is 160/94 mmHg, but she reports bilateral ankle swelling. Best step?

Accepted Answer

Answer reason: She has persistent stage 2 hypertension despite a calcium-channel blocker, and diabetes with evidence of target-organ damage, so combination therapy is indicated. Dihydropyridine CCB–related ankle edema is due to preferential arteriolar dilation causing increased capillary hydrostatic pressure; adding an ACE inhibitor can counter this by reducing postcapillary resistance and may lessen edema. ACE inhibitors also provide renal and cardiovascular protection in diabetes and help regress LV hypertrophy. Adding a loop diuretic does not address the mechanism of CCB edema, increasing the CCB dose may worsen edema, and hydralazine is not preferred as a chronic first-line substitute here.
Category reason: This question primarily tests antihypertensive drug selection and adverse-effect management (amlodipine-induced edema) and the appropriate add-on therapy in a diabetic patient, which is pharmacology-focused rather than nursing care prioritization.

Question 45

Q. Iodine is used as for _?

Accepted Answer

Answer reason: Iodine (e.g., povidone-iodine) is a topical antimicrobial agent used on skin and wounds to reduce microbial load before procedures and to prevent infection. It acts broadly against bacteria, viruses, fungi, and some spores by oxidizing and iodinating cellular components. It is not an antibiotic (systemic agent targeting bacteria), and “carbohydrates” and “protein” are nutrient classes rather than clinical uses.
Category reason: This is a foundational question about the therapeutic use/classification of a chemical agent, which is primarily covered under Pharmacology rather than nursing decision-making.

Question 46

Which is the drug of choice for uncomplicated UTI?

Accepted Answer

Answer reason: C) Nitrofurantoin It is a first-line agent for acute uncomplicated cystitis because it concentrates well in urine and has strong activity against common uropathogens such as E. coli. Fluoroquinolones like ciprofloxacin are generally avoided as first-line therapy when alternatives exist due to resistance and serious adverse-effect risks. Amoxicillin has high resistance rates among typical UTI pathogens, and metronidazole targets anaerobes/protozoa rather than the usual aerobic gram-negative causes of uncomplicated UTI.
Category reason: This item tests selection of an appropriate antibiotic for a specific infection, emphasizing drug choice and spectrum of activity, which is primarily Pharmacology rather than nursing care prioritization.

Question 47

Presents with red-green color blindness and blurred vision Likely offending drug?

Accepted Answer

Answer reason: Ethambutol can cause optic neuritis due to dose-related toxicity to the optic nerve. This classically presents with decreased visual acuity, blurred vision, and red-green color discrimination deficits. The risk increases with higher doses and renal impairment, so baseline and periodic visual testing is recommended while on therapy. The other first-line TB drugs have different hallmark toxicities (e.g., hepatotoxicity, neuropathy, hyperuricemia) rather than red-green color blindness.
Category reason: This question tests recognition of a characteristic adverse effect of a specific anti-tuberculosis medication, which is primarily pharmacology knowledge rather than a nursing care prioritization scenario.

Question 48

Another name for Omeprazole is _____.?

Accepted Answer

Answer reason: Omeprazole is the generic name for the proton pump inhibitor marketed as Prilosec. Ranitidine is an H2-receptor antagonist (and not a PPI). Flagyl is metronidazole (an antimicrobial), and Brufen is ibuprofen (an NSAID), so neither is a trade name for omeprazole.
Category reason: This question tests recognition of a drug’s generic-to-brand name relationship, which is a core Pharmacology concept.

Question 49

Which of the following is a beta-blocker commonly used to treat hypertension and angina?

Accepted Answer

Answer reason: It is a beta-1 selective adrenergic blocker that lowers heart rate and myocardial contractility, reducing cardiac output and oxygen demand. These effects make it useful for treating both hypertension and stable angina. The other options are different drug classes: lisinopril is an ACE inhibitor, amlodipine is a calcium channel blocker, and furosemide is a loop diuretic.
Category reason: This question tests identification of a medication class (beta-blocker) and matching it to a specific drug used for hypertension/angina, which is core Pharmacology knowledge rather than a nursing judgment scenario.

Question 50

If someone has a headache or fever, which of these is the BEST first choice?

Accepted Answer

Answer reason: For uncomplicated headache or fever, an antipyretic/analgesic like acetaminophen (paracetamol) is an appropriate first-line symptomatic treatment when taken at recommended doses. An antibiotic such as amoxicillin is not indicated unless there is evidence of a bacterial infection and inappropriate use contributes to resistance and exposes the person to unnecessary adverse effects/allergy risk. “Spirit” used for cleaning the body is not a treatment for pain or fever and ingestion can be toxic; topical use will not address these symptoms.
Category reason: This question tests medication selection for common symptoms (analgesic/antipyretic vs antibiotic vs inappropriate substance), which is primarily a pharmacology concept rather than a nursing care scenario.

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