Pharmacology Practice Test 22
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 22nd 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.
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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 22
What is the rare but characteristic adverse effect of Atorvastatin?
- Neuropathy
- Myopathy
- Onycholysis
- Alopecia
Explanation: Answer reason: Statins can rarely but characteristically cause dose-related myopathy/rhabdomyolysis; the other options are not typical hallmark effects.
On which day of the menstrual cycle should the first oral contraceptive pill be started?
- 5th
- 10th
- 2nd
- 7th
Explanation: Answer reason: Traditional regimen initiates combined oral contraceptives on the 5th day of the menstrual cycle to ensure non-pregnancy and cycle alignment; among given options, 5th day is correct.
What is the antidote of Digoxin?
- CCB
- Glucogan
- Digibind
- Activated Charcol
Explanation: Answer reason: Digoxin immune Fab (Digibind) binds circulating digoxin and neutralizes its effects; the others are not specific antidotes for digoxin toxicity.
Which medication is the odd one out among the following antiemetics?
- Ondansetron
- Domperidone
- Duloxetine
Explanation: Answer reason: Duloxetine is an SNRI antidepressant, not an antiemetic. Ondansetron (5-HT3 antagonist) and domperidone (dopamine antagonist/prokinetic) are antiemetics.
Which of the following drug-urine color pairs is incorrect?
- Phenazopyridine - Orange
- Nitrofurantoin - Brown
- Metronidazole - Blue
- Rifampicin - Red
Explanation: Answer reason: Metronidazole may darken urine to a brown or reddish-brown color, not blue. The other pairs are accurate: phenazopyridine—orange, nitrofurantoin—brown, rifampicin—red.
Which of the following is NOT a beta-lactam antibiotic?
- Amoxicillin
- Aztreonam
- Vancomycin
- Ceftriaxone
Explanation: Answer reason: Vancomycin is a glycopeptide antibiotic, not a beta-lactam. Amoxicillin (penicillin), Aztreonam (monobactam), and Ceftriaxone (cephalosporin) are beta-lactams.
What are the most common side effects of chemotherapy?
- Hair Loss
- Loss of Appetite
- Weight Loss
- All of the Above
Explanation: Answer reason: Alopecia, anorexia, and weight loss are all common adverse effects associated with chemotherapy regimens; therefore, all listed options are correct.
Furosemide is used in the treatment of which conditions?
- Hypertension
- Heart failure
- Oedema
- All
Explanation: Answer reason: Furosemide is a loop diuretic used to lower blood pressure and relieve fluid overload; it is indicated for hypertension and for edema due to heart failure and other causes.
What is the term for the frequency of administration of a drug in a particular dose?
- Onset-of action
- Duration of action
- Dosage form
- Dosage regimen
Explanation: Answer reason: The schedule that specifies how often and at what dose a drug is given is the dosage regimen.
Which of the following drugs is most likely to cause ototoxicity?
- Tazobactum
- Cefazoline
- Sitagliptin
- Gentamicin
Explanation: Answer reason: Gentamicin is an aminoglycoside antibiotic; this class is well known for ototoxicity due to cochlear and vestibular hair cell toxicity. The other listed drugs are not commonly associated with ototoxicity.
Pharmacokinetics is?
- The study of biological and therapeutic effects of drugs
- The study of absorption, distribution, metabolism and excretion of drugs
- The study of mechanisms of drug action
- The study of methods of new drug development
Explanation: Answer reason: Pharmacokinetics refers to what the body does to a drug—absorption, distribution, metabolism, and excretion (ADME).
The main mechanism of most drugs absorption in GI tract is?
- Active transport (carrier-mediated diffusion)
- Filtration (aqueous diffusion)
- Endocytosis and exocytosis
- Passive diffusion (lipid diffusion)
Explanation: Answer reason: Most drugs are absorbed across GI membranes by nonionized, lipophilic passive diffusion; the other mechanisms account for a minority of drugs.
What kind of substances can't permeate membranes by passive diffusion?
- Lipid-soluble
- Non-ionized substances
- Hydrophobic substances
- Hydrophilic substances
Explanation: Answer reason: Simple lipid diffusion favors lipid-soluble, nonionized, hydrophobic molecules. Hydrophilic (often ionized) substances cannot cross the lipid bilayer by passive diffusion.
A hydrophilic medicinal agent has the following property?
- Low ability to penetrate through the cell membrane lipids
- Penetrate through membranes by means of endocytosis
- Easy permeation through the blood-brain barrier
- High reabsorption in renal tubules
Explanation: Answer reason: Hydrophilic (water-soluble) drugs have poor lipid solubility and therefore cross lipid membranes poorly, including the BBB; they are also less reabsorbed in renal tubules. Thus option A best describes their property.
What is implied by active transport?
- Transport of drugs trough a membrane by means of diffusion
- Transport without energy consumption
- Engulf of drug by a cell membrane with a new vesicle formation
- Transport against concentration gradient
Explanation: Answer reason: Active transport moves substances against their concentration gradient and requires energy. The other options describe diffusion, energy-free transport, or endocytosis.
What does the term "bioavailability" mean?
- Plasma protein binding degree of substance
- Permeability through the brain-blood barrier
- Fraction of an uncharged drug reaching the systemic circulation following any route administration
- Amount of a substance in urine relative to the initial doze
Explanation: Answer reason: Bioavailability is the fraction of an administered dose that reaches the systemic circulation unchanged; this is option C.
The reasons determing bioavailability are?
- Rheological parameters of blood
- Amount of a substance obtained orally and quantity of intakes
- Extent of absorption and hepatic first-pass effect
- Glomerular filtration rate
Explanation: Answer reason: Bioavailability is the fraction of an administered dose reaching systemic circulation. It is primarily determined by the extent of gastrointestinal absorption and the degree of hepatic first-pass metabolism. Blood rheology and glomerular filtration rate do not directly determine bioavailability.
Parenteral administration?
- Cannot be used with unconsciousness patients
- Generally results in a less accurate dosage than oral administration
- Usually produces a more rapid response than oral administration
- Is too slow for emergency use
Explanation: Answer reason: Parenteral routes (e.g., IV, IM, SC) bypass the GI tract, providing rapid onset and accurate dosing; they can be used in unconscious patients and are suitable for emergencies. Hence, option C is correct.
What is characteristic of the intramuscular route of drug administration?
- Only water solutions can be injected
- Oily solutions can be injected
- Opportunity of hypertonic solution injections
- The action develops slower, than at oral administration
Explanation: Answer reason: IM injections can deliver aqueous, oily, and suspension (depot) preparations; they act faster than oral and hypertonic solutions are generally avoided due to tissue irritation.
What is the reason of complicated penetration of some drugs through brain-blood barrier?
- High lipid solubility of a drug
- Meningitis
- Absence of pores in the brain capillary endothelium
- High endocytosis degree in a brain capillary
Explanation: Answer reason: The blood-brain barrier endothelium has tight junctions and lacks fenestrations, limiting paracellular passage of many drugs. Thus the absence of pores restricts penetration.
The volume of distribution (Vd) relates?
- Single to a daily dose of an administrated drug
- An administrated dose to a body weight
- An uncharged drug reaching the systemic circulation
- The amount of a drug in the body to the concentration of a drug in plasma
Explanation: Answer reason: Volume of distribution is defined as Vd = amount of drug in the body divided by the plasma drug concentration. The other options describe dosing, weight-normalization, or bioavailability concepts, not Vd.
For the calculation of the volume of distribution (Vd) one must take into account?
- Concentration of a substance in plasma
- Concentration of substance in urine
- Therapeutical width of drug action
- A daily dose of drug
Explanation: Answer reason: Vd is defined as the amount of drug in the body divided by its plasma concentration. Thus plasma concentration is required; urine concentration, therapeutic range, or daily dose are not used to calculate Vd.
The term “biotransformation” includes the following?
- Accumulation of substances in a fat tissue
- Binding of substances with plasma proteins
- Accumulation of substances in a tissue
- Process of physicochemical and biochemical alteration of a drug in the body
Explanation: Answer reason: Biotransformation refers to drug metabolism—chemical modification of drugs by the body. The other options describe storage or binding, not transformation.
Pick out the right statement?
- Microsomal oxidation always results in inactivation of a compound
- Microsomal oxidation results in a decrease of compound toxicity
- Microsomal oxidation results in an increase of ionization and water solubility
- Microsomal oxidation results in an increase of lipid solubility of a drug thus its ex
Explanation: Answer reason: Microsomal (CYP450) oxidation is a Phase I reaction that adds/uncovers polar groups, increasing ionization and water solubility for excretion. It does not always inactivate drugs and can increase or decrease toxicity; it decreases, not increases, lipid solubility.
Pick out the right statement?
- Microsomal oxidation always results in inactivation of a compound
- Microsomal oxidation results in a decrease of compound toxicity
- Microsomal oxidation results in an increase of ionization and water solubility of a drug
- Microsomal oxidation results in an increase of lipid solubility of a drug thus its excretion from the organism is facilitated
Explanation: Answer reason: Cytochrome P450–mediated (microsomal) oxidation is a Phase I reaction that introduces or exposes functional groups, increasing polarity/ionization and water solubility. It does not always inactivate drugs and can produce toxic metabolites; it does not increase lipid solubility.
Stimulation of liver microsomal enzymes can?
- Require the dose increase of some drugs
- Require the dose decrease of some drugs
- Prolong the duration of the action of a drug
- Intensify the unwanted reaction of a drug
Explanation: Answer reason: Enzyme induction increases hepatic metabolism, lowering plasma levels and effect of many drugs. This typically shortens duration and necessitates higher doses; it does not usually require dose decreases or prolong action.
Metabolic transformation (phase 1) is?
- Acetylation and methylation of substances
- Transformation of substances due to oxidation, reduction or hydrolysis
- Glucuronide formation
- Binding to plasma proteins
Explanation: Answer reason: Phase I metabolism involves functionalization reactions such as oxidation, reduction, or hydrolysis. Acetylation, methylation, and glucuronidation are Phase II conjugation reactions, and plasma protein binding is distribution, not metabolism.
In case of liver disorders accompanied by a decline in microsomal enzyme activity the duration of action of some drugs is?
- Decreased
- Enlarged
- Remained unchanged
- Changed insignificantly
Explanation: Answer reason: Hepatic dysfunction with reduced microsomal enzyme activity slows drug metabolism, decreasing clearance and prolonging duration of action.
Half life (t 1/2) is the time required to?
- Change the amount of a drug in plasma by half during elimination
- Metabolize a half of an introduced drug into the active metabolite
- Absorb a half of an introduced drug
- Bind a half of an introduced drug to plasma proteins
Explanation: Answer reason: Half-life is defined as the time for the plasma concentration or amount of drug in the body to decrease by 50% due to elimination, not absorption, metabolism to active metabolite, or protein binding.
Elimination is expressed as follows?
- Rate of renal tubular reabsorption
- Clearance speed of some volume of blood from substance
- Time required to decrease the amount of drug in plasma by one-half
- Clearance of an organism from a xenobiotic
Explanation: Answer reason: In pharmacokinetics, drug elimination is quantified by clearance, defined as the volume of blood (or plasma) from which a substance is completely removed per unit time. Option C defines half-life, not the definition of elimination.
Systemic clearance (CLs) is related with?
- Only the concentration of substances in plasma
- Only the elimination rate constant
- Volume of distribution, half life and elimination rate constant
- Bioavailability and half life
Explanation: Answer reason: Clearance is linked to elimination rate constant and volume of distribution (CL = k × Vd) and relates to half-life via t1/2 = 0.693 × Vd/CL, thus involving Vd, k, and half-life.
Pharmacodynamics involves the study of following EXCEPT?
- Biological and therapeutic effects of drugs
- Absorption and distribution of drugs
- Mechanisms of drug action
- Drug interactions
Explanation: Answer reason: Pharmacodynamics deals with what the drug does to the body—therapeutic effects, mechanisms of action, and interactions. Absorption and distribution are pharmacokinetics, not pharmacodynamics.
Pharmacodynamics involves the study of following?
- Mechanisms of drug action
- Biotransformation of drugs in the organism
- Distribution of drugs in the organism
- Excretion of drug from the organism
Explanation: Answer reason: Pharmacodynamics examines what the drug does to the body, including mechanisms and effects. The other options describe pharmacokinetics (biotransformation, distribution, excretion).
Pharmacodynamics involves the following?
- Information about main mechanisms of drug absorption
- Information about unwanted effects
- Information about biological barriers
- Information about excretion of a drug from the organism
Explanation: Answer reason: Pharmacodynamics explains what drugs do to the body—their mechanisms and effects, including adverse (unwanted) effects. Absorption, biological barriers (distribution), and excretion are pharmacokinetics.
Pick out the answer which is the most appropriate to the term "receptor"?
- All types of ion channels modulated by a drug
- Enzymes of oxidizing-reducing reactions activated by a drug
- Active macromolecular components of a cell or an organism which a drug molecule has to combine with in order to elicit its specific effect
- Carriers activated by a drug
Explanation: Answer reason: A receptor is defined in pharmacology as a specific macromolecular target that a drug binds to in order to produce a biological effect. Option C states this general definition; the other options describe particular types of targets but are not the broad definition.
What does “affinity” mean?
- A measure of how tightly a drug binds to plasma proteins
- A measure of how tightly a drug binds to a receptor
- A measure of inhibiting potency of a drug
- A measure of bioavailability of a drug
Explanation: Answer reason: Affinity is the strength of binding between a drug and its receptor; it is not about plasma protein binding, potency, or bioavailability.
An agonist is a substance that?
- Interacts with the receptor without producing any effect
- Interacts with the receptor and initiates changes in cell function, producing various effects
- Increases concentration of another substance to produce effect
- Interacts with plasma proteins and doesn’t produce any effect
Explanation: Answer reason: An agonist binds to a receptor and activates it, causing a cellular response. The other options describe antagonism, indirect effects, or protein binding without effect.
An antagonist is a substance that?
- Binds to the receptors and initiates changes in cell function, producing maximal effect
- Binds to the receptors and initiates changes in cell function, producing submaximal effect
- Interacts with plasma proteins and doesn't produce any effect
Explanation: Answer reason: An antagonist has no intrinsic activity at the receptor and therefore does not produce an effect; it blocks agonist action. Among the options, only the one indicating no effect best fits this concept.
A competitive antagonist is a substance that?
- Interacts with receptors and produces submaximal effect
- Binds to the same receptor site and progressively inhibits the agonist response
- Binds to the nonspecific sites of tissue
- Binds to one receptor subtype as an agonist and to another as an antagonist
Explanation: Answer reason: A competitive antagonist competes with an agonist at the same receptor site, reducing the agonist effect in a dose-dependent, surmountable manner.
The increase of second messengers’ (cAMP, cGMP, Ca2+ etc.) concentration leads to?
- Inhibition of intracellular protein kinases and protein phosphorylation
- Protein kinases activation and protein phosphorylation
- Blocking of interaction between a receptor and an effector
- Antagonism with endogenous ligands
Explanation: Answer reason: Second messengers such as cAMP, cGMP, and Ca2+ activate specific protein kinases (e.g., PKA, PKG, CaMK), resulting in phosphorylation of target proteins.
Tick the substances whose mechanisms are based on interaction with ion channels?
- Sodium channel blockers
- Calcium channel blockers
- Potassium channels activators
- All of the above
Explanation: Answer reason: All listed drug classes exert effects by directly interacting with ion channels: sodium channel blockers, calcium channel blockers, and potassium channel activators.
Give the definition for a therapeutical dose?
- The amount of a substance to produce the minimal biological effect
- The amount of a substance to produce effects hazardous for an organism
- The amount of a substance to produce the required effect in most patients
- The amount of a substance to accelerate an increase of concentration of medicine in an organism
Explanation: Answer reason: A therapeutic dose is defined as the dose that produces the desired clinical effect in most patients. Option A is threshold/minimal effective dose, B is toxic dose, and D describes a loading dose.
Pick out the correct definition of a toxic dose?
- The amount of substance to produce the minimal biological effect
- The amount of substance to produce effects hazardous for an organism
- The amount of substance to produce the necessary effect in most of patients
- The amount of substance to fast creation of high concentration of medicine in an organism
Explanation: Answer reason: A toxic dose is defined as the amount of a substance that produces harmful or hazardous effects in an organism.
Tachyphylaxis is?
- A drug interaction between two similar types of drugs
- Very rapidly developing tolerance
- A decrease in responsiveness to a drug, taking days or weeks to develop
- None of the above
Explanation: Answer reason: Tachyphylaxis is an acute, rapidly developing decrease in drug response after repeated doses in a short time—i.e., rapid tolerance. Options A and C describe different concepts.
Tolerance and drug resistance can be a consequence of?
- Change in receptors, loss of them or exhaustion of mediators
- Increased receptor sensitivity
- Decreased metabolic degradation
- Decreased renal tubular secretion
Explanation: Answer reason: Tolerance commonly results from receptor downregulation/desensitization or depletion of mediators. Increased receptor sensitivity or reduced elimination would enhance drug effect, not cause tolerance.
The situation when failure to continue administering the drug results in serious psychological and somatic disturbances is called?
- Tachyphylaxis
- Sensibilization
- Abstinence syndrome
- Idiosyncrasy
Explanation: Answer reason: Stopping a dependent drug causing significant psychological and physical disturbances describes withdrawal, i.e., abstinence syndrome.
What is the type of drug-to-drug interaction which is connected with processes of absorption, biotransformation, distribution and excretion?
- Pharmacodynamic interaction
- Physical and chemical interaction
- Pharmaceutical interaction
- Pharmacokinetic interaction
Explanation: Answer reason: Absorption, distribution, metabolism (biotransformation), and excretion are ADME processes, which define pharmacokinetics; drug–drug interactions affecting these are pharmacokinetic interactions.
What is the type of drug-to-drug interaction which is the result of interaction at receptor, cell, enzyme or organ level?
- Pharmacodynamic interaction
- Physical and chemical interaction
- Pharmaceutical interaction
- Pharmacokinetic interaction
Explanation: Answer reason: Pharmacodynamic interactions occur at the receptor/effector level (cells, enzymes, organs), altering the drug’s effect. Pharmacokinetic interactions involve ADME, and pharmaceutical/physical-chemical interactions are compatibility issues before absorption.
If two drugs with the same effect, taken together, produce an effect that is equal in magnitude to the sum of the effects of the drugs given individually, it is called as?
- Antagonism
- Potentiation
- Additive effect
- None of the above
Explanation: Answer reason: When the combined response of two drugs equals the arithmetic sum of their individual effects, the interaction is additive.
The term "chemical antagonism" means that?
- Two drugs combine with one another to form an inactive compound
- Two drugs combine with one another to form a more active compound
- Two drugs combine with one another to form a more water soluble compound
- Two drugs combine with one another to form a more fat soluble compound
Explanation: Answer reason: Chemical antagonism occurs when two substances directly interact to form an inactive complex, reducing the effect of the active drug.
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