Pharmacology Practice Test 18
Pharmacology NCLEX Practice Test
Pharmacology is a key topic within the NCLEX test plan, located under Nursing Science → Clinical Foundations → Pharmacology. This section details drug mechanisms, safe administration, and patient education across nursing specialties. Each test contains 50 questions designed to mirror the difficulty and variety of the real exam.
This is the 18th part of the Pharmacology series. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
Continue Learning
In the Pharmacology Study Cards section, shared by real NCLEX candidates, you’ll find concise summaries and high-yield insights related to the most tested concepts. It’s a perfect space to reinforce challenging topics and sharpen your recall through quick, focused repetitions. Short, powerful, and repeatable!
Pharmacology Practice Test 18
A client is prescribed lisinopril for hypertension. What is the primary action of lisinopril?
- Increasing heart rate
- Blocking angiotensin receptors
- Stimulating the sympathetic nervous system
- Inhibiting aldosterone secretion
Explanation: Answer reason: Lisinopril is an ACE inhibitor; by preventing conversion of angiotensin I to angiotensin II, it reduces aldosterone secretion and promotes vasodilation. It does not block angiotensin receptors (that is an ARB).
Beta lactam antibiotics are active against?
- Bacteria
- Virus
- Fungi
- All of these
Explanation: Answer reason: Beta-lactams inhibit bacterial cell wall synthesis (peptidoglycan) and thus are active only against bacteria, not viruses or fungi.
Antibiotics inhibiting the bacterial cell wall synthesis are?
- Beta-lactam antibiotics
- Tetracyclines
- Aminoglycosides
- Macrolides
Explanation: Answer reason: Beta-lactams (penicillins, cephalosporins, etc.) block peptidoglycan cross-linking by binding penicillin-binding proteins, inhibiting cell wall synthesis. Tetracyclines, aminoglycosides, and macrolides inhibit bacterial protein synthesis.
Which of the following drugs contain beta lactam ring in their chemical structure?
- Loracarbif
- Cefipime
- Both of these
- None of these
Explanation: Answer reason: Loracarbif (a carbacephem) and cefipime (a cephalosporin) are beta‑lactam antibiotics; both contain the beta‑lactam ring.
Ciprofloxacin is?
- Narrow spectrum
- Broad spectrum
- For Gram +ve bacteria
- Only for Gram −ve
Explanation: Answer reason: Ciprofloxacin, a fluoroquinolone, has activity against a wide range of organisms including many Gram-negative bacteria and some Gram-positive organisms, making it a broad-spectrum antibiotic.
The side effect of fluoroquinolones is?
- Cartilage damage
- Tooth discoloration
- Jaundice
- Bone marrow depression
Explanation: Answer reason: Fluoroquinolones are associated with cartilage toxicity and tendinopathy, so they are avoided in children and pregnancy. Tooth discoloration is linked to tetracyclines; bone marrow depression and jaundice are not characteristic fluoroquinolone effects.
Tick the antibacterial drug – a fluoroquinolone derivative?
- Chloramphenicol
- Nitrofurantoin
- Nalidixic acid
- Ciprofloxacin
Explanation: Answer reason: Ciprofloxacin is a fluoroquinolone antibiotic; nalidixic acid is a non-fluorinated quinolone, and the others are different classes.
Pick out the beta-lactamase inhibitor for co-administration with penicillins?
- Clavulanic acid
- Sulbactam
- Tazobactam
- All of the above
Explanation: Answer reason: Clavulanic acid, sulbactam, and tazobactam are all beta-lactamase inhibitors used with penicillins to extend antimicrobial coverage.
Co-amoxiclave is a combination of amoxicillin and?
- Clavulonic acid
- Carbenicillin
- Ticarcillin
- Azobactam
Explanation: Answer reason: Co-amoxiclav (Augmentin) combines amoxicillin with the beta-lactamase inhibitor clavulanic acid.
All of these antibiotics are aminoglycosides, EXCEPT?
- Gentamycin
- Streptomycin
- Clindamycin
- Neomycin
Explanation: Answer reason: Clindamycin is a lincosamide, not an aminoglycoside. Gentamycin, streptomycin, and neomycin are aminoglycosides.
Tick the mechanism of metoclopramide antiemetic action?
- H1 and H2-receptor blocking effect
- M-cholinoreceptor stimulating effect
- D2-dopamine and 5-HT3-serotonin receptor blocking effect
- M-cholinoblocking effect
Explanation: Answer reason: Metoclopramide’s antiemetic effect is due to antagonism of D2 receptors in the chemoreceptor trigger zone and 5‑HT3 receptors; it does not block H1/H2 or muscarinic receptors.
If a person has acute rejection of a transplanted organ, which drug is most likely used?
- Tacrolimus
- Cyclosporine
- Cellcept
- Daclizumab
Explanation: Answer reason: Daclizumab is an IL-2 receptor monoclonal antibody used in transplant immunosuppression for acute rejection management/induction, whereas tacrolimus, cyclosporine, and mycophenolate (Cellcept) are primarily maintenance agents.
Which is a vesicant drug?
- Dactinomycin
- Morphine
- Azithrocin
- Voveran
Explanation: Answer reason: Dactinomycin is an antineoplastic vesicant that can cause severe tissue necrosis with extravasation; morphine, azithromycin (Azithrocin), and diclofenac (Voveran) are not vesicant chemotherapeutics.
Bactericidal effect is?
- Inhibition of bacterial cell division
- Inhibition of young bacterial cell growth
- Destroying of bacterial cells
- Formation of bacterial L-form
Explanation: Answer reason: Bactericidal agents kill bacteria; they cause destruction of bacterial cells. Inhibition of growth or division is bacteriostatic.
The most frequent side effect of oral ampicillin is?
- Bone marrow depression
- Diarrhea
- Constipation
- Cartilage damage
Explanation: Answer reason: Aminopenicillins commonly cause gastrointestinal upset from alteration of gut flora; diarrhea is the most frequent adverse effect. Bone marrow depression and cartilage damage are not typical for ampicillin; constipation is uncommon.
Tick the drug, inhibiting uncoating of the viral RNA?
- Vidarabine
- Rimantadine
- Acyclovir
- Didanosine
Explanation: Answer reason: Rimantadine (like amantadine) blocks the M2 proton channel of influenza A, preventing viral uncoating and release of viral RNA. The others are nucleoside analogs affecting DNA/RNA polymerases or reverse transcriptase.
The mechanism of action of fluoroquinolones is?
- Protein synthesis inhibitors
- Cell wall inhibitors
- DNA gyrase inhibitors
- Folate inhibitors
Explanation: Answer reason: Fluoroquinolones inhibit bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, blocking DNA replication.
Tick the drug belonging to antibiotics – tetracyclines?
- Doxycycline
- Streptomycin
- Clarithromycin
- Amoxicillin
Explanation: Answer reason: Doxycycline is a tetracycline-class antibiotic; streptomycin is an aminoglycoside, clarithromycin is a macrolide, and amoxicillin is a penicillin.
The following antibiotic is used for constipation and to increase gastric emptying?
- Amikacin
- Ciprofloxacin
- Erythromycin
- Gentamycin
Explanation: Answer reason: Erythromycin acts as a motilin receptor agonist, stimulating GI motility and promoting gastric emptying; the others lack this prokinetic effect.
All of these antibiotics are aminoglycosides, EXCEPT?
- Gentamycin
- Streptomycin
- Griseofulvin
- Neomycin
Explanation: Answer reason: Griseofulvin is an antifungal drug, not an aminoglycoside; gentamycin, streptomycin, and neomycin are aminoglycoside antibiotics.
Isoniazid has the following unwanted effects?
- Cardiotoxicity
- Hepatotoxicity, peripheral neuropathy
- Loss of hair
- Immunotoxicity
Explanation: Answer reason: Isoniazid commonly causes hepatotoxicity and pyridoxine (B6) deficiency leading to peripheral neuropathy; the other options are not characteristic adverse effects.
The most frequent side effect of penicillin is?
- Bone deformity
- Hypersensitivity reaction
- Cartilage damage
- Euphoria
Explanation: Answer reason: Penicillins commonly cause allergic hypersensitivity reactions (rash, urticaria, anaphylaxis); bone/cartilage effects and euphoria are not typical for this class.
Mechanism of sulfonamides’ antibacterial effect is?
- Inhibition of dihydropteroate reductase
- Inhibition of dihydropteroate synthase
- Inhibition of cyclooxygenase
- Activation of DNA gyrase
Explanation: Answer reason: Sulfonamides are PABA analogs that competitively inhibit dihydropteroate synthase, blocking folate synthesis in bacteria. Trimethoprim inhibits dihydrofolate reductase; cyclooxygenase and DNA gyrase are unrelated targets.
The mechanism of fluoroquinolones’ action is?
- Inhibition of phospholipase C
- Inhibition of DNA gyrase
- Inhibition of bacterial cell synthesis
Explanation: Answer reason: Fluoroquinolones inhibit bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, blocking DNA replication. They do not target phospholipase C or bacterial cell wall synthesis.
Tick the antimycobacterial drug belonging to first-line agents?
- PAS
- Isoniazid
- Kanamycin
- Pyrazinamide
Explanation: Answer reason: Isoniazid is a core first-line antitubercular drug; PAS and kanamycin are second-line agents.
Levocetirizine is classified as which type of medication?
- Antihistamine
- Antiemetic
- Analgesic
- Antibiotic
Explanation: Answer reason: Levocetirizine is a second-generation H1 antihistamine used for allergic rhinitis and urticaria; it is not an antiemetic, analgesic, or antibiotic.
Which of the following drugs may cause Gray baby syndrome?
- Chloramphenicol
- Penicillin
- Doxycycline
- Kanamycin
Explanation: Answer reason: Gray baby syndrome occurs in neonates due to impaired glucuronidation causing chloramphenicol accumulation, leading to cyanosis and cardiovascular collapse.
Which medication is used for infection?
- Ciprofloxacin
- Paracetamol
- Cetirizine
- Diclofenac
Explanation: Answer reason: Ciprofloxacin is a fluoroquinolone antibiotic used to treat bacterial infections; the others are not antimicrobials (paracetamol analgesic/antipyretic, cetirizine antihistamine, diclofenac NSAID).
What are the primary indications for aspirin use?
- Inflammation
- Fever
- Pain
- Toothache
Explanation: Answer reason: Aspirin is an NSAID with primary therapeutic uses of anti-inflammatory, analgesic, and antipyretic effects; among the options, inflammation represents a core indication, whereas toothache is just a specific pain condition.
What is the term for injection of a drug directly into joints?
- Intra-articular
- Intra-arterial
- Intra-ossicular
- Intramedullary
Explanation: Answer reason: Intra-articular means within a joint, the correct term for injecting a drug directly into a joint space. Intra-arterial is into an artery, intra-ossicular relates to ear ossicles, and intramedullary is within the bone marrow canal.
What is the primary indication for the medication chloroquine?
- Malaria
- Protozoa infections
- Solar urticaria
Explanation: Answer reason: Chloroquine is a classic antimalarial agent; its primary clinical use is treatment and prophylaxis of malaria caused by susceptible Plasmodium species.
Which of the following drugs is an example of a proton pump inhibitor?
- Pantoprazole
- Famotidine
- Ranitidine
- Sucralfate
Explanation: Answer reason: Pantoprazole is a proton pump inhibitor; famotidine and ranitidine are H2 receptor antagonists, and sucralfate is a mucosal protectant.
What is the common major side effect of morphine?
- Respiratory depression
- Hypertension
- Tachycardia
- Hyperglycemia
Explanation: Answer reason: Morphine, a mu-opioid agonist, depresses the brainstem respiratory centers leading to dose-dependent respiratory depression. It more commonly causes hypotension and bradycardia, not hypertension or tachycardia, and is not associated with hyperglycemia.
Which drug is classically associated with congenital limb abnormalities such as phocomelia?
- Thalidomide
- Warfarin
- Misoprostol
Explanation: Answer reason: Thalidomide is the classic teratogen causing limb reduction defects (phocomelia). Warfarin more typically causes nasal hypoplasia/stippled epiphyses, and misoprostol is linked to Moebius sequence.
What is the primary use of tranexamic acid injection?
- To stop bleeding
- To treat measles
- To stop diarrhea
Explanation: Answer reason: Tranexamic acid is an antifibrinolytic that inhibits plasminogen activation to reduce or prevent bleeding; it is not used for measles or diarrhea.
Which antibiotic is used for infection?
- Ciprofloxacin
- Amoxicillin
- Ofloxacin
Explanation: Answer reason: Amoxicillin is a commonly used broad-spectrum penicillin antibiotic for many general bacterial infections and is the typical first-line choice among the listed options.
Morphine is contraindicated in which of the following conditions?
- Angina
- Bronchial asthma
- Pancreatitis
- Myocardial infarction
Explanation: Answer reason: Opioids like morphine can cause respiratory depression and histamine release leading to bronchoconstriction, making them contraindicated in acute bronchial asthma.
What is the therapeutic dosage range of lithium in mg/day?
- 300-600 mg/day
- 500-800 mg/day
- 900-2100 mg/day
- 2000-3000 mg/day
Explanation: Answer reason: Typical therapeutic daily dosing of lithium for adults is approximately 900–2100 mg/day in divided doses; the other ranges are below or above common therapeutic dosing.
Tramadol drug is used as?
- Antibiotic
- Antivirus
- Analgesic
- Antifungal
Explanation: Answer reason: Tramadol is an opioid analgesic used to manage moderate pain.
The maximum effect of a drug is defined by which term?
- Therapeutic index
- Potency
- Efficacy
- Adversity
Explanation: Answer reason: Efficacy refers to a drug’s maximal achievable effect (Emax). Potency is the dose needed for a given effect, therapeutic index is a safety margin, and adversity is not the defining term.
Which tablet is used for diarrhea?
- Ciprofloxacin
- Cetirizine
- Loperamide
- Ofloxacin
Explanation: Answer reason: Loperamide is an antidiarrheal that slows intestinal motility to reduce stool frequency; the others are an antibiotics (ciprofloxacin, ofloxacin) and an antihistamine (cetirizine).
What is metoclopramide injection used for?
- Stroke
- Allergy
- Nausea
- Fever
Explanation: Answer reason: Metoclopramide is a dopamine D2 antagonist with prokinetic and antiemetic effects, used to treat nausea and vomiting.
Dextromethorphan is classified as which type of medication?
- Antihistaminic
- Expectorant
- Antiallergic
- Antitussive
Explanation: Answer reason: Dextromethorphan is a cough suppressant that acts on the medullary cough center, classifying it as an antitussive.
What is the term for the application of a drug to the skin with friction?
- Inhalation
- Infiltration
- Infusion
- Inunction
Explanation: Answer reason: Inunction is the method of administering a drug by rubbing it into the skin. Inhalation is via the respiratory tract, infiltration refers to diffusion into tissues, and infusion is administration into the bloodstream.
In the absence of Dinoprostone, which drug is commonly used first for cervical ripening in labor induction?
- Oxytocin
- Methylergometrine
- Carboprost
- Misoprostol
Explanation: Answer reason: Misoprostol, a PGE1 analog, is commonly used for cervical ripening when dinoprostone (PGE2) is unavailable. Oxytocin induces uterine contractions but does not ripen the cervix; methylergometrine and carboprost are used mainly for postpartum hemorrhage.
What is the drug of choice for treating Swine flu?
- Acyclovir
- Adefovir
- Cidofovir
- Oseltamivir
Explanation: Answer reason: Swine flu is caused by influenza A (H1N1); neuraminidase inhibitors such as oseltamivir are the recommended first-line antivirals. The other options target herpes or DNA viruses, not influenza.
What is Propofol Injection used for?
- Anesthesia
- Constipation
- Labyrinthitis
- Tonsillitis
Explanation: Answer reason: Propofol is an intravenous general anesthetic used for induction and maintenance of anesthesia and procedural sedation; it does not treat constipation, labyrinthitis, or tonsillitis.
What condition is prevented by injection of Konakion (Phytomenadion, Vitamin K)?
- Blood clotting
- Meningitis
- Nephritis
- Blepharitis
Explanation: Answer reason: Konakion (vitamin K1) promotes synthesis of clotting factors II, VII, IX, and X, preventing vitamin K deficiency bleeding. Of the choices, it is related to blood clotting.
What is the antidote for Diazepam overdose?
- Flumazenil
- Naloxone
- Fomepizole
- Deferoxamine
Explanation: Answer reason: Diazepam is a benzodiazepine; flumazenil is a competitive benzodiazepine receptor antagonist that reverses benzodiazepine effects. Naloxone treats opioid overdose, fomepizole treats ethylene glycol/methanol poisoning, and deferoxamine treats iron toxicity.
Deferoxamine is an antidote used to treat which condition?
- Iron Toxicity
- Lead Toxicity
- Digoxin Toxicity
- Cholinergic Toxicity
Explanation: Answer reason: Deferoxamine is an iron-chelating agent that binds free iron to form ferrioxamine, promoting urinary excretion. It is used for acute iron poisoning and iron overload. Lead uses EDTA/dimercaprol or succimer; digoxin uses digoxin-specific Fab; cholinergic toxicity uses atropine +/- pralidoxime.
Think you’re ready for the NCLEX?
Run through a full 150-question exam just like the real thing. You’ll hit the 85-question checkpoint and get a clear report showing where you stand.