Pharmacology Practice Test 3
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 3rd 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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Pharmacology Practice Test 3
The mechanism of action of aspirin is?
- Converts inactive plasminogen into active plasmin.
- Inhibits COX and, thus, thromboxane synthesis.
- Enhances the interaction of antithrombin III with both thrombin and the factors involved in the intrinsic clotting cascade.
- Inhibits the glycoprotein IIb/IIIa complex.
Explanation: Answer reason: Aspirin irreversibly acetylates cyclooxygenase (COX), preventing thromboxane A2 synthesis in platelets and thereby inhibiting aggregation.
Most antipsychotic drugs?
- Strongly block postsynaptic D2 receptor
- Stimulate the postsynaptic D2 receptor
- Block the NMDA receptor.
- Stimulate the 5-HT2 receptor
Explanation: Answer reason: Most antipsychotics are dopamine D2 receptor antagonists, reducing dopaminergic transmission in the mesolimbic system and alleviating psychotic symptoms.
Tick the feature of the sublingual route?
- Pretty fast absorption.
- The drug is exposed to gastric secretions.
- The drug is exposed to more prominent liver metabolism.
- The drug can be administered in a variety of doses.
Explanation: Answer reason: Sublingual administration provides rapid absorption through the oral mucosa and bypasses gastric exposure and first-pass hepatic metabolism, but dosing variety is limited.
Beta2-receptor stimulation includes all of the following effects EXCEPT?
- Stimulation of renin secretion
- Fall in potassium concentration in plasma
- Relaxation of the bladder and uterus
- Tachycardia
Explanation: Answer reason: Beta2 activation causes smooth muscle relaxation (e.g., uterus, bladder) and promotes cellular K+ uptake, leading to decreased plasma potassium. Renin secretion is primarily stimulated by beta1 receptors in juxtaglomerular cells, not beta2; therefore, it is the exception.
Which of the following sympathomimetics is preferable for the treatment of chronic orthostatic hypotension?
- Epinephrine
- Norepinephrine
- Ephedrine
- Salmeterol
Explanation: Answer reason: Ephedrine is an orally active mixed alpha- and beta-agonist that increases vascular tone and cardiac output, making it useful for chronic orthostatic hypotension. Epinephrine and norepinephrine are short-acting parenteral agents, and salmeterol is a beta2-selective bronchodilator.
Indicate the beta-adrenoceptor antagonist that has partial beta-agonist activity?
- Propranolol
- Metoprolol
- Pindolol
- Betaxolol
Explanation: Answer reason: Pindolol is a nonselective beta-blocker with intrinsic sympathomimetic activity (a partial agonist). Propranolol, metoprolol, and betaxolol lack ISA.
Indicate an antiseizure drug that has an potent effect on the T-type calcium channels in thalamic neurons?
- Carbamazepine
- Lamotrigine
- Ethosuximide
- Phenytoin
Explanation: Answer reason: Ethosuximide blocks T-type calcium channels in thalamic neurons—the key mechanism for treating absence seizures.
The mechanism of action of both topiramate and felbamate is?
- Reduction of excitatory glutamatergic neurotransmission
- Inhibition of voltage-sensitive Na+ channels
- Potentiation of GABAergic neuronal transmission
- All of the above.
Explanation: Answer reason: Both agents reduce excitatory glutamatergic signaling (AMPA/NMDA antagonism), inhibit voltage-gated sodium channels, and enhance GABAergic transmission, so all the listed mechanisms apply.
A long-acting drug effective against both absence and myoclonic seizures is?
- Primidone
- Carbamazepine
- Clonazepam
- Phenytoin
Explanation: Answer reason: Clonazepam is a long-acting benzodiazepine effective for both absence and myoclonic seizures. Carbamazepine and phenytoin can worsen absence seizures, and primidone is not preferred for these seizure types.
Which of the following non-opioid agents is an antidepressant with analgesic activity?
- Fluoxetine
- Moclobemide
- Tranylcypromine
- Amitriptyline
Explanation: Answer reason: Amitriptyline, a tricyclic antidepressant, has established analgesic properties, especially for neuropathic pain. Fluoxetine (an SSRI) and the MAOIs moclobemide and tranylcypromine are not used as analgesics.
Indicate the antidepressant that blocks the reuptake pumps for serotonin and norepinephrine?
- Amitriptyline
- Fluoxetine
- Maprotiline
- Phenelzine
Explanation: Answer reason: Amitriptyline is a tricyclic antidepressant that inhibits reuptake of both serotonin and norepinephrine. Fluoxetine is an SSRI (serotonin-only); Maprotiline is primarily a norepinephrine reuptake inhibitor; and Phenelzine is an MAOI.
Which of the following drugs is a proteolytic enzyme?
- Potassium iodide
- Deoxyribonuclease
- Carbocysteine
- Acetylcysteine
Explanation: Answer reason: Among the choices, deoxyribonuclease is the enzymatic mucolytic (an enzyme preparation), whereas potassium iodide, carbocysteine, and acetylcysteine are non-enzymatic agents.
Tick the drug belonging to non-selective beta2-adrenomimetics?
- Salbutamol
- Isoprenaline
- Salmeterol
- Terbutaline
Explanation: Answer reason: Isoprenaline (isoproterenol) is a non-selective beta-adrenergic agonist acting on both beta1 and beta2 receptors, whereas salbutamol, salmeterol, and terbutaline are selective beta2 agonists.
Indicate an antiemetic agent that is related to neuroleptics?
- Metoclopramide
- Nabilone
- Tropisetron
- Prochlorperazine
Explanation: Answer reason: Prochlorperazine is a phenothiazine neuroleptic (a dopamine D2 antagonist) used as an antiemetic; the others are not neuroleptics.
This drug is used intravenously to terminate supraventricular tachycardias?
- Nifedipine
- Verapamil
- Both of the above.
- None of the above
Explanation: Answer reason: IV verapamil slows AV nodal conduction and is effective for terminating PSVT and other supraventricular tachycardias. Nifedipine (a dihydropyridine) is not used for this purpose.
Which of the following nitrate and nitrite drugs is short-acting?
- Nitroglycerin 2% ointment (Nitrol)
- Nitroglycerin, oral, sustained-release (Nitrong)
- Amyl nitrite inhalant (Aspirols, Vaporele)
- Sustac
Explanation: Answer reason: Inhaled amyl nitrite has a rapid onset, within seconds, and a very short duration of action; ointment and sustained-release nitrates (including Sustac) are long-acting formulations.
Which of the following antianginal agents is a beta-adrenoceptor-blocking drug?
- Dipyridamole
- Validol
- Atenolol
- Alindine
Explanation: Answer reason: Atenolol is a cardioselective beta-1 adrenergic blocker used for angina. Dipyridamole is a vasodilator/antiplatelet; Validol is a sedative/vasodilatory remedy; and Alindine is not a beta-blocker.
Characteristics of pilocarpine include all of the following except?
- It is a tertiary amine alkaloid.
- It causes miosis and decreases intraocular pressure.
- Causes a decrease in the secretory and motor activity of the gut.
- It is useful in the treatment of glaucoma.
Explanation: Answer reason: Pilocarpine is a direct-acting muscarinic agonist that stimulates parasympathetic activity, leading to increased glandular secretion, miosis, and enhanced gastrointestinal motility. It does not decrease GI activity. Its clinical use in glaucoma reduces intraocular pressure by facilitating aqueous humor outflow.
Most strong mu-receptor agonists cause?
- Hypertension
- Increasing pulmonary arterial pressure and myocardial work.
- Cerebral vasodilation causes an increase in intracranial pressure.
- All of the above.
Explanation: Answer reason: Mu-opioid receptor agonists such as morphine depress respiration, increasing carbon dioxide levels and leading to cerebral vasodilation, which raises intracranial pressure. They typically reduce blood pressure and myocardial workload through vasodilation and decreased sympathetic tone, not increase them.
Antimuscarinics are used in the treatment of the following disorders except?
- Motion sickness
- Glaucoma
- Hyperhidrosis
- Asthma
Explanation: Answer reason: Antimuscarinics are used for motion sickness (scopolamine), hyperhidrosis (glycopyrrolate), and as bronchodilators in asthma (ipratropium and tiotropium). They are contraindicated in glaucoma because they cause mydriasis and can increase intraocular pressure.
Nondepolarizing neuromuscular blocking agents?
- Block acetylcholine reuptake.
- Prevent access of the transmitter to its receptor and prevent depolarization.
- Block transmission with an excess of a depolarizing agonist
- All of the above.
Explanation: Answer reason: Nondepolarizing neuromuscular blockers are competitive antagonists at nicotinic acetylcholine receptors at the neuromuscular junction, thereby preventing ACh from binding and depolarization. They do not block ACh reuptake and do not act as excessive depolarizing agonists.
Which of the following agents is an alpha1-selective agonist?
- Norepinephrine
- Methoxamine
- Ritodrine
- Ephedrine
Explanation: Answer reason: Methoxamine is a selective alpha-1 adrenergic agonist. Norepinephrine and ephedrine act on multiple receptors, and ritodrine is a beta-2 agonist.
Which of the following drugs is a nonselective beta-receptor antagonist?
- Metoprolol
- Atenolol
- Propranolol
- Acebutolol
Explanation: Answer reason: Propranolol blocks both beta-1 and beta-2 receptors (nonselective). Metoprolol, atenolol, and acebutolol are primarily beta-1 selective.
Characteristics of reserpine include all of the following except?
- It inhibits the uptake of norepinephrine into vesicles and inhibits MAO.
- It decreases cardiac output and peripheral resistance, and inhibits pressor reflexes.
- It may cause a transient sympathomimetic effect.
- It depletes stores of catecholamines and serotonin in the brain.
Explanation: Answer reason: Reserpine irreversibly blocks VMAT, preventing the storage of monoamines in vesicles and leading to depletion of norepinephrine, dopamine, and serotonin. This lowers cardiac output and peripheral resistance and blunts pressor reflexes. It does not produce an initial transient sympathomimetic effect (seen with agents like guanethidine).
This drug inhibits the breakdown of cAMP in vascular smooth muscle?
- Digoxin
- Dobutamine
- Amrinone
- Dopamine
Explanation: Answer reason: Amrinone (inamrinone) is a phosphodiesterase-3 inhibitor that prevents the breakdown of cAMP in cardiac and vascular smooth muscle, causing increased inotropy and vasodilation. Digoxin inhibits Na+/K+-ATPase; dobutamine is a beta-1 agonist; dopamine is a catecholamine with dopaminergic, beta, and alpha effects.
Which of the following drugs is used to treat malaria?
- Chloroquine
- Mefloquine
- Artemether
- All of the above
Explanation: Answer reason: Chloroquine, mefloquine, and artemether are all antimalarial agents used to treat malaria; therefore, all listed options apply.
Which of the following is not a component of Ringer's lactate (RL)?
- Potassium chloride
- Calcium chloride
- Sodium chloride
- Potassium lactate
Explanation: Answer reason: Lactated Ringer's contains sodium chloride, potassium chloride, calcium chloride, and sodium lactate as the buffer. Potassium lactate is not a component.
Grey baby syndrome is the ADR of which drug?
- Amoxicillin
- Ceftriaxone
- Chloramphenicol
- Doxycycline
Explanation: Answer reason: Gray baby syndrome is a classic toxicity of chloramphenicol in neonates due to deficient glucuronidation, causing gray discoloration, hypotension, and cyanosis.
Chills, fever, and muscle aches are common reactions to which one of the following antiviral drugs?
- Acyclovir
- Amantadine
- Ribavirin
- Ganciclovir
Explanation: Answer reason: Ribavirin commonly causes influenza-like adverse effects such as fever, chills, and myalgias. Acyclovir is more associated with nephrotoxicity and neurotoxicity, amantadine with CNS effects and livedo reticularis, and ganciclovir with bone marrow suppression.
A patient has a cutaneous mycotic infection, so what should be the choice of drug?
- Ceftriaxone
- Isoniazid
- Rifampicin
- Terbinafine
Explanation: Answer reason: Cutaneous mycotic (dermatophyte) infections are treated with antifungals; terbinafine is a first-line agent. The other options are antibacterial or antitubercular drugs.
Which of the following local anesthetics is an acetanilide derivative?
- Tetracaine
- Lidocaine
- Cocaine
- Procaine
Explanation: Answer reason: Lidocaine (lignocaine) is an amide local anesthetic that is chemically an acetanilide (anilide) derivative, unlike tetracaine, cocaine, and procaine, which are ester derivatives.
Tetracaine has all of the following properties except?
- Slow onset
- Low potency
- Long duration
- High toxicity
Explanation: Answer reason: Tetracaine is a highly potent ester local anesthetic with a slow onset, long duration, and a higher toxicity risk; therefore, "low potency" is the exception.
Atropine causes?
- Bradycardia, hypotension, and bronchoconstriction
- Tachycardia, little effect on blood pressure, and bronchodilation.
- Decrease in contractile strength and conduction velocity through the AV node
- Tachycardia, hypertensive crisis, and bronchodilation
Explanation: Answer reason: Atropine is an antimuscarinic that blocks vagal effects, increases SA rate and AV conduction (causing tachycardia), has minimal effect on blood pressure due to limited parasympathetic control of vessels, and reduces bronchial smooth muscle tone, causing bronchodilation.
Indicate the long-acting neuromuscular-blocking agent?
- Rapacuronium
- Mivacurium
- Tubocurarine
- Rocuronium
Explanation: Answer reason: Among neuromuscular blockers, d-tubocurarine is a long-acting nondepolarizing agent. Mivacurium and rapacuronium are short-acting, and rocuronium is intermediate-acting.
Which of the following drugs is an imidazoline derivative and a potent competitive antagonist at both alpha1 and alpha2 receptors?
- Prazosin
- Labetalol
- Phenoxybenzamine
- Phentolamine
Explanation: Answer reason: Phentolamine is an imidazoline derivative that reversibly and competitively blocks both alpha1 and alpha2 receptors. Prazosin is selective for alpha1; phenoxybenzamine is an irreversible, noncompetitive alpha blocker (a haloalkylamine); and labetalol is a mixed beta/alpha blocker, not an imidazoline alpha1/alpha2 antagonist.
Indicate an alpha receptor antagonist that is an efficacious drug in the treatment of mild to moderate systemic hypertension?
- Phentolamine
- Tolazoline
- Ergotamine
- Prazosin
Explanation: Answer reason: Prazosin is a selective alpha-1 adrenergic antagonist effective in treating mild to moderate hypertension. Phentolamine and tolazoline are nonselective alpha blockers used mainly for pheochromocytoma or hypertensive crises; ergotamine is not an antihypertensive.
Pindolol and oxprenolol have all of the following properties except?
- They are nonselective beta-antagonists.
- They have no partial agonist activity.
- They are less likely to cause bradycardia and abnormalities in plasma lipids.
- They are effective for hypertension and angina.
Explanation: Answer reason: Pindolol and oxprenolol are nonselective beta blockers with intrinsic sympathomimetic activity (partial agonist activity). Because they have ISA, they cause less bradycardia and fewer lipid abnormalities and are useful in treating hypertension and angina. Therefore, the statement that they have no partial agonist activity is the exception.
Select a hypnotic drug that is a benzodiazepine derivative?
- Zolpidem
- Flurazepam
- Secobarbital
- Phenobarbital
Explanation: Answer reason: Flurazepam is a benzodiazepine hypnotic. Zolpidem is a non-benzodiazepine Z-drug, and secobarbital and Phenobarbital are barbiturates.
The most effective drug for stopping generalized tonic-clonic status epilepticus in adults is?
- Lamotrigine
- Ethosuximide
- Diazepam
- Zonisamide
Explanation: Answer reason: First-line therapy for stopping status epilepticus is an IV benzodiazepine; diazepam (or lorazepam) rapidly terminates seizures. Ethosuximide is used for absence seizures, and lamotrigine and zonisamide are not used for acute status.
Which of the following antiseizure drugs binds to an allosteric regulatory site on the GABA-BZ receptor and increases the duration of Cl- channel openings?
- Diazepam
- Valproate
- Phenobarbital
- Topiramate
Explanation: Answer reason: Barbiturates such as phenobarbital act at an allosteric site on the GABA-A receptor complex and prolong the duration of chloride channel opening. Diazepam (a benzodiazepine) increases the frequency, while valproate and topiramate act via other mechanisms.
Which of the following antipsychotic agents is preferable for patients with coronary and cerebrovascular disease?
- Chlorpromazine
- Fluphenazine
- Haloperidol
- Perphenazine
Explanation: Answer reason: Haloperidol (a butyrophenone) has less alpha-1-blocking and anticholinergic activity than phenothiazines such as chlorpromazine, fluphenazine, and perphenazine, so it causes less orthostatic hypotension and is generally preferred in patients with cardiovascular or cerebrovascular disease.
Which of the following antipsychotic agents is used in combination with the opioid fentanyl in neuroleptanalgesia?
- Haloperidol
- Droperidol
- Chlorpromazine
- Clozapine
Explanation: Answer reason: Neuroleptanalgesia is classically produced by combining the butyrophenone antipsychotic droperidol with fentanyl (e.g., Innovar).
Indicate the inhaled anesthetic that may cause nephrotoxicity?
- Halothane
- Sevoflurane
- Nitrous oxide
- Diethyl ether
Explanation: Answer reason: Sevoflurane can release fluoride ions and form compound A during low-flow anesthesia, and compound A has been associated with renal injury; halothane is linked to hepatotoxicity, nitrous oxide to B12-related hematologic effects, and diethyl ether is not known to be nephrotoxic.
Pick out the bronchodilator drug related to xanthines?
- Atropine
- Orciprenaline
- Adrenaline
- Theophylline
Explanation: Answer reason: Theophylline is a methylxanthine bronchodilator. The others are not xanthines (atropine is an anticholinergic; orciprenaline and adrenaline are adrenergic agonists).
Choose the drug affecting the biliary system and relaxing the sphincter of Oddi?
- Cholosas
- Oxaphenamide
- No-Spa
- Cholenzyme
Explanation: Answer reason: No-Spa (drotaverine) is a smooth-muscle antispasmodic that relaxes the sphincter of Oddi, relieving biliary spasm.
All of the following agents are cardiac glycosides EXCEPT?
- Digoxin
- Strophanthin K
- Amrinone
- Digitoxin
Explanation: Answer reason: Amrinone (inamrinone) is a phosphodiesterase-3 inhibitor and inotrope, not a cardiac glycoside. Digoxin, Strophanthin K, and Digitoxin are cardiac glycosides.
Which of the following statements concerning the mechanism of action of nitrates is true?
- Therapeutically active agents in this group are capable of releasing nitric oxide (NO) into vascular smooth muscle target tissues.
- Nitric oxide (NO) is an effective activator of soluble guanylyl cyclase and probably acts mainly through this mechanism.
- Nitrates, useful in angina, decrease myocardial oxygen requirements (by decreasing the determinants of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm).
- All of the above
Explanation: Answer reason: All statements are correct: organic nitrates release NO in vascular smooth muscle; NO activates soluble guanylyl cyclase to increase cGMP, causing relaxation; and clinically, nitrates reduce myocardial oxygen demand and relieve coronary spasm to improve oxygen delivery.
The following agents are cardioselective beta1-adrenoceptor-blocking drugs labeled for use in angina, except?
- Metoprolol
- Talinolol
- Atenolol
- Propranolol
Explanation: Answer reason: Propranolol is a nonselective beta-blocker (β1 and β2). Metoprolol, talinolol, and atenolol are cardioselective β1-blockers.
This drug is a non-peptide angiotensin II receptor antagonist?
- Clonidine
- Captopril
- Losartan
- Diazoxide
Explanation: Answer reason: Losartan is an angiotensin II receptor blocker (ARB) and a non-peptide antagonist at AT1 receptors. Clonidine is an alpha-2 agonist, captopril is an ACE inhibitor, and diazoxide is a potassium-channel opener and vasodilator.
Cloxacillin is indicated in infections caused by which organism?
- Staphylococci
- Streptococci
- Gonococci
- All of the above.
Explanation: Answer reason: Cloxacillin is a penicillinase-resistant penicillin with primary activity against penicillinase-producing Staphylococcus aureus (MSSA). It is not used for gonococci and is not first-line for streptococci.
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