Question 1

A life-threatening reaction to antipsychotic drugs as characterized by muscle rigidity, fever, altered mental status, irregular heartbeat, and autonomic dysfunction is known as?

Accepted Answer

Answer reason: Autonomic instability (e.g., tachycardia/irregular rhythm, labile blood pressure, diaphoresis) is a defining feature and makes it rapidly life-threatening. Malignant hyperthermia is typically triggered by volatile anesthetics or succinylcholine rather than antipsychotics. Tardive dyskinesia is a chronic, usually afebrile, hyperkinetic movement disorder without the acute rigidity and autonomic collapse described.

Question 2

Among the following identify the long term effect of steroid therapy?

Accepted Answer

Answer reason: With longer duration and/or higher doses, patients may develop mood changes, mania, depression, delirium, or psychosis, making this a recognized long-term complication of steroid therapy. In contrast, steroids more commonly cause hyperglycemia (not hypoglycemia) through increased gluconeogenesis and insulin resistance. They also tend to promote weight gain and fluid retention rather than weight loss, so that option is inconsistent with typical long-term steroid effects.

Question 3

The drug used for dilation of pupil in children is?

Accepted Answer

Answer reason: Mydriasis is produced by antimuscarinic drugs that block parasympathetic stimulation of the iris sphincter muscle, leading to pupil dilation (often with cycloplegia). This mechanism is classically used in pediatric eye exams and for cycloplegic refraction. The other options are not mydriatics: betamethasone is a corticosteroid, while levofloxacin and gentamycin are antibiotics used for ocular infections rather than dilation. Therefore, the anticholinergic agent is the best choice.

Question 4

The action of the drug on the body is known as ...?

Accepted Answer

Answer reason: This directly matches the stem asking about the drug’s action on the body. Pharmacokinetics is a common distractor but refers to what the body does to the drug (absorption, distribution, metabolism, excretion). Pharmacology is the broad study of drugs overall, and pharmacotherapeutics focuses on clinical use of drugs to treat disease rather than the mechanism/effect itself.

Question 5

Patient is allergic to B-lactamase and which of the following drug is safe to administer?

Accepted Answer

Answer reason: Cefazoline (a cephalosporin), amoxicillin (an aminopenicillin), and penicillin are all beta-lactams and share the core beta-lactam ring, so cross-reactivity can occur. Vancomycin is a glycopeptide that inhibits cell-wall synthesis without a beta-lactam structure, making it a common alternative when beta-lactams are contraindicated. A frequent test-trap is selecting a cephalosporin as “different,” but it remains within the beta-lactam class.

Question 6

The drug used by health workers in the management of acute respiratory illness is?

Accepted Answer

Answer reason: This agent provides broad coverage against several community respiratory bacteria and is practical for frontline health workers due to oral dosing and availability. Chloramphenicol is generally avoided because of serious toxicity risk (e.g., aplastic anemia) and is not a routine first-line ARI drug. Benzylpenicillin and gentamycin are typically reserved for more severe infections requiring parenteral therapy or specific indications rather than standard outpatient ARI management.

Question 7

A 38-year-old female patient with hyperlipidemia is interested in weight loss medication. She states that a friend of hers had good results with phentermine (Adipex-P). At what BMI would phentermine be recommended for this patient?

Accepted Answer

Answer reason: Hyperlipidemia is a cardiometabolic comorbidity that meets this criterion, so medication can be considered starting at this threshold when lifestyle measures are insufficient. A BMI ≥25 kg/m2 is classified as overweight but does not meet the usual medication-indication cutoff. A BMI ≥35 kg/m2 is a higher threshold more relevant to bariatric surgery considerations rather than initial sympathomimetic therapy eligibility.

Question 8

Side Effects While statins are generally well-tolerated, they can have side effects, including?

Accepted Answer

Answer reason: Muscle Pain: Myalgia is the most common side effect. In rare cases, severe muscle problems like rhabdomyolysis can occur. Statins most commonly cause muscle-related adverse effects due to effects on skeletal muscle metabolism and, rarely, can progress to myopathy with rhabdomyolysis. This makes muscle symptoms the key adverse effect nurses screen for because severe cases can lead to acute kidney injury from myoglobinuria. Liver enzyme elevation and GI upset are recognized adverse effects but are less characteristic as the most frequent and are often asymptomatic or mild. Hyperglycemia and rare cognitive complaints have been reported, but they are not the predominant or most test-emphasized side effect compared with myalgias.

Question 9

Which of the following is potassium-wasting?

Accepted Answer

Answer reason: Furosemide is a classic loop diuretic and commonly causes hypokalemia, especially at higher doses or with poor intake. Spironolactone (also known by the brand name Aldactone) is a potassium-sparing diuretic that antagonizes aldosterone and tends to increase serum potassium. Therefore, “all of the above” is incorrect because two listed choices are the same potassium-sparing medication.

Question 10

ADRENALINE is used in–?

Accepted Answer

Answer reason: This makes it useful for rapid relief in severe asthma exacerbations, particularly when associated with anaphylaxis or significant airway edema. It also has alpha-1 effects that decrease mucosal swelling, helping improve airflow. Diabetes is not a primary indication (it can worsen hyperglycemia), and fever management relies on antipyretics rather than adrenergic agonists.

Question 11

Which medication is a direct oral anticoagulant (DOAC)?

Accepted Answer

Answer reason: Rivaroxaban is a factor Xa inhibitor and is taken orally, fitting the definition of a DOAC. Warfarin is an oral vitamin K antagonist (indirect anticoagulant), not a DOAC. Heparin is a parenteral anticoagulant, and aspirin is an antiplatelet agent rather than an anticoagulant.

Question 12

Drug of choice for acute asthma attack?

Accepted Answer

Answer reason: Acute asthma exacerbations require rapid reversal of bronchospasm with a short-acting beta-2 agonist. This medication has a fast onset via inhalation and directly relaxes airway smooth muscle, improving airflow within minutes. A long-acting beta-2 agonist like salmeterol is not appropriate for immediate relief and should not be used as monotherapy in asthma. Montelukast is a controller agent with delayed benefit, and theophylline has a narrow therapeutic index and is not first-line for acute relief.

Question 13

Which drug is safest in pregnancy?

Accepted Answer

Answer reason: Medication safety in pregnancy prioritizes avoiding known teratogens and fetotoxic drugs while choosing agents with the best established maternal-fetal safety record. Paracetamol is widely considered the preferred first-line analgesic/antipyretic in pregnancy when used at recommended doses. Tetracyclines can impair fetal bone growth and discolor developing teeth, making them unsafe. Warfarin crosses the placenta and can cause fetal warfarin syndrome and bleeding, and isotretinoin is highly teratogenic with a high risk of major congenital malformations.

Question 14

Which drug follows zero-order kinetics at therapeutic dose?

Accepted Answer

Answer reason: Zero-order (capacity-limited) kinetics occurs when metabolic pathways become saturated, making a constant amount (not fraction) of drug eliminated per unit time. Phenytoin exhibits saturable hepatic metabolism (Michaelis–Menten), so small dose increases near the therapeutic range can cause disproportionate rises in serum concentration and toxicity. This property is a classic test point contrasted with most drugs that follow first-order kinetics across therapeutic ranges. Theophylline is generally first-order at therapeutic levels (may become nonlinear near toxicity), and digoxin/gentamicin do not characteristically show zero-order elimination at therapeutic dosing.

Question 15

Digoxin toxicity causes?

Accepted Answer

Answer reason: This predisposes the patient to a variety of dysrhythmias (e.g., PVCs, AV block, atrial tachycardia with block), making rhythm abnormalities the hallmark finding. Tachycardia may occur in some dysrhythmias, but toxicity is not best characterized by sinus tachycardia alone. Hypertension and fever are not typical direct effects of digoxin toxicity and would prompt evaluation for other causes.

Question 16

What is the generic name for Prilosec?

Accepted Answer

Answer reason: Among the options, only one is the specific generic drug marketed as Prilosec. The other “-prazole” medications listed are different PPIs with different brand names despite similar mechanisms. One distractor is from a different class (H2-receptor antagonist), making it an incorrect match for this brand-generic pairing.

Question 17

Tuberculosis is treated with?

Accepted Answer

Answer reason: This drug is a first-line antitubercular agent that inhibits mycolic acid synthesis, weakening the bacterial cell wall. The other options are symptomatic/supportive drugs (analgesic/antipyretic, antihistamine, proton-pump inhibitor) and do not treat the underlying mycobacterial infection. Clinically, recognition of first-line TB drugs is key because they have specific monitoring needs (e.g., hepatotoxicity risk and pyridoxine supplementation to reduce neuropathy).

Question 18

A client with Parkinson's disease is prescribed levodopa (L-dopa) therapy. Improvement in which of the following indicates effective therapy?

Accepted Answer

Answer reason: A meaningful indicator of effectiveness is reduced stiffness and improved range of motion because rigidity is one of the cardinal motor symptoms targeted by dopaminergic therapy. Non-motor changes like mood or appetite are not primary or reliable markers of levodopa response and can fluctuate for many other reasons. Alertness may even worsen due to adverse effects such as somnolence or orthostatic hypotension, so it is not a dependable indicator of therapeutic benefit.

Question 19

Which of the following is a drug of choice for a pregnant mother woth chronic hypertension?

Accepted Answer

Answer reason: This option is a centrally acting alpha-2 agonist with long history of use and acceptable teratogenic risk, making it a classic first-line choice in many exam settings. Atenolol is generally avoided due to association with fetal growth restriction and neonatal bradycardia/hypoglycemia. Magnesium sulphate is primarily used for seizure prophylaxis/treatment in preeclampsia/eclampsia rather than as a chronic antihypertensive, and diazepam is not an antihypertensive medication.

Question 20

An agent that prevents the growth of bacteria are known as?

Accepted Answer

Answer reason: Agents described as inhibiting growth and replication without necessarily causing bacterial death are classified as bacteriostatic. In contrast, bactericidal agents reduce viable bacterial counts by killing organisms, which does not match the stem. “Antimicrobial” and “antibiotic” are broader categories that can include both bacteriostatic and bactericidal actions, so they are less specific than the term requested.

Question 21

Which of the following medications is contraindicated for administration to a patient with asthma?

Accepted Answer

Answer reason: This creates a clinically significant risk of worsening wheeze and triggering an asthma exacerbation. In contrast, atenolol, metoprolol, and esmolol are relatively cardioselective (β1-preferring) and are generally safer when a beta-blocker is necessary, though caution is still warranted at higher doses or in severe asthma. Therefore, the nonselective agent is the contraindicated choice.

Question 22

......... Is analgesic, anti pyretic and anti inflammatory?

Accepted Answer

Answer reason: Among the options, ibuprofen is a prototypical NSAID and reliably provides all three effects at usual therapeutic doses. Paracetamol is analgesic and antipyretic but has minimal anti-inflammatory action in peripheral tissues. Tramadol is an opioid-like analgesic without antipyretic or anti-inflammatory properties.

Question 23

Which clinical manifestation is a typical reaction to long-term phenytoin sodium therapy?

Accepted Answer

Answer reason: This adverse effect is classic and is a key long-term monitoring/teaching point, including meticulous oral hygiene and regular dental care. Weight gain and insomnia are not typical hallmark long-term reactions for this medication. Visual changes can occur with toxicity (e.g., nystagmus, diplopia), but “deteriorating eyesight” is not the characteristic chronic manifestation being tested.

Question 24

Drug which can cause hallucinations when used During anesthesia?

Accepted Answer

Answer reason: This adverse effect is a well-known, characteristic CNS reaction that can be mitigated with benzodiazepine premedication and a calm recovery environment. Propofol more typically causes rapid hypnosis with hypotension and respiratory depression rather than hallucinations. Etomidate is notable for adrenal suppression and myoclonus, and thiopentone (thiopental) is mainly associated with cardiorespiratory depression and prolonged sedation.

Question 25

Which is not the first line drug in tuberculosis?

Accepted Answer

Answer reason: Streptomycin is an aminoglycoside historically used for TB but is not part of the standard first-line regimen due to toxicity risks (notably ototoxicity/nephrotoxicity) and availability of safer, more effective oral agents. Isoniazid, pyrazinamide, and ethambutol are all standard first-line drugs included in initial therapy. Therefore, the option that is not first-line is the injectable aminoglycoside.

Question 26

Which antitubercular medication can cause vision changes?

Accepted Answer

Answer reason: This medication can cause optic neuritis, leading to decreased visual acuity and red-green color discrimination changes, so baseline and periodic vision testing is recommended. By contrast, isoniazid is classically associated with peripheral neuropathy (prevented with pyridoxine), rifampin commonly causes orange discoloration of body fluids, and pyrazinamide is associated with hyperuricemia and hepatotoxicity. Prompt recognition of visual symptoms is important because toxicity may be reversible if the drug is stopped early.

Question 27

The characteristic toxicity of Doxorubicin is?

Accepted Answer

Answer reason: This leads to dilated cardiomyopathy and can progress to congestive heart failure, so cumulative dose limits and baseline/periodic LVEF monitoring are key. The other choices align more with different drug classes (e.g., pulmonary fibrosis classically with bleomycin) rather than being the hallmark toxicity. Kidney and liver injury can occur with various chemotherapy agents, but they are not the signature, exam-tested toxicity for this drug.

Question 28

What medication class does Sitagliptin fall under?

Accepted Answer

Answer reason: This increases glucose-dependent insulin secretion and decreases glucagon release, improving postprandial and fasting glucose with a relatively low hypoglycemia risk when used alone. Sulfonylureas instead stimulate insulin release regardless of glucose level and therefore carry more hypoglycemia risk. TZDs work via PPAR-γ to improve insulin sensitivity, and metformin decreases hepatic gluconeogenesis—neither matches sitagliptin’s mechanism or drug class.

Question 29

Diazepam is used as —?

Accepted Answer

Answer reason: This pharmacologic profile fits the clinical use as a sedative (e.g., procedural sedation, acute agitation/anxiety, status epilepticus adjunct). Antipyretics lower fever via prostaglandin inhibition and diazepam has no primary antipyretic action. Antacids neutralize gastric acid and are unrelated to diazepam’s central mechanism and indications.

Question 30

ASPIRIN is used as —?

Accepted Answer

Answer reason: This is why low-dose aspirin is used to prevent arterial thrombosis events such as myocardial infarction and ischemic stroke. The other options do not match aspirin’s primary clinically tested mechanism in this context; it is not an acid-neutralizing agent, antifungal medication, or sedative. A key exam point is the irreversible platelet effect, which distinguishes aspirin from many other NSAIDs.

Question 31

SALBUTAMOL is used in –?

Accepted Answer

Answer reason: This directly treats acute bronchospasm and provides quick relief of wheeze and dyspnea in obstructive airway disease, most classically asthma. Diabetes and hypertension are not indications; in fact beta-agonists can cause transient hyperglycemia and tachycardia that may worsen those conditions. Tuberculosis requires antimycobacterial therapy rather than bronchodilators, although bronchodilators may be used only for coexisting reactive airway symptoms.

Question 32

The diluent used for the reconstitution of BCG vaccine is?

Accepted Answer

Answer reason: In standard immunization practice, this diluent is sterile normal saline, which preserves stability and is compatible for intradermal administration. Distilled water and dextrose are inappropriate because they can alter tonicity and reduce organism viability or increase injection site reactions. Glycerine is used as a stabilizer/preservative in some biological preparations but is not the routine diluent for reconstituting BCG.

Question 33

Which of the following foods is not contraindicated for a patient taking selegiline?

Accepted Answer

Answer reason: Aged/fermented/cured foods are classic high-tyramine sources, which makes cured meats a key dietary restriction. Some items like certain avocados and chocolate can contain enough tyramine to be discouraged with MAOIs depending on preparation/amount. Fresh citrus fruits are not tyramine-rich, so they do not create the MAOI-tyramine interaction risk.

Question 34

Which of the following is not a common side effect of captopril?

Accepted Answer

Answer reason: This explains why dry cough is frequent and why a potentially life-threatening but recognized reaction is angioedema. By reducing aldosterone, these drugs can also increase serum potassium, making hyperkalemia a known effect. Unintentional weight loss is not a typical or expected adverse effect attributable to captopril and should prompt evaluation for other causes.

Question 35

Which of the following is not a symptom of levothyroxine toxicity?

Accepted Answer

Answer reason: Expected toxicity findings include heat intolerance, tachycardia/palpitations, and unintentional weight loss from increased energy expenditure. Somnolence is more consistent with hypothyroidism or other sedating conditions rather than thyroid hormone over-replacement. Therefore the option describing decreased alertness does not fit the typical toxidrome compared with the other hypermetabolic symptoms listed.

Question 36

Which of the following is not a sign of digoxin toxicity?

Accepted Answer

Answer reason: Gastrointestinal upset (especially nausea and vomiting) is a common early manifestation due to direct effects on the GI tract and chemoreceptor trigger zone. Visual disturbances such as yellow/green halos (xanthopsia) are classic neuro-ophthalmic findings in toxicity. While digoxin can cause various dysrhythmias, bradyarrhythmias and AV block are more characteristic than isolated sinus tachycardia.

Question 37

Which of the following medications may be used for acute alcohol withdrawal?

Accepted Answer

Answer reason: This option directly treats the hyperexcitable CNS state and can be symptom-triggered or scheduled based on withdrawal severity (e.g., CIWA-Ar). In contrast, acamprosate, naltrexone, and disulfiram are used for maintenance of abstinence/relapse prevention after detox rather than treating acute withdrawal physiology. Key nursing considerations include monitoring sedation/respiratory status and vital signs while preventing withdrawal complications.

Question 38

The physician has ordered Aspirin therapy for a client with severe rheumatoid arthritis. A sign of acute aspirin toxicity is?

Accepted Answer

Answer reason: Ringing in the ears often appears before more severe findings such as hyperventilation, respiratory alkalosis progressing to metabolic acidosis, fever, and altered mental status. This makes it a high-yield early warning sign requiring prompt dose reduction/cessation and evaluation. The other options are nonspecific GI or dermatologic symptoms that are not the hallmark indicator of acute salicylism.

Question 39

A client with type 2 diabetes mellitus (DM2) has been taking regular human insulin for several years. The client asks the nurse, "When does this insulin reach its peak ?" Which is the most accurate response by the nurse?

Accepted Answer

Answer reason: A peak at 2–4 hours best fits standard pharmacokinetic ranges for regular insulin and aligns with when hypoglycemia risk is highest. The 10–15 minute peak is characteristic of rapid-acting analogs (e.g., lispro/aspart/glulisine), not regular insulin. A 6–8 hour peak is more consistent with intermediate-acting insulin such as NPH rather than short-acting regular insulin.

Question 40

Which antibiotic is notorious for causing "Red Man Syndrome" if infused too rapidly?

Accepted Answer

Answer reason: This antibiotic is well known to cause flushing, erythema of the face/neck/upper torso, pruritus, and sometimes hypotension when infused too quickly. The risk is reduced by slowing the infusion rate (commonly over at least 60 minutes, longer for larger doses) and giving antihistamines when indicated. The other listed agents are not characteristically associated with this rapid-infusion histamine release pattern.

Question 41

Which of the following drugs is commonly used for the management of acute gout attacks?

Accepted Answer

Answer reason: This medication reduces neutrophil migration and activation, which can quickly decrease pain, swelling, and erythema during a flare. In contrast, xanthine oxidase inhibitors and uricosurics are primarily for long-term urate lowering and are not first-line for immediate symptom control in an acute attack. Starting urate-lowering therapy during a flare can also worsen or prolong symptoms if not appropriately managed.

Question 42

INTRA-ARTERIAL injection is used for --?

Accepted Answer

Answer reason: Delivering chemotherapy directly into an arterial supply can increase local cytotoxic effect (e.g., regional perfusion/infusion approaches). By contrast, routine vaccinations are typically intramuscular or subcutaneous, and allergy testing uses intradermal or skin-prick techniques, not arterial injection. Intra-arterial injection is also not a standard approach for treating fever, which is managed with systemic antipyretics and treating the underlying cause.

Question 43

Cetirizine is mainly used as --?

Accepted Answer

Answer reason: Its primary therapeutic role is allergy symptom control rather than pain relief or antimicrobial activity. Antibiotics and antifungals target bacterial and fungal pathogens respectively, which is a different mechanism and indication. Compared with many first-generation agents, it is generally less sedating due to lower central nervous system penetration, supporting its common outpatient use for allergies.

Question 44

Amlodipine belongs to --?

Accepted Answer

Answer reason: Among the provided choices, this option represents an antihypertensive class used to lower blood pressure via inhibition of the renin-angiotensin-aldosterone system. In contrast, beta-blockers act primarily via adrenergic receptor blockade and diuretics lower blood pressure by promoting sodium and water excretion; “asthma” is not a medication class. Therefore, this option is the best match within the given answer set for an antihypertensive class label.

Question 45

Fever is controlled by which medicine?

Accepted Answer

Answer reason: This option is an NSAID with reliable antipyretic action via COX inhibition. The antihistamine choice targets allergic symptoms rather than thermoregulation. The statin and proton-pump inhibitor are used for lipid lowering and acid suppression, respectively, and do not treat pyrexia.

Question 46

A patient has stomach pain due to gas in the GI tract. Which GI medication will help this patient best?

Accepted Answer

Answer reason: This directly targets the stated cause of pain (intestinal gas) and is commonly used for bloating and flatulence. Alosetron is reserved for severe IBS-D and does not specifically relieve gas. Lubiprostone treats chronic constipation/IBS-C, and sulfasalazine is used for inflammatory bowel disease—neither is the best match for isolated gas pain.

Question 47

Which of the following medications may be used both to treat depression and as a smoking deterrent?

Accepted Answer

Answer reason: This drug is an NDRI (norepinephrine-dopamine reuptake inhibitor) indicated for major depressive disorder and also approved for smoking cessation by reducing nicotine cravings and withdrawal symptoms. Varenicline is used for smoking cessation but is not an antidepressant, making it an important distractor. Sertraline and venlafaxine are antidepressants (SSRI and SNRI, respectively) but are not standard first-line agents specifically indicated as smoking deterrents.

Question 48

A patient reports taking sumatriptan as needed at home. The nurse knows this is likely to treat which condition?

Accepted Answer

Answer reason: Its PRN use at home fits episodic attacks rather than daily prophylaxis. It is not an antiemetic (so it would not be the primary medication for vomiting) and it does not have sedative-hypnotic properties for insomnia. It also does not relax skeletal muscle, so muscle spasm would be treated with agents such as centrally acting muscle relaxants instead.

Question 49

Atropine sulfate (Atropine) is indicated in all but not one of the following client?

Accepted Answer

Answer reason: This makes it contraindicated in narrow-angle (angle-closure) glaucoma and generally avoided in glaucoma patients unless specifically directed by ophthalmology. Anticholinergics can also reduce GI motility and cause urinary retention, so bowel obstruction and urinary problems are cautionary contexts rather than classic indications. Among the listed choices, glaucoma is the clearest “do not use” scenario due to risk of precipitating acute angle-closure and vision-threatening pressure rise.

Question 50

Which of the following drugs is the antidote for magnesium toxicity?

Accepted Answer

Answer reason: g., loss of deep tendon reflexes, respiratory depression, hypotension, conduction abnormalities) due to magnesium’s calcium-antagonist effects at the neuromuscular junction and myocardium. Intravenous calcium salts rapidly antagonize these effects, restoring neuromuscular transmission and improving hemodynamic/cardiac stability while definitive elimination is addressed. Hydralazine is an antihypertensive used for blood pressure control (including in preeclampsia) and does not reverse magnesium’s toxic physiology. Naloxone reverses opioid toxicity, and Rho(D) immune globulin is used for Rh incompatibility prevention, neither of which treats hypermagnesemia.

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