Question 1

Odd One Out H2 receptor blockers

Accepted Answer

Answer reason: Tizanidine The other listed drugs are histamine-2 receptor antagonists used to reduce gastric acid secretion for conditions like GERD and peptic ulcer disease. This option is a centrally acting alpha-2 adrenergic agonist used as a skeletal muscle relaxant for spasticity, not an acid-suppressing agent. Therefore it does not belong to the H2-blocker class.
Category reason: This question tests recognition of medication classes (H2 receptor antagonists vs a different pharmacologic agent), which is a foundational drug-classification task in Pharmacology rather than a nursing intervention scenario.

Question 2

Patients with chronic kidney disease should avoid magnesium-based antacids.?

Accepted Answer

Answer reason: True Reduced renal clearance in chronic kidney disease increases the risk of magnesium accumulation when magnesium-containing antacids are used. This can lead to hypermagnesemia with neuromuscular depression (weakness, diminished reflexes), hypotension, bradyarrhythmias, and potentially respiratory depression. For patients with impaired kidney function, safer alternatives are typically preferred and electrolyte-containing OTC products should be used cautiously.
Category reason: This tests medication safety based on altered drug/electrolyte elimination in kidney disease, which is primarily a pharmacology concept.

Question 3

Which medication reduces blood pressure by decreasing fluid volume?

Accepted Answer

Answer reason: Diuretic Diuretics lower blood pressure primarily by promoting renal excretion of sodium and water, which decreases intravascular volume and reduces cardiac output. Over time, they also reduce peripheral vascular resistance, contributing to sustained BP reduction. Beta blockers mainly decrease heart rate/contractility and renin release; calcium channel blockers reduce vascular smooth muscle tone; nitroglycerin primarily venodilates to reduce preload rather than lowering BP via fluid loss.
Category reason: This tests the mechanism of action of antihypertensive drug classes (how they reduce blood pressure), which is a core Pharmacology concept rather than a nursing judgment/intervention scenario.

Question 4

Drug of choice for paracetamol poisoning?

Accepted Answer

Answer reason: N-Acetyl Cysteine It replenishes hepatic glutathione stores and enhances detoxification of the toxic paracetamol metabolite (NAPQI), preventing or limiting liver injury. It is most effective when started early after overdose, but still provides benefit even with delayed presentation in many cases. Other listed agents are antidotes for different toxicities (e.g., calcium gluconate for calcium channel blocker/fluoride exposure complications, flumazenil for benzodiazepines) and do not treat acetaminophen hepatotoxicity.
Category reason: This question tests knowledge of the specific antidote used in acetaminophen (paracetamol) overdose, which is a core Pharmacology concept.

Question 5

Odd One Out Emetics

Accepted Answer

Answer reason: Morphine The other options are classic emetics used to induce vomiting (apomorphine is a centrally acting emetic; ipecac and emetine are related to ipecac and have emetic activity). This option is an opioid analgesic that more commonly causes nausea/vomiting as an adverse effect rather than being used therapeutically to induce emesis. Therefore it does not belong in the emetics group.
Category reason: This is a medication classification question asking which drug is not an emetic, which is primarily pharmacology knowledge rather than a nursing care decision.

Question 6

Which of the following is NOT a side effect of Sodium Bicarbonate?

Accepted Answer

Answer reason: Hypoglycemia Sodium bicarbonate adds a significant sodium load and can increase intravascular volume, so hypernatremia and fluid overload are recognized adverse effects, especially with IV use. Alkalinization also promotes intracellular shift of potassium, which can precipitate hypokalemia. It does not directly lower blood glucose; hypoglycemia is not a typical adverse effect attributable to sodium bicarbonate.
Category reason: This item tests adverse effects of a medication (sodium bicarbonate), which is primarily pharmacology knowledge rather than a nursing judgment/prioritization scenario.

Question 7

Which of the following is a side effect of Sodium Bicarbonate?

Accepted Answer

Answer reason: Hypernatremia Sodium bicarbonate provides a significant sodium load, especially when given IV, which can raise serum sodium and contribute to fluid retention. This can worsen edema and precipitate or exacerbate heart failure in susceptible patients. It can also cause metabolic alkalosis, but among the listed choices, elevated sodium is the most direct adverse effect.
Category reason: This question tests an adverse effect of a medication (sodium bicarbonate), which is primarily Pharmacology rather than a nursing judgment scenario.

Question 8

Following injection is used for the treatment of?

Accepted Answer

Answer reason: Allergic reaction Triamcinolone acetonide is a corticosteroid injection used to treat inflammatory and allergic conditions by suppressing immune-mediated inflammation. It is not an antibiotic, so it does not treat syphilis, and it is not indicated for dyspepsia or gastritis (which are typically managed with acid suppression and/or eradication of infectious causes). Corticosteroids may actually worsen peptic disease risk, making the GI options inappropriate.
Category reason: This question tests identification of a medication (triamcinolone acetonide) and its therapeutic indication, which is pharmacology knowledge rather than a nursing care prioritization or intervention scenario.

Question 9

A patient on anti-depressants presented to you with hypotension. An ECG was done, which showed wide QRS complexes and right axis deviation. How will you manage this patient?

Accepted Answer

Answer reason: IV NaHCO3 The combination of hypotension with a wide QRS suggests sodium-channel blockade toxicity, classically from tricyclic antidepressant overdose. Sodium bicarbonate narrows the QRS and improves hemodynamics by increasing serum sodium and alkalinizing plasma, reducing drug binding to cardiac sodium channels. Other antiarrhythmics can worsen conduction slowing, and beta-blockers would aggravate hypotension and bradyarrhythmias. Phenytoin is not first-line for this toxidrome and does not address the primary conduction abnormality.
Category reason: This question tests recognition and treatment of antidepressant (especially TCA) cardiotoxicity based on ECG findings, which is primarily a pharmacology/toxicology management concept rather than a nursing process prioritization scenario.

Question 10

Which medicine is commonly used for piles/hemorrhoids?

Accepted Answer

Answer reason: Laxatives Reducing constipation and straining is a key part of hemorrhoid management because straining increases venous pressure in the hemorrhoidal plexus and worsens pain/bleeding. Laxatives and stool softeners help produce softer stools and ease defecation, thereby minimizing trauma to inflamed tissue. Aspirin can increase bleeding risk, diazepam is not indicated for this condition, and rifampicin is an antibiotic used primarily for tuberculosis and certain bacterial infections.
Category reason: This is primarily testing which drug class is used for symptomatic management of hemorrhoids, making it a medication-indication question best classified under Pharmacology rather than a nursing-care prioritization scenario.

Question 11

Odd One Out Anticancer drugs

Accepted Answer

Answer reason: Dapsone The other listed agents are used as antineoplastic therapies: cisplatin is a platinum-based chemotherapy, daunorubicin is an anthracycline antitumor antibiotic, and sorafenib is a tyrosine kinase inhibitor used in several cancers. This option is primarily an antimicrobial (sulfone) used for conditions such as leprosy, dermatitis herpetiformis, and as prophylaxis/treatment in certain infections. Therefore, it does not belong in the anticancer drug group.
Category reason: This question tests recognition of drug classes/indications and identifying which medication is not an antineoplastic agent, which is a core Pharmacology concept rather than a nursing care decision.

Question 12

IS THE AREA OF PHARMACOLOGY CONCERNED WITH THE UNDESIRABLE EFFECTS OF CHEMICALS ON BIOLOGIC SYSTEMS.??

Accepted Answer

Answer reason: Toxicology Toxicology is the branch of pharmacology that studies harmful and adverse effects of chemicals (including drugs and poisons) on living organisms. It focuses on mechanisms of toxicity, dose-response relationships, and organ-specific damage. The other options describe broader drug study (pharmacology), normal body function (physiology), and chemical processes in living systems (biochemistry) rather than specifically undesirable effects.
Category reason: This is a foundational drug-science question about adverse and harmful effects of chemicals/drugs, which is primarily studied within Pharmacology (including toxicology).

Question 13

A client taking antacids reports severe constipation. Which antacid is most likely responsible for this side effect?

Accepted Answer

Answer reason: Aluminum hydroxide Aluminum-containing antacids commonly cause constipation by decreasing gastrointestinal motility and having an astringent effect on the gut. In contrast, magnesium hydroxide tends to cause diarrhea due to its osmotic laxative effect. Calcium carbonate can also contribute to constipation, but aluminum salts are the classic and most strongly associated cause among standard antacid options. Sodium bicarbonate is more associated with systemic alkalosis and sodium load rather than constipation as a primary adverse effect.
Category reason: This question tests drug adverse effects and identification of which antacid is associated with constipation, which is core Pharmacology content.

Question 14

Which drug is commonly used for Helicobacter pylori treatment?

Accepted Answer

Answer reason: Omeprazole H. pylori eradication regimens commonly include a proton pump inhibitor to suppress gastric acid, improve antibiotic efficacy, and promote ulcer healing. Omeprazole is a standard PPI used in triple or quadruple therapy with antibiotics (e.g., clarithromycin/amoxicillin or metronidazole, plus bismuth in some regimens). Metformin is an antidiabetic drug and artesunate is an antimalarial, so neither is used for H. pylori treatment.
Category reason: This question tests knowledge of a medication used in a standard infectious disease treatment regimen (H. pylori therapy), which is primarily a pharmacology topic rather than a nursing care/prioritization scenario.

Question 15

The following is a macrolide antibiotic-?

Accepted Answer

Answer reason: Azithromycin Azithromycin is a macrolide antibiotic in the same class as erythromycin and clarithromycin, characterized by binding to the 50S ribosomal subunit to inhibit bacterial protein synthesis. Vancomycin is a glycopeptide antibiotic that inhibits cell wall synthesis, and clindamycin is a lincosamide, not a macrolide. Therefore, only one listed option fits the macrolide class, making “All of the above” incorrect.
Category reason: This question tests recognition of antibiotic drug classes, which is a core Pharmacology concept rather than a nursing care decision or safety/intervention scenario.

Question 16

Odd One Out Penicillins

Accepted Answer

Answer reason: Cefazolin It is a first-generation cephalosporin, whereas the others are penicillin-class antibiotics. Ampicillin is an aminopenicillin, and cloxacillin and methicillin are penicillinase-resistant antistaphylococcal penicillins. The question tests recognition of antibiotic classes based on drug names, which is a core pharmacology skill for anticipating spectrum and cross-reactivity.
Category reason: This question asks to distinguish drug classes within antibiotics, which is primarily medication classification knowledge and belongs to Pharmacology.

Question 17

A patient with osteoporosis is prescribed raloxifene. Which condition should the nurse assess for before administering this drug?

Accepted Answer

Answer reason: C. History of thromboembolism Raloxifene is a selective estrogen receptor modulator (SERM) that increases the risk of venous thromboembolism (e.g., DVT/PE). A prior thromboembolic event is a key contraindication/major precaution because the medication can further elevate clot risk. The other listed conditions are not primary pre-administration safety screens specific to this drug compared with thromboembolism history.
Category reason: This item tests drug safety screening/contraindications for raloxifene, which is primarily pharmacology knowledge rather than a nursing prioritization or care-management scenario.

Question 18

Which of the following is an expected outcome of digoxin therapy in a client with heart failure.?

Accepted Answer

Answer reason: Digoxin increases myocardial contractility (positive inotropy), which can raise stroke volume and overall cardiac output in systolic heart failure. As perfusion improves, symptoms of congestion typically lessen rather than worsen. It also tends to slow the heart rate by increasing vagal tone, so an increased heart rate would be unexpected. Improved forward flow commonly supports renal perfusion, making decreased urine output an incorrect expected outcome.
Category reason: This question tests the therapeutic effect of a specific medication (digoxin) and expected clinical outcome, which is primarily Pharmacology knowledge rather than a nursing judgment/prioritization scenario.

Question 19

Odd One Out Cephalosporins

Accepted Answer

Answer reason: Ciprofloxacin is a fluoroquinolone antibiotic, not a beta-lactam cephalosporin. The other listed drugs (cefazolin, cefalexin, and cephadroxil) are cephalosporins and share the beta-lactam mechanism of inhibiting bacterial cell wall synthesis. Fluoroquinolones instead inhibit bacterial DNA gyrase and topoisomerase IV, making this medication the clear outlier by class and mechanism.
Category reason: This is a drug-classification question distinguishing cephalosporins from a non-cephalosporin antibiotic, which is core Pharmacology knowledge rather than a nursing-care intervention scenario.

Question 20

Odd One Out Antidiarrhoeal agents

Accepted Answer

Answer reason: It is an osmotic laxative used primarily to treat constipation and hepatic encephalopathy by increasing stool water content and promoting bowel movements. The other listed drugs are used to manage diarrhea: loperamide and diphenoxylate reduce intestinal motility, while kaolin acts as an adsorbent to help firm stools. Therefore, this choice is not an antidiarrhoeal agent and is the odd one out.
Category reason: This question tests recognition of drug classes and therapeutic uses, which is core Pharmacology rather than a nursing care prioritization scenario.

Question 21

MINI-CASE FILE: BELL'S PALSY (3 DAYS DURATION) Which of the following medications is considered the standard first-line treatment for a patient presenting with Bell's palsy for the past three days?

Accepted Answer

Answer reason: Corticosteroids started within 72 hours of symptom onset reduce facial nerve inflammation and edema, improving the likelihood of complete recovery. Antivirals such as acyclovir are not considered superior to steroids alone for most cases and are typically reserved for select presentations or used as adjuncts. Vitamin B complex has no proven disease-modifying benefit in acute facial nerve palsy. Gabapentin treats neuropathic pain but does not address the underlying inflammatory neuropathy driving the facial weakness.
Category reason: This question tests knowledge of the medication that is first-line for Bell’s palsy within a specific time window, which is a pharmacologic treatment selection rather than a nursing-care prioritization scenario.

Question 22

Case: A 35-year-old asthmatic patient is prescribed montelukast. A week later, he complains of vivid dreams and mood swings. Which adverse effect of montelukast is the patient most likely experiencing?

Accepted Answer

Answer reason: Montelukast carries a known risk of neuropsychiatric adverse effects, including abnormal/vivid dreams, insomnia, agitation, anxiety, depression, and mood changes, which can occur soon after starting therapy. The patient’s vivid dreams and mood swings fit this characteristic profile. While other side effects can occur, these CNS/behavioral changes are the most directly supported by the presentation and the drug’s safety warnings. Clinically, such symptoms warrant prompt evaluation and consideration of discontinuation or alternative asthma control therapy.
Category reason: This item tests recognition of a specific adverse drug reaction associated with montelukast, which is a pharmacology-focused competency rather than a nursing care prioritization scenario.

Question 23

Which drug is given to a mother before preterm birth to accelerate fetal lung maturity?

Accepted Answer

Answer reason: Antenatal corticosteroids are administered when preterm birth is anticipated to stimulate type II pneumocytes and increase surfactant production, reducing neonatal respiratory distress syndrome and intraventricular hemorrhage risk. Dexamethasone (and betamethasone) are preferred because they cross the placenta effectively and have an evidence-based dosing regimen for fetal lung maturation. Prednisolone is largely inactivated by placental enzymes, making it less effective for this indication, and hydrocortisone/methylprednisolone are not standard first-line choices for fetal lung maturation.
Category reason: This tests identification of the appropriate medication used antenatally to accelerate fetal lung maturation, which is primarily pharmacologic knowledge about drug selection in pregnancy rather than nursing prioritization or bedside intervention.

Question 24

Which of the following is a drug used in the treatment of arrhythmia?

Accepted Answer

Answer reason: It is a class III antiarrhythmic that prolongs repolarization and refractory period, helping control both atrial and ventricular tachyarrhythmias. It is commonly used for rhythm control in atrial fibrillation and for ventricular arrhythmias such as VT/VF, especially in acute care settings. The other options are not antiarrhythmics: amoxicillin is an antibiotic and ibuprofen is an NSAID analgesic/anti-inflammatory.
Category reason: This question tests recognition of a medication class and its indication (antiarrhythmic therapy), which is a core Pharmacology concept rather than a nursing care decision.

Question 25

What is the drug of choice for the treatment and prophylaxis of Pneumocystis jiroveci pneumonia (PCP) in HIV-infected patients?

Accepted Answer

Answer reason: TMP-SMX is first-line for both treatment and primary prophylaxis of PCP in people with HIV due to strong efficacy and outcome data. Alternatives like pentamidine (often inhaled for prophylaxis or IV for treatment), dapsone (prophylaxis), and clindamycin (used with primaquine for treatment) are generally reserved for intolerance, contraindication, or failure of TMP-SMX. TMP-SMX also provides additional protection against some other opportunistic infections, which is advantageous in HIV care.
Category reason: This item tests knowledge of the first-line antimicrobial regimen for a specific opportunistic infection (PCP) and its prophylaxis, which is a medication-focused foundational science question under Pharmacology rather than a nursing care/judgment scenario.

Question 26

Odd One Out Macrolides

Accepted Answer

Answer reason: It is an aminoglycoside antibiotic (30S ribosomal inhibitor) rather than a macrolide. The other listed drugs are macrolides (or closely related agents) that primarily inhibit bacterial protein synthesis at the 50S ribosomal subunit. Therefore it does not belong to the macrolide class.
Category reason: This question tests drug classification within antibiotics, which is a core topic in Pharmacology rather than nursing care decision-making.

Question 27

Which of the following medication is used to treat osteoporosis?

Accepted Answer

Answer reason: It is a bisphosphonate that inhibits osteoclast-mediated bone resorption, increasing bone mineral density and reducing vertebral and hip fracture risk. The other choices do not treat the underlying increased bone turnover seen in osteoporosis: atropine is an anticholinergic, antacids mainly neutralize gastric acid, and ibuprofen is an NSAID for pain/inflammation. Therefore, it is the appropriate medication for osteoporosis management.
Category reason: This question tests knowledge of which drug is indicated for treating osteoporosis, focusing on medication class and therapeutic use, which falls under Pharmacology.

Question 28

Bactrim Forte tablet is use for -?

Accepted Answer

Answer reason: Bactrim Forte (trimethoprim–sulfamethoxazole) is an antibacterial effective against various susceptible bacteria, and it has recognized use in certain Salmonella infections (including enteric fever in susceptible strains). It does not treat Candida species because those are fungi and require antifungal therapy, making that option incorrect. “Infection” is too nonspecific and would incorrectly imply broad coverage of all infectious causes. Therefore the most accurate choice among the options is the Salmonella organism listed.
Category reason: This item tests knowledge of what organism/disease a specific antibiotic (trimethoprim–sulfamethoxazole) is used to treat, which is a medication mechanism/indication concept in Pharmacology.

Question 29

Odd One Out Antiemetics 5HT3 antagonists

Accepted Answer

Answer reason: B) Sertraline 5-HT3 antagonists are antiemetics in the “-setron” class used especially for chemotherapy- and postoperative-induced nausea/vomiting. Ondansetron and granisetron are established 5-HT3 receptor blockers, and “polanosetron” appears intended to represent another -setron antiemetic (e.g., palonosetron). Sertraline is an SSRI antidepressant that inhibits serotonin reuptake rather than blocking 5-HT3 receptors, so it does not belong in this group.
Category reason: This item tests recognition of drug classes and mechanisms (5-HT3 antagonist antiemetics vs SSRI), which is a core Pharmacology concept rather than a nursing-care prioritization task.

Question 30

Odd One Out Diuretics: Identify the odd one out.

Accepted Answer

Answer reason: Thiazides, loop diuretics, and potassium-sparing agents are all classes of diuretics used to promote renal excretion of water and electrolytes to manage conditions like hypertension and edema. Metformin is an oral antihyperglycemic (biguanide) that lowers blood glucose primarily by decreasing hepatic gluconeogenesis and improving insulin sensitivity. It does not act as a diuretic and is used for diabetes management rather than fluid removal.
Category reason: This question tests recognition of medication classes and drug category differences (diuretic classes versus an antidiabetic agent), which is a core Pharmacology concept rather than a nursing care decision.

Question 31

Which drug is used as a first-line treatment for anaphylactic shock?

Accepted Answer

Answer reason: It rapidly reverses life-threatening airway edema/bronchospasm and hypotension through alpha-1 vasoconstriction and beta-1/beta-2 cardiac and bronchodilatory effects. Antihistamines and corticosteroids are adjuncts that have slower onset and do not promptly treat shock or airway compromise. Beta-agonists like albuterol may help persistent bronchospasm but do not address systemic vasodilation and are not first-line in anaphylaxis.
Category reason: This asks for the first-line medication for a specific emergency condition, which is primarily pharmacology knowledge about drug choice and mechanism in anaphylaxis.

Question 32

Q.1121: What color is the barrel cap of an adrenaline auto-injector (EpiPen)?

Accepted Answer

Answer reason: Standard epinephrine auto-injectors are color-coded to support rapid identification in emergencies. The commonly used adult 0.3 mg device has a yellow barrel cap, while the safety release is typically blue. Recognizing these device markings helps prevent handling errors and delays when treating anaphylaxis. Color-coding also helps differentiate products and dosages during high-stress situations.
Category reason: This tests recognition of medication device labeling/color coding for epinephrine auto-injectors, which is a pharmacology-related knowledge point rather than a nursing prioritization/intervention scenario.

Question 33

What is the main use of Tranexamic Acid (Trenexa) Injection?

Accepted Answer

Answer reason: Tranexamic acid is an antifibrinolytic that inhibits plasminogen activation to plasmin, stabilizing formed clots and reducing ongoing bleeding. Clinically it is used to prevent or treat excessive bleeding in settings such as trauma, surgery, and heavy menstrual bleeding (and in some protocols postpartum hemorrhage). It does not lower blood pressure, does not provide analgesia, and has no antibacterial mechanism.
Category reason: This question tests the primary therapeutic use/mechanism of a specific medication (tranexamic acid), which is foundational drug knowledge in Pharmacology rather than a nursing judgment scenario.

Question 34

Odd One Out Antiemetics

Accepted Answer

Answer reason: It is an SNRI antidepressant primarily used for major depressive disorder, generalized anxiety disorder, neuropathic pain, and fibromyalgia, rather than for nausea/vomiting control. The other listed drugs are established antiemetics: ondansetron is a 5-HT3 antagonist, while metoclopramide and domperidone are dopamine D2 antagonists with prokinetic/antiemetic effects. Therefore it does not belong to the antiemetic group.
Category reason: This is a medication-classification question distinguishing antiemetics from a non-antiemetic drug, which is a core Pharmacology concept.

Question 35

Toothache is treated with?

Accepted Answer

Answer reason: Analgesics (e.g., acetaminophen or NSAIDs) are standard first-line symptomatic treatment to reduce dental pain while the underlying cause (often caries, pulpitis, or infection) is assessed and treated by a dentist. Insulin is for glycemic control, vitamin B does not treat acute odontogenic pain, and antacids address gastric acid-related symptoms rather than dental pathology. Persistent toothache warrants dental evaluation, and antibiotics are only indicated when there are signs of spreading infection/systemic involvement.
Category reason: This item tests basic medication knowledge about which drug class provides symptomatic relief of pain, which aligns best with Pharmacology rather than nursing judgment or care prioritization.

Question 36

A nurse is teaching a female client newly diagnosed with Helicobacter pylori infection. The nurse anticipates that which of the following medications will not be used after learning the client is pregnant?

Accepted Answer

Answer reason: Fluoroquinolones are generally avoided in pregnancy due to potential fetal toxicity, particularly concerns for effects on developing cartilage and musculoskeletal tissue. In contrast, amoxicillin is commonly considered safe in pregnancy, and metronidazole is often permitted when clinically indicated. While clarithromycin is typically avoided when alternatives exist, the clearest contraindicated choice among the options is the fluoroquinolone.
Category reason: This question tests medication safety/contraindications in pregnancy and antibiotic selection, which is primarily pharmacology knowledge rather than nursing prioritization or care-management decision-making.

Question 37

Hypertension is controlled by?

Accepted Answer

Answer reason: This medication is a dihydropyridine calcium channel blocker that lowers blood pressure primarily by causing peripheral arterial vasodilation, reducing systemic vascular resistance. It is commonly used as first-line or add-on therapy for chronic hypertension. The other options do not treat hypertension: vitamin B12 treats deficiency, paracetamol is an analgesic/antipyretic, and antacids neutralize gastric acid.
Category reason: This question tests identification of a drug used to manage hypertension, which is primarily pharmacologic knowledge about medication classes and therapeutic uses.

Question 38

Which medication is used to prevent seizures in preeclampsia?

Accepted Answer

Answer reason: It is the first-line agent for seizure prophylaxis in preeclampsia and for treatment of eclamptic seizures, with better maternal outcomes than traditional anticonvulsants. It depresses CNS excitability and reduces neuromuscular transmission, helping prevent progression to seizures. Key safety monitoring includes deep tendon reflexes, respiratory rate, and urine output due to risk of toxicity, with calcium gluconate as the antidote if needed.
Category reason: This question tests knowledge of the specific drug used for seizure prophylaxis in preeclampsia, which is a medication-selection/therapeutic pharmacology concept rather than a nursing care prioritization scenario.

Question 39

Odd One Out Systemic Antifungals

Accepted Answer

Answer reason: Systemic antifungals are used for infections requiring absorption and distribution throughout the body. Nystatin is not systemically absorbed from the GI tract and is primarily used topically or as an oral suspension for local mucocutaneous Candida infections (e.g., oral thrush). In contrast, amphotericin B, griseofulvin, and fluconazole have systemic uses via oral and/or IV administration.
Category reason: This is a drug-classification question distinguishing systemic vs non-systemic antifungal agents, which is core Pharmacology knowledge rather than a nursing care decision scenario.

Question 40

Which drug is commonly used for malaria treatment?

Accepted Answer

Answer reason: B) Artesunate Artesunate is an artemisinin derivative and a key antimalarial, used especially for severe malaria (typically IV) and as part of artemisinin-based combination therapy for uncomplicated disease. Metformin is an antihyperglycemic for type 2 diabetes, and omeprazole is a proton pump inhibitor for acid-related disorders, so neither treats Plasmodium infection. Therefore, the only option that matches standard malaria therapy is artesunate.
Category reason: This question tests knowledge of a medication’s therapeutic use (which drug treats malaria), which is a core Pharmacology concept rather than a nursing care decision.

Question 41

Odd One Out Proton Pump Inhibitors

Accepted Answer

Answer reason: Pantoprazole, esomeprazole, and rabeprazole are proton pump inhibitors that suppress gastric acid by irreversibly inhibiting the H+/K+ ATPase in parietal cells. Fluconazole is an azole antifungal used for Candida and other fungal infections and does not act on gastric acid secretion. Therefore it is the only option not belonging to the PPI class.
Category reason: This question tests recognition of drug classes (proton pump inhibitors vs an antifungal), which is a core Pharmacology concept rather than a nursing care decision.

Question 42

All among the following are expected action of drug lasix except?

Accepted Answer

Answer reason: Furosemide (Lasix) is a loop diuretic that increases renal excretion of sodium and water, leading to increased urine output. By reducing intravascular volume, it decreases edema (including pulmonary congestion) and can lower blood pressure. It does not have an anticholinergic or mucolytic effect on airway glands, so changing tracheal secretions is not an expected pharmacologic action.
Category reason: This item tests the pharmacologic actions/effects of furosemide (a loop diuretic), which is a foundational medication knowledge question rather than a nursing-care judgment scenario.

Question 43

Which of the following drugs is/are responsible for this condition?

Accepted Answer

Answer reason: The image shows black discoloration of the tongue consistent with black hairy tongue or drug-related tongue staining. Antibiotics such as linezolid can alter oral flora and promote this benign discoloration, and bismuth subsalicylate (Pepto-Bismol) can darken oral mucosa via bismuth sulfide formation. Antipsychotics like olanzapine may contribute through xerostomia and reduced oral hygiene, which increases keratin/debris accumulation on filiform papillae. The condition is typically harmless and improves with improved oral hygiene and stopping the offending agent when appropriate.
Category reason: This question tests medication adverse effects and drug causation of a clinical finding, which is primarily Pharmacology rather than nursing prioritization or care management.

Question 44

Q.1228: Retinoic acid used in acne (pimples) is-?

Accepted Answer

Answer reason: Retinoic acid (tretinoin) is a retinoid derived from vitamin A and is commonly used topically for acne. It normalizes follicular keratinization, promotes comedone expulsion, and prevents new comedone formation. Retinoids also have anti-inflammatory effects that help reduce acne lesions. The other listed vitamins are not the chemical class retinoic acid belongs to.
Category reason: This question tests identification of a drug/chemical (retinoic acid/tretinoin) and its relationship to a vitamin class, which is core medication knowledge within Pharmacology rather than nursing care decision-making.

Question 45

Which drug is used as first-line treatment for Raynaud’s phenomenon?

Accepted Answer

Answer reason: Raynaud’s phenomenon is caused by episodic vasospasm of small arteries/arterioles, leading to reduced digital blood flow. Dihydropyridine calcium channel blockers (e.g., nifedipine, amlodipine) are first-line because they promote peripheral vasodilation and reduce frequency/severity of attacks. Beta blockers can worsen vasospasm, and ACE inhibitors or thiazide diuretics are not preferred first-line agents for this condition.
Category reason: This is primarily a medication-therapy knowledge question about the first-line drug class for a vascular vasospastic disorder, which falls under Pharmacology rather than nursing care prioritization.

Question 46

Odd One Out Anthelminthic Drugs

Accepted Answer

Answer reason: It is an antiprotozoal (antifolate) medication primarily used for toxoplasmosis and malaria, not for treating helminth (worm) infections. The other listed agents are classic anthelmintics: albendazole and mebendazole are benzimidazoles effective against many nematodes, and niclosamide is active against cestodes (tapeworms). Therefore it is the odd one out among anthelmintic drugs.
Category reason: This is a drug-classification question testing recognition of antiparasitic medication classes and indications, which is Pharmacology rather than a nursing care decision.

Question 47

Which of the following diseases have oral vaccine?

Accepted Answer

Answer reason: Oral poliovirus vaccine (OPV) is administered by mouth and is a classic example of an oral vaccine used in immunization programs. The other listed vaccines are typically given via injection (e.g., measles as MMR, yellow fever as subcutaneous, rabies IM/ID, and smallpox via scarification). OPV induces strong intestinal mucosal immunity, helping reduce fecal-oral transmission in endemic settings.
Category reason: This tests knowledge of vaccine formulations and routes of administration, which is primarily pharmacology/immunization content rather than a nursing care decision scenario.

Question 48

What is the mechanism of action of nitroglycerin in angina relief?

Accepted Answer

Answer reason: Nitroglycerin is converted to nitric oxide, causing venodilation (and some arteriolar dilation) that decreases venous return. This lowers left ventricular end-diastolic volume and wall stress, reducing myocardial oxygen consumption and relieving ischemic chest pain. It can also dilate coronary arteries and relieve vasospasm, improving oxygen supply as a secondary benefit. The other options are inconsistent: it does not increase inotropy, it is not primarily a conduction-slowing drug, and it decreases rather than increases preload.
Category reason: This question tests the drug mechanism of nitroglycerin for angina, which is a core Pharmacology concept focused on medication actions rather than nursing care prioritization.

Question 49

Which antihypertensive class is most likely to cause a dry, persistent cough?

Accepted Answer

Answer reason: C. ACE inhibitors These drugs decrease breakdown of bradykinin, leading to accumulation in the respiratory tract and stimulation of cough receptors. The cough is typically dry, persistent, and may start days to months after initiation. It is a common reason for discontinuation and often resolves after switching to an ARB, which does not raise bradykinin levels.
Category reason: This question tests an adverse effect associated with a medication class used to treat hypertension, which is primarily a Pharmacology concept rather than a nursing care prioritization scenario.

Question 50

What is the primary reason for administering aspirin in acute MI?

Accepted Answer

Answer reason: In acute myocardial infarction, aspirin is given early for its antiplatelet effect (irreversible COX-1 inhibition), which decreases thromboxane A2–mediated platelet aggregation. This helps limit ongoing thrombus propagation at the site of plaque rupture and reduces further coronary occlusion. While it may provide some analgesic benefit, pain relief is not the primary therapeutic goal in acute MI. Aspirin does not primarily act by dilating coronary arteries or increasing heart rate.
Category reason: This question tests the mechanism and therapeutic rationale of aspirin in acute MI, which is a medication action/outcome concept within Pharmacology rather than a nursing prioritization/intervention scenario.

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