Question 1

A drug lacking vasodilator properties that is useful in angina is ?

Accepted Answer

Answer reason: Metoprolol, a β₁-selective beta-blocker, does not have vasodilator properties. It helps in angina by reducing heart rate, myocardial contractility, and oxygen demand—without causing direct vascular dilation like nitrates or calcium channel blockers.

Question 2

In which year was the Influenza-A (H1N1) vaccine approved?

Accepted Answer

Answer reason: The Influenza A (H1N1) vaccine was approved in 2009, during the swine flu pandemic. Rapid development and release allowed large-scale immunization in the same year to control global spread.

Question 3

Mechanism of penicillins’ antibacterial effect is?

Accepted Answer

Answer reason: Penicillins exert their antibacterial action by inhibiting transpeptidation during peptidoglycan synthesis in the bacterial cell wall. They bind to penicillin-binding proteins (PBPs), preventing cross-linking of the cell wall, which leads to weakened structure and bacterial lysis.

Question 4

Which of the following agents is an alpha2-selective antagonist?

Accepted Answer

Answer reason: Yohimbine is a selective α₂-adrenergic receptor antagonist. By blocking presynaptic α₂ receptors, it increases norepinephrine release and enhances sympathetic activity. The other agents target α₁ receptors (tamsulosin, prazosin) or are non-selective (tolazoline).

Question 5

The reason for preferring ethosuximide to valproate for uncomplicated absence seizures is?

Accepted Answer

Answer reason: Ethosuximide is preferred for uncomplicated absence seizures because it is highly effective and avoids the risk of valproate’s idiosyncratic hepatotoxicity, which can be severe, especially in young children. Ethosuximide specifically blocks T-type calcium channels with fewer serious adverse effects.

Question 6

Choose the drug that causes constipation?

Accepted Answer

Answer reason: Aluminum hydroxide frequently causes constipation because aluminum salts reduce gastrointestinal motility and form insoluble complexes in the intestine. This decreases water retention in the stool and slows transit time, leading to hard, infrequent bowel movements. In contrast, magnesium-containing antacids tend to cause diarrhea, not constipation.

Question 7

Cefaclor is ____________ generation cephalosporin?

Accepted Answer

Answer reason: Cefaclor is a second-generation cephalosporin. Second-generation agents (such as cefaclor, cefuroxime, and cefoxitin) were developed to provide expanded Gram-negative coverage compared to first-generation drugs. Their activity includes organisms like H. influenzae, which is why cefaclor is classified in this group.

Question 8

Which route of drug administration is most likely to lead to the first-pass effect?

Accepted Answer

Answer reason: The oral route is most likely to undergo the first-pass effect because drugs absorbed from the gastrointestinal tract enter the portal circulation and pass through the liver before reaching systemic circulation. Significant hepatic metabolism during this first pass can reduce the amount of active drug available. Sublingual, IV, and IM routes bypass this hepatic first-pass metabolism.

Question 9

All of the following statements about efficacy and potency are true EXCEPT?

Accepted Answer

Answer reason: The incorrect statement is “The ED50 is a measure of a drug’s efficacy.”
ED50 (effective dose 50) reflects potency, not efficacy. It represents the dose required to produce 50% of the drug’s maximal effect.

Efficacy = the maximum achievable effect of a drug (Emax).

Potency = how much drug is needed to produce a given effect (ED50).
Thus, using ED50 to judge efficacy is wrong, making option D the correct EXCEPT statement.

Question 10

Which of the following drugs is useful in the treatment of Parkinson's disease?

Accepted Answer

Answer reason: Benztropine is useful in treating Parkinson’s disease because it is an anticholinergic agent that reduces excess cholinergic activity in the striatum. Parkinson’s involves dopamine deficiency, creating an imbalance between dopamine and acetylcholine. By blocking muscarinic receptors, benztropine helps reduce tremor and rigidity.
Edrophonium is used in myasthenia gravis diagnosis, succinylcholine is a depolarizing neuromuscular blocker, and hexamethonium is a ganglionic blocker—not used for Parkinson’s.

Question 11

Which of the following agents is a nonselective beta receptor agonist?

Accepted Answer

Answer reason: Isoproterenol is a classic nonselective β-adrenergic agonist, stimulating both β₁ and β₂ receptors. This leads to increased heart rate/contractility (β₁) and bronchodilation/vasodilation (β₂).
Norepinephrine primarily stimulates α and β₁ receptors, terbutaline is a selective β₂ agonist, and dobutamine is mainly β₁-selective, making isoproterenol the only nonselective β agonist in the list.

Question 12

Which of the following hypnotic drugs increases the activity of hepatic drug-metabolizing enzyme systems?

Accepted Answer

Answer reason:Phenobarbital is a potent inducer of hepatic cytochrome P450 enzymes. By increasing the activity of drug-metabolizing enzymes, it accelerates the metabolism of many other medications, potentially reducing their effectiveness.
Zolpidem, flurazepam, and zaleplon do not significantly induce hepatic enzyme systems.

Question 13

Zafirlucast prevents aspirin-sensitive asthma. This consideration is?

Accepted Answer

Answer reason:The statement is True.
Zafirlukast is a leukotriene receptor antagonist that blocks the effects of leukotrienes, which play a major role in aspirin-sensitive asthma. In aspirin-exacerbated respiratory disease (AERD), inhibition of COX-1 by aspirin shunts arachidonic acid toward leukotriene production, worsening bronchoconstriction. By blocking leukotriene receptors, zafirlukast helps prevent bronchospasm in aspirin-sensitive patients.

Question 14

This drug is useful in terminating atrial but not ventricular tachycardias?

Accepted Answer

Answer reason: Verapamil is effective in treating atrial tachycardias (such as PSVT and atrial flutter) because it is a calcium channel blocker that slows conduction through the AV node. However, it is not effective—and can even be dangerous—for ventricular tachycardias, since ventricular tissue depends less on calcium channels and more on sodium channels.
Lidocaine treats ventricular arrhythmias, flecainide can treat both atrial and some ventricular arrhythmias, and sotalol has broad antiarrhythmic effects. Verapamil is the one that works for atrial but not ventricular tachycardias.

Question 15

Tick the drug of choice for herpes and cytomegalovirus infection treatment?

Accepted Answer

Answer reason:The marked answer Acyclovir is correct for herpes, but NOT correct for cytomegalovirus (CMV).

Acyclovir is the drug of choice for HSV-1, HSV-2, and VZV.

However, CMV lacks the viral thymidine kinase needed to activate acyclovir effectively.

The actual drug of choice for CMV infections is Ganciclovir (or valganciclovir).

So the question itself is flawed: no single option listed treats both herpes and CMV, but among the choices, acyclovir is the only one that treats herpes, which is why it’s selected.

Question 16

The mechanism of action of non-opioid analgesics involves the inhibition of which of the following?

Accepted Answer

Answer reason:Non-opioid analgesics such as NSAIDs (e.g., ibuprofen, aspirin) and acetaminophen work primarily by inhibiting prostaglandin synthesis. NSAIDs block cyclooxygenase (COX-1 and/or COX-2), reducing the production of prostaglandins responsible for pain, inflammation, and fever. They do not act on GABA receptors, opioid receptors, or sodium channels.

Question 17

What does “pharmacokinetics” include?

Accepted Answer

Answer reason:Pharmacokinetics refers to what the body does to a drug, which includes the four major processes:

Absorption (how the drug enters the bloodstream)

Distribution (how it spreads through tissues and fluids)

Metabolism (how it is biotransformed, usually in the liver)

Excretion (how it is removed from the body, usually via kidneys or bile)

Therefore, the correct statement is that pharmacokinetics includes absorption, distribution, metabolism, and excretion (ADME).

Question 18

Which of the following local anesthetics is an useful antiarrhythmic agent?

Accepted Answer

Answer reason:Lidocaine is both a local anesthetic and a Class IB antiarrhythmic drug. It blocks sodium channels in cardiac tissue, shortening the action potential and reducing automaticity in ventricular cells. This makes it particularly effective for ventricular arrhythmias, especially post–myocardial infarction.
Cocaine, bupivacaine, and ropivacaine do not have clinically useful antiarrhythmic actions.

Question 19

Although the benzodiazepines continue to be the agents of choice for insomnia, they have?

Accepted Answer

Answer reason:Benzodiazepines are effective for insomnia, but they carry a significant risk of both psychological and physiological dependence. With continued use, tolerance can develop, and abrupt withdrawal may cause rebound insomnia, anxiety, or even seizures. Although they also cause CNS depression (especially with alcohol) and residual sedation, the most important and characteristic drawback is their dependence potential.

Question 20

Which of the following inhalants is a gas anesthetic?

Accepted Answer

Answer reason:
Nitrous oxide is the only true gas anesthetic among the options. It exists as a gas at room temperature, unlike halothane, isoflurane, and desflurane, which are volatile liquids that must be vaporized for inhalational anesthesia. Nitrous oxide provides rapid onset and recovery due to its low blood–gas solubility.

Question 21

The mechanism of methylxanthines action is?

Accepted Answer

Answer reason:
Methylxanthines (e.g., theophylline, caffeine) exert their bronchodilatory effects primarily by inhibiting phosphodiesterase (PDE).
PDE inhibition increases intracellular cAMP, leading to relaxation of bronchial smooth muscle. They also antagonize adenosine receptors, further contributing to bronchodilation. They do not stimulate β₂ receptors, inhibit cytokines, or block muscarinic receptors.

Question 22

Microtubules inhabitors are?

Accepted Answer

Answer reason:Vincristine and vinblastine are both microtubule inhibitors.
They bind to tubulin and prevent microtubule polymerization, thereby halting mitosis at the metaphase stage. This makes them effective chemotherapeutic agents, especially for rapidly dividing cells.
Isoniazid is an anti-tuberculosis drug and has no effect on microtubules.

Therefore, the correct answer is both A and B.

Question 23

Identify the B-lactam antibiotic?

Accepted Answer

Answer reason:Clavulanic acid, sulbactam, and tazobactam are NOT β-lactam antibiotics — they are β-lactamase inhibitors.
They contain a β-lactam ring but have no significant antibacterial activity on their own. Their role is to protect true β-lactam antibiotics (like penicillins) from enzymatic destruction.

Therefore, none of the listed agents is a β-lactam antibiotic, and the option “All” is incorrect in meaning, even though they all contain β-lactam rings.

Question 24

__________ can be given only orally?

Accepted Answer

Answer reason:Ketoconazole is the only agent on the list that is exclusively given orally.
It has no reliable IV formulation and is administered only by mouth due to its pharmacokinetics and solubility profile.

Fluconazole and voriconazole, in contrast, are available in both oral and IV forms.

Question 25

Encircle alkylating agent?

Accepted Answer

Answer reason:Cisplatin is the correct alkylating-like agent.
Although not a classical alkylating drug, cisplatin acts like an alkylating agent by forming DNA cross-links, inhibiting DNA replication and transcription, and causing apoptosis in rapidly dividing cells.

Dacarbazine is also an alkylating agent (a triazene),

Vincristine is a microtubule inhibitor,

Floxuridine is an antimetabolite.

However, among the answer choices, cisplatin is the best-known and most classically recognized alkylating-like agent for NCLEX-style classification.

Question 26

Most of drugs are distributed homogeneously?

Accepted Answer

Answer reason:
The statement is False.
Most drugs are not distributed homogeneously throughout the body. Distribution varies widely depending on factors such as:

tissue blood flow

protein binding

lipid solubility

tissue permeability

presence of physiological barriers (e.g., blood–brain barrier)

As a result, different tissues receive different drug concentrations, making homogeneous distribution unrealistic for the vast majority of medications.

Question 27

Zileuton prevents the production of leukotrienes. This statement is?

Accepted Answer

Answer reason:The statement is True.
Zileuton works by inhibiting 5-lipoxygenase, the key enzyme responsible for converting arachidonic acid into leukotrienes (LTC₄, LTD₄, LTE₄). By blocking this enzyme, zileuton prevents the actual production of leukotrienes, reducing bronchoconstriction and inflammation in asthma.

Question 28

Ethyl alcohol is an agent decreasing appetite. It’s?

Accepted Answer

Answer reason:The statement is False.
Ethyl alcohol does not decrease appetite. In fact, alcohol often increases appetite by lowering inhibitions, altering glucose metabolism, and stimulating certain neurohormonal pathways. This is why people frequently feel hungrier or snack more when drinking alcohol. Alcohol is not classified as an anorectic (appetite-suppressing) agent.

Question 29

Metoclopramide is a potent dopamine antagonist. It's?

Accepted Answer

Answer reason:The statement is True.
Metoclopramide is a potent dopamine D₂ receptor antagonist, especially in the chemoreceptor trigger zone (CTZ). By blocking dopamine, it enhances gastrointestinal motility (prokinetic effect) and provides antiemetic action. Its dopamine antagonism also explains extrapyramidal side effects such as dystonia or akathisia.

Question 30

pH of the fermentation medium for chlorotetracyclins is?

Accepted Answer

Answer reason:The correct pH for the fermentation medium of chlortetracyclines is 5–6.
Tetracycline-producing Streptomyces species grow and produce antibiotics optimally in a slightly acidic environment. A pH of 5–6 maximizes enzyme activity involved in tetracycline biosynthesis and prevents degradation of the antibiotic during fermentation.

Higher pH ranges (6–9) reduce yield and stability of chlortetracycline.

Question 31

Encircle antimetabolites?

Accepted Answer

Answer reason: 5-Fluorouracil (5-FU) is the correct antimetabolite.
It is a pyrimidine analog that inhibits thymidylate synthase, blocking DNA synthesis—making it a classic S-phase antimetabolite chemotherapeutic.

Bleomycin → antitumor antibiotic

Doxorubicin → anthracycline antibiotic

Busulfan → alkylating agent

Thus, only 5-FU fits the definition of an antimetabolite.

Question 32

Identify the inhibitors of folate synthesis?

Accepted Answer

Answer reason: All listed drugs—sulfamethoxazole, sulfacetamide, and sulfadiazine—are sulfonamides, and all of them inhibit folate synthesis in bacteria.
They block dihydropteroate synthase, preventing the incorporation of PABA into folic acid. Because bacteria must synthesize their own folate, inhibition of this pathway is bacteriostatic.

Therefore, the correct answer is All.

Question 33

The maximum cytotoxic effects of antimetabolites are in ______ phase?

Accepted Answer

Answer reason: Antimetabolites (such as 5-fluorouracil, methotrexate, cytarabine) exert their maximum cytotoxic effects during the S phase of the cell cycle.
This is because they interfere with DNA synthesis—either by inhibiting nucleotide formation or by acting as false substrates—making them most effective when cells are actively replicating DNA.

Question 34

Heparin is effective when administered orally. This consideration is?

Accepted Answer

Answer reason: The statement is False.
Heparin is not effective orally because it is a large, highly charged polysaccharide that is not absorbed from the gastrointestinal tract. Digestive enzymes and the gut wall prevent it from entering systemic circulation.
For this reason, heparin must be given IV or subcutaneously, never orally.

Question 35

Tranexamic acid is an analog of aminocaproic acid. It’s?

Accepted Answer

Answer reason: The statement is True.
Tranexamic acid is a synthetic analog of ε-aminocaproic acid. Both drugs work as antifibrinolytics by competitively inhibiting plasminogen activation, thereby preventing fibrin degradation and stabilizing clots. Tranexamic acid is more potent than aminocaproic acid.

Question 36

An important action of digitalis is to increase vagal tone. It's?

Accepted Answer

Answer reason: The statement is True.
Digitalis (digoxin) increases vagal tone, which enhances parasympathetic activity on the heart. This leads to slower AV nodal conduction and a decreased heart rate, which is why digoxin is useful in conditions like atrial fibrillation for controlling ventricular rate.
This vagotonic effect is separate from its inotropic action (inhibition of Na⁺/K⁺-ATPase → increased intracellular Ca²⁺).

Question 37

Chlorotetracyclin is soluble in?

Accepted Answer

Answer reason: Chlorotetracycline is primarily soluble in water; it is not well soluble in ether and only sparingly soluble in organic solvents. Thus, the correct answer is water.

Question 38

Verapamil is a more potent vasodilator than nifedipine. this statement is?

Accepted Answer

Answer reason: Nifedipine is a more potent vasodilator compared to verapamil. Verapamil has more pronounced effects on the heart, whereas nifedipine is primarily a vascular selective calcium channel blocker with strong vasodilatory effect.

Question 39

Hypnotic benzodiazepines are more powerful enzyme inducers than barbiturates?

Accepted Answer

Answer reason: Barbiturates are strong hepatic CYP450 enzyme inducers, whereas benzodiazepines are not significant inducers. Therefore, benzodiazepines are not more powerful enzyme inducers than barbiturates.

Question 40

Verapamil has a significant effect on automaticity in the SA node. It's?

Accepted Answer

Answer reason: Verapamil, a non‑dihydropyridine calcium channel blocker, inhibits L‑type Ca2+ channels in nodal tissue, decreasing phase 4 depolarization and conduction, thereby reducing SA node automaticity.

Question 41

Ticlopidine is an inhibitor of ADP-induced platelet aggregation. It's?

Accepted Answer

Answer reason: Ticlopidine is a P2Y12 (ADP) receptor antagonist that inhibits ADP-induced platelet aggregation

Question 42

Odd One Out: Inhaled Corticosteroids - asthma?

Accepted Answer

Answer reason: Montelukast is a leukotriene receptor antagonist taken orally, not an inhaled corticosteroid. Budesonide, fluticasone, and beclomethasone are inhaled corticosteroids used for asthma control

Question 43

Drug dose calculation is studied in?

Accepted Answer

Answer reason: Posology is the branch of pharmacology that deals specifically with drug dosing and dose calculations. Pharmacoeconomics concerns cost, toxicology studies poisons, and clinical pharmacology focuses on drug effects in humans, not dose calculation per se.

Question 44

Which category of drugs undergo first-pass metabolism?

Accepted Answer

Answer reason: Oral drugs are absorbed from the GI tract and carried via the portal vein to the liver, where significant first-pass metabolism can occur. IV, IM, and sublingual routes bypass hepatic first-pass

Question 45

Neurokinin 1 receptor blocker is ____________?

Accepted Answer

Answer reason: Aprepitant is an NK1 (substance P) receptor antagonist. Nabilone is a cannabinoid, Droperidol is a dopamine D2 antagonist, and Granisetron is a 5-HT3 antagonist.

Question 46

Chloramphenicol binds to ___________ unit of the ribosome?

Accepted Answer

Answer reason: Chloramphenicol binds to the 50S ribosomal subunit (23S rRNA) and inhibits peptidyl transferase.

Question 47

The anti tumour antibiotic acts on the __________ of the tumour cell?

Accepted Answer

Answer reason: Antitumor antibiotics (e.g., doxorubicin, dactinomycin, bleomycin) intercalate DNA and cause strand breaks or inhibit topoisomerase II, thereby acting primarily on DNA.

Question 48

The property of prolonged theophyllines is the prevention of night asthmatic attacks. It's?

Accepted Answer

Answer reason: Extended-release theophylline provides sustained bronchodilation and is used to prevent nocturnal (night-time) asthma symptoms.

Question 49

Which doses of Aspirin may be more effective in inhibiting Tromboxane A2?

Accepted Answer

Answer reason: Low-dose aspirin preferentially and irreversibly inhibits platelet COX-1, suppressing thromboxane A2 synthesis while sparing endothelial prostacyclin; thus low doses are most effective for TXA2 inhibition.

Question 50

Mechanism of urokinase action is an inhibition of Thromboxane A2. This statement is?

Accepted Answer

Answer reason: Urokinase is a fibrinolytic that converts plasminogen to plasmin to lyse fibrin; inhibition of thromboxane A2 is the antiplatelet mechanism of aspirin, not urokinase.

Train with a large NCLEX question bank and jump into a full exam-style simulator

Pharmacology NCLEX Practice Test

Continue Learning