Pharmacology Practice Test 62
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 62nd 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 62
What is the mechanism of action of prednisone?
- Inhibits inflammation
- Enhances GABA activity
- Blocks sodium channels
- Stimulates insulin release
Explanation: Answer reason: This decreases cytokine production, inhibits phospholipase A2 (via lipocortin), and reduces prostaglandin/leukotriene synthesis, producing broad anti-inflammatory and immunosuppressive effects. Prednisone also reduces leukocyte migration and capillary permeability, which directly explains its clinical benefit in inflammatory and autoimmune conditions. Enhancing GABA activity is characteristic of benzodiazepines, blocking sodium channels fits local anesthetics/antiarrhythmics, and stimulating insulin release is associated with sulfonylureas—none match prednisone’s mechanism.
Which drug is used to prevent rejection in organ transplants?
- Cyclosporine
- Warfarin
- Ibuprofen
- Simvastatin
Explanation: Answer reason: Cyclosporine is a calcineurin inhibitor that decreases IL-2 transcription, thereby suppressing T-cell proliferation and reducing graft rejection risk. Warfarin is an anticoagulant used to prevent/treat thrombosis, not immune rejection. Ibuprofen is an NSAID for pain/inflammation, and simvastatin is an HMG-CoA reductase inhibitor for hyperlipidemia—neither prevents transplant rejection.
Kaun-sa second generation antihistamine hai?
- Promethazine
- Diphenhydramine
- Loratadine
- Cyproheptadine
Explanation: Answer reason: Loratadine is a classic second-generation antihistamine used for allergic rhinitis and urticaria with relatively fewer anticholinergic effects. Promethazine, diphenhydramine, and cyproheptadine are first-generation antihistamines that commonly cause sedation and anticholinergic adverse effects. Therefore, the best choice among the options is the second-generation agent.
What type of drug is used to prevent blood clot formation?
- Analgesics
- Antibiotics
- Anticoagulants
- Antidepressants
Explanation: Answer reason: g., thrombin or factor Xa activity), thereby decreasing fibrin clot development. This directly addresses prevention of new thrombus formation and extension of existing clots in conditions like DVT/PE or atrial fibrillation. Analgesics primarily relieve pain and do not alter coagulation mechanisms in a therapeutic way. Antibiotics treat bacterial infections, and antidepressants target neurotransmitter pathways, neither of which are intended to prevent thrombosis.
Which drug is used to treat erectile dysfunction?
- Aspirin
- Phenytoin
- Sildenafil
- Metformin
Explanation: Answer reason: This option directly matches that mechanism and is a first-line oral therapy for ED. Aspirin is an antiplatelet/analgesic without a primary role in treating ED, and phenytoin is an antiepileptic that can worsen sexual dysfunction. Metformin treats type 2 diabetes and may improve metabolic contributors over time but is not a direct ED medication.
Amoxicillin is mainly effective against which type of organisms?
- Viruses
- Fungi
- Protozoa
- Bacteria
Explanation: Answer reason: This mechanism targets peptidoglycan, a structural component present in bacteria but absent in viruses, fungi, and protozoa, making antibacterial activity the primary effect. Clinically it is used for susceptible Gram-positive and some Gram-negative bacterial infections (e.g., streptococcal pharyngitis, otitis media, certain respiratory infections). A common distractor is viruses, but antibiotics do not treat viral illnesses and inappropriate use increases resistance and adverse effects.
Which of the following is effective antibiotic in urinary tract infections?
- Clarithromycin
- Ciprofloxacin
- Moxifloxacin
- None of above.
Explanation: Answer reason: coli, making them effective for many UTIs. This option fits the pharmacologic requirement of renal excretion with therapeutic levels in urine. Clarithromycin has poor coverage of typical uropathogens and is not a standard UTI drug. Moxifloxacin is not preferred for UTIs because it attains relatively low urinary concentrations compared with other fluoroquinolones and is less suitable for lower tract infection.
A 47-year-old male patient diagnosed with hemophilia A is receiving desmopressin acetate (DDAVP) as a part of his treatment. Nurse Maribeth knows the drug is used to stimulate blood clotting factors and expects which of the following result?
- Elevated RBCs
- Low bleeding time
- Elevated reticulocytes
- Elevated platelets
Explanation: Answer reason: This pharmacologic effect leads to faster formation of an effective platelet plug and improved clot stability, which clinically corresponds to a reduced bleeding tendency and shortened bleeding time. It does not increase red cell mass or reticulocyte count, which reflect erythropoiesis rather than coagulation. It also does not raise the platelet count; it improves platelet function via vWF rather than increasing platelet production.
After an argument with her mother, an adolescent female takes an overdose of Tylenol (acetaminophen). The health care provider knows to watch for complications in which organ?
- Kidney
- Liver
- Pancreas
- Heart
Explanation: Answer reason: This leads to centrilobular hepatic necrosis and can progress to acute liver failure, making the liver the key organ to monitor. Clinically, worsening AST/ALT, rising INR, hypoglycemia, jaundice, and encephalopathy indicate significant hepatic injury. While renal injury can occur in severe cases, it is less common and typically secondary compared with the dominant risk of liver failure. Early antidotal therapy with N-acetylcysteine is aimed at preventing this hepatic complication by restoring glutathione and detoxifying NAPQI.
Which analgesic drug is often used to treat fibromyalgia?
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Acetaminophen
- Opioids
- Antidepressants
Explanation: Answer reason: Medications that modulate central neurotransmitters (especially serotonin and norepinephrine) can reduce pain amplification and improve sleep and fatigue. Antidepressants such as SNRIs and certain TCAs are commonly used because they target these pathways and provide analgesic benefit independent of mood effects. In contrast, NSAIDs and acetaminophen may help some patients symptomatically but are often insufficient as primary therapy, and opioids are generally avoided due to limited efficacy for central pain and higher risk of dependence and hyperalgesia.
Which side effect is associated with metronidazole overdose?
- Bradycardia
- Seizures
- Excessive sweating
- Hair loss
Explanation: Answer reason: Among the options, seizure activity is the most characteristic serious adverse effect tied to excessive exposure. Bradycardia and excessive sweating are not typical hallmark findings of metronidazole toxicity and would prompt evaluation for alternative causes or co-ingestions. Hair loss is not a recognized acute overdose manifestation for this medication.
In acute episodes of mania, lithium is effective in 1-2 weeks, but it may take up to 4 weeks, or even a few months, to treat symptoms fully. Sometimes an antipsychotic agent is prescribed during the first few days or weeks of an acute episode to manage severe behavioral excitement and acute psychotic symptoms. In addition to the lithium, which one of the following medications might the physician prescribe?
- Diazepam (Valium)
- Haloperidol (Haldol)
- Sertraline (Zoloft)
- Alprazolam (Xanax)
Explanation: Answer reason: A high-potency antipsychotic provides faster reduction in psychomotor agitation, pressured behavior, and psychotic features, making it appropriate as a short-term adjunct early in treatment. Benzodiazepines may reduce anxiety or insomnia but do not reliably treat acute psychosis and are not the primary choice when psychotic symptoms are prominent. An SSRI antidepressant can worsen or precipitate manic symptoms and is not indicated for acute mania management.
Which of these drugs should be avoided with iodinated contrast media?
- Metronidazole
- Metoclopramide
- Mometasone
- Metformin
Explanation: Answer reason: Elevated metformin levels increase the risk of metformin-associated lactic acidosis, a rare but serious complication. Therefore, metformin is the key medication to hold/avoid around contrast exposure, especially in patients with impaired renal function or other risk factors for AKI. The other listed drugs do not have this specific, well-established interaction risk tied to contrast-induced renal function changes.
Which is the emergency drug for muscle spasm in tetanus?
- Diazepam
- Aspirin
- Paracetamol
- Amoxicillin
Explanation: Answer reason: Benzodiazepines enhance GABA-A–mediated inhibition, which directly counteracts the disinhibition that drives tetanic spasms and helps prevent complications such as rhabdomyolysis and respiratory compromise. Analgesics/antipyretics like aspirin or paracetamol do not treat the underlying spasticity mechanism and are inadequate for emergency spasm control. Amoxicillin is an antibiotic and does not provide immediate spasm relief (and tetanus treatment typically prioritizes antitoxin, wound care, and appropriate antimicrobials alongside spasm control).
What is the primary function of the drug albuterol?
- To reduce inflammation and mucus production in the airways
- To treat bacterial infections
- To reduce fever
- To dilate the airways and improve breathing
Explanation: Answer reason: This makes it a rescue medication for acute bronchospasm in conditions like asthma or COPD. Reducing airway inflammation and mucus is primarily achieved with anti-inflammatory agents such as inhaled corticosteroids, not albuterol. It has no role as an antibiotic or antipyretic, so those options do not match its mechanism or clinical use.
A 35 year old lady who is on anticancer therapy is now suffering from severe nausea and vomiting; which of the following drugs is having most effective antiemetic actions in this case?
- Dexamethasone
- Levodopa
- Apomorphine
- Sucrulfate.
Explanation: Answer reason: The listed corticosteroid has well-established efficacy as an antiemetic in oncology, commonly used alone for some regimens and as an adjunct to 5-HT3 and NK1 antagonists for higher-risk regimens. One option is a dopamine precursor and is not used to control emesis; another is a dopamine agonist that can itself trigger vomiting. The remaining option is a GI mucosal protectant for ulcer disease and does not provide meaningful antiemetic benefit.
Drug of choice in severe PIH to prevent convulsion is?
- Diazepam
- Magnesium sulphate
- Nifedipine
- Methyldopa
Explanation: Answer reason: It stabilizes excitable membranes and reduces neuromuscular transmission, lowering seizure risk more effectively than benzodiazepines for this indication. Antihypertensives like nifedipine and methyldopa address blood pressure but do not provide primary seizure prophylaxis. Diazepam may terminate an active seizure if needed, but it is not the preferred drug to prevent convulsions in severe preeclampsia.
What is the mechanism of action of fluconazole?
- Inhibition of fungal ergosterol synthesis
- Activation of dopamine receptors
- Blockade of sodium channels
- Inhibition of cyclooxygenase
Explanation: Answer reason: This disruption increases membrane permeability and inhibits fungal growth, making it effective for Candida and other susceptible fungi. The other options describe mechanisms of unrelated drug classes (dopamine agonists, local anesthetics/antiarrhythmics, and NSAIDs). Therefore, the option describing impaired ergosterol production best matches fluconazole’s established pharmacologic action.
Which of these is a proton pump inhibitor (PPI)?
- Omeprazole
- Ranitidine
- Metformin
- Lisinopril
Explanation: Answer reason: pylori therapy. This mechanism is characteristic of the “-prazole” drugs. Ranitidine is an H2-receptor antagonist (reduces acid via histamine blockade), not a PPI. Metformin is an antihyperglycemic for type 2 diabetes, and lisinopril is an ACE inhibitor for hypertension/heart failure.
What is the primary side effect of amlodipine?
- Edema
- Bradycardia
- Hypokalemia
- Drowsiness
Explanation: Answer reason: Amlodipine is particularly associated with ankle/lower-extremity swelling and it is a frequent dose-limiting adverse effect. Bradycardia is more characteristic of non-dihydropyridines (e.g., verapamil, diltiazem) that depress AV nodal conduction. Hypokalemia is not a typical effect of calcium channel blockers, and drowsiness is less characteristic than vasodilatory effects such as edema, flushing, and headache.
Which antibiotic is used to treat tuberculosis?
- Isoniazid
- Erythromycin
- Ciprofloxacin
- Amoxicillin
Explanation: Answer reason: This medication is a classic first-line antitubercular drug used for active TB (as part of RIPE therapy) and for latent TB infection in appropriate patients. The other options listed are general antibacterials that do not reliably treat Mycobacterium tuberculosis in standard TB regimens. A key clinical association is the need to monitor for hepatotoxicity and provide pyridoxine (vitamin B6) to reduce neuropathy risk when indicated.
Which drug is used in the treatment of heart failure?
- Digoxin
- Simvastatin
- Aspirin
- Warfarin
Explanation: Answer reason: This medication increases intracellular calcium via Na+/K+-ATPase inhibition, leading to stronger myocardial contractions and improved cardiac output, and it can also help control ventricular rate in atrial fibrillation with heart failure. By contrast, simvastatin targets hyperlipidemia, aspirin is primarily antiplatelet for atherosclerotic disease, and warfarin is an anticoagulant for thromboembolism prevention rather than direct heart failure symptom management. Its use requires close monitoring because toxicity risk increases with renal impairment and hypokalemia.
Which drug is used to treat migraine prophylaxis?
- Propranolol
- Sumatriptan
- Ibuprofen
- Acetaminophen
Explanation: Answer reason: Beta-blockers are established first-line preventives for many patients by modulating adrenergic tone and reducing neuronal excitability implicated in migraine pathways. Triptans like sumatriptan are primarily for acute abortive treatment, not routine prevention. NSAIDs and acetaminophen are symptomatic analgesics for acute pain and do not provide consistent long-term prophylaxis when used as stand-alone preventives.
Which drug is a calcium channel blocker?
- Amlodipine
- Losartan
- Hydrochlorothiazide
- Spironolactone
Explanation: Answer reason: This option is a dihydropyridine CCB that primarily produces arterial vasodilation. By contrast, one distractor is an angiotensin II receptor blocker, which lowers blood pressure via RAAS blockade rather than calcium channel inhibition. The remaining options are diuretics (a thiazide and a potassium-sparing aldosterone antagonist), not calcium channel blockers.
Which drug is a carbapenem antibiotic?
- Meropenem
- Erythromycin
- Azithromycin
- Metronidazole
Explanation: Answer reason: Meropenem is a prototypical carbapenem (along with imipenem, ertapenem, doripenem), so it directly matches the drug class asked. Erythromycin and azithromycin are macrolides, not beta-lactams, and mainly target atypicals/respiratory pathogens. Metronidazole is a nitroimidazole used for anaerobes and protozoa and is not a carbapenem. Recognizing the “-penem” suffix is a reliable test-taking cue for carbapenems.
Which drug is used to treat type 2 diabetes?
- Metformin
- Lisinopril
- Atorvastatin
- Ibuprofen
Explanation: Answer reason: Metformin decreases gluconeogenesis in the liver and improves peripheral insulin sensitivity, leading to lower fasting and postprandial glucose without causing hypoglycemia when used alone. Lisinopril is an ACE inhibitor used for hypertension and kidney protection, atorvastatin treats hyperlipidemia, and ibuprofen is an NSAID for pain/inflammation—none directly treat hyperglycemia. Therefore, the only option that is an antidiabetic medication for type 2 diabetes is the biguanide listed.
Which drug is a beta-2 agonist used in asthma?
- Albuterol
- Fluticasone
- Prednisone
- Metoprolol
Explanation: Answer reason: A short-acting inhaled agent is the classic rescue medication for wheeze and bronchospasm, which matches this option. In contrast, inhaled corticosteroids are controller therapies that reduce airway inflammation but do not provide immediate bronchodilation. Systemic steroids treat exacerbations by decreasing inflammation over hours, and beta-blockers can worsen bronchospasm by opposing beta-2 effects in the lungs.
Which of the following drugs is a local anesthetic?
- Lidocaine
- Ibuprofen
- Simvastatin
- Furosemide
Explanation: Answer reason: This option is a commonly used amide local anesthetic for topical, infiltration, and regional anesthesia. By contrast, ibuprofen is an NSAID analgesic/anti-inflammatory, simvastatin is an HMG-CoA reductase inhibitor for hyperlipidemia, and furosemide is a loop diuretic for fluid overload and hypertension. Therefore the only choice that fits the pharmacologic class of local anesthetic is the selected one.
Which drug is commonly used to relieve osteoarthritis pain?
- NSAIDs
- Insulin
- Antimalarials
- Diuretics
Explanation: Answer reason: This makes anti-inflammatory analgesics appropriate for reducing pain and improving function in many patients. Insulin treats hyperglycemia, antimalarials are used for certain infections and autoimmune diseases (e.g., lupus), and diuretics manage fluid overload and hypertension rather than joint pain. Key nursing considerations with this drug class include GI bleeding risk, renal impairment, and cardiovascular risk, especially in older adults.
Which drug reduces fluid overload in HF?
- Diuretics
- Antibiotics
- Antacids
- Steroids
Explanation: Answer reason: This directly lowers preload, improving symptoms such as peripheral edema and pulmonary congestion. Antibiotics treat infection, antacids neutralize gastric acid, and steroids can worsen fluid retention, making them inappropriate for reducing volume overload. Diuretics (e.g., loop diuretics) are therefore the most directly effective drug class for decongestion in HF.
Which type of analgesic drug is derived from opium?
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Acetaminophen
- Opioids
- Antidepressants
Explanation: Answer reason: g., morphine, codeine) that act on opioid receptors to produce analgesia. Drugs derived from or modeled after these alkaloids are classified as opioids (including natural, semi-synthetic, and synthetic agents). NSAIDs and acetaminophen are non-opioid analgesics that work primarily via prostaglandin-related pathways rather than opioid receptors. Antidepressants can be used as adjuvant analgesics for neuropathic pain but are not derived from opium.
What is the primary side effect of clopidogrel?
- Bleeding
- Hypertension
- Hypoglycemia
- Drowsiness
Explanation: Answer reason: This mechanism directly increases the likelihood of bruising, epistaxis, GI bleeding, and intracranial hemorrhage, especially when combined with other antithrombotics. The other options are not typical primary adverse effects of platelet inhibition and do not reflect its pharmacologic action. Monitoring focuses on clinical bleeding and avoiding unnecessary concurrent NSAIDs/anticoagulants unless clearly indicated.
Which drug is used to treat depression?
- Sertraline
- Furosemide
- Lisinopril
- Metoprolol
Explanation: Answer reason: This medication is an SSRI, a first-line class for major depressive disorder due to efficacy and comparatively favorable safety in overdose versus older agents. By contrast, a loop diuretic is used for edema/heart failure, an ACE inhibitor treats hypertension/heart failure, and a beta-blocker primarily treats cardiovascular conditions. Therefore, the antidepressant option is the appropriate choice.
Which anticoagulant inhibits thrombin directly?
- Warfarin
- Clopidogrel
- Dabigatran
- Heparin
Explanation: Answer reason: This medication is a direct oral anticoagulant that targets thrombin itself rather than acting through antithrombin or reducing clotting factor synthesis. Heparin works indirectly by potentiating antithrombin (mainly inhibiting IIa and Xa) rather than directly binding thrombin. Warfarin decreases vitamin K–dependent clotting factor production and clopidogrel is an antiplatelet agent, so neither directly inhibits thrombin.
Which of the following is a common side effect of long-term opioid use?
- Nausea and vomiting
- Constipation
- Addiction and dependence
- Diarrhea
Explanation: Answer reason: With long-term use, tolerance develops to many opioid effects (e.g., nausea, sedation), but constipation typically persists with minimal tolerance. This makes constipation one of the most predictable chronic adverse effects and often requires proactive bowel regimen management. Diarrhea is not expected with opioid therapy and is more consistent with opioid withdrawal or other GI pathology.
Which drug is used to treat hyperlipidemia?
- Aspirin
- Atorvastatin
- Phenytoin
- Metformin
Explanation: Answer reason: Statins inhibit HMG-CoA reductase in the liver, lowering hepatic cholesterol synthesis and increasing LDL receptor expression to clear LDL from the blood. This mechanism directly targets the primary abnormality in most hyperlipidemia cases, making it first-line therapy. Aspirin is an antiplatelet drug for thrombosis prevention rather than lipid reduction, while phenytoin and metformin treat seizures and type 2 diabetes, respectively.
Which drug is a DPP-4 inhibitor used in diabetes?
- Metformin
- Glipizide
- Sitagliptin
- Pioglitazone
Explanation: Answer reason: This mechanism matches the medication class asked for. Metformin is a biguanide that decreases hepatic gluconeogenesis, glipizide is a sulfonylurea that increases insulin release irrespective of glucose level, and pioglitazone is a thiazolidinedione that increases insulin sensitivity via PPAR-γ. Therefore, the only DPP-4 inhibitor among the choices is the “-gliptin” agent.
What is a hallmark side effect of ACE inhibitors?
- Constipation
- Dry cough
- Hypoglycemia
- Photosensitivity
Explanation: Answer reason: This bradykinin effect commonly triggers a persistent, nonproductive cough and is considered a classic adverse effect of the drug class. Constipation and photosensitivity are not characteristic class effects of ACE inhibitors. Hypoglycemia is not a hallmark adverse effect; more typical safety concerns include hyperkalemia, renal function decline (especially with renal artery stenosis), and angioedema.
Which antibiotic is a fluoroquinolone?
- Erythromycin
- Azithromycin
- Ciprofloxacin
- Vancomycin
Explanation: Answer reason: This makes them broad-spectrum agents used for infections such as complicated UTIs, some GI infections, and certain respiratory pathogens depending on the specific drug. The other options are different antibiotic classes: erythromycin and azithromycin are macrolides, while vancomycin is a glycopeptide primarily targeting gram-positive organisms. Therefore the fluoroquinolone among the choices is the one with the “-floxacin” suffix.
Antihistamines ka major therapeutic use kya hai?
- Hypertension
- Peptic ulcer
- Allergic conditions
- Diabetes
Explanation: Answer reason: Therefore, their major therapeutic use is management of allergic states like allergic rhinitis and hives. Hypertension and diabetes are not treated by histamine receptor blockade as a primary mechanism. Although H2 blockers are used for peptic ulcer disease, the term “antihistamines” in common clinical/teaching usage typically refers to H1 agents for allergy relief, making this the best answer.
Which of the following drugs is a local anesthetic?
- Ibuprofen
- Furosemide
- Simvastatin
- Lidocaine
Explanation: Answer reason: The option selected is a classic amide local anesthetic used topically and by infiltration/nerve block for localized numbness. By contrast, ibuprofen is an NSAID analgesic/anti-inflammatory, furosemide is a loop diuretic, and simvastatin is an HMG-CoA reductase inhibitor for hyperlipidemia. Therefore, only one choice matches the pharmacologic class of local anesthetics.
Which drug is a glycopeptide antibiotic?
- Erythromycin
- Ciprofloxacin
- Vancomycin
- Azithromycin
Explanation: Answer reason: The option that belongs to this class is the drug commonly used for MRSA and severe Clostridioides difficile (oral formulation). Erythromycin and azithromycin are macrolides (50S ribosomal inhibitors), while ciprofloxacin is a fluoroquinolone (DNA gyrase/topoisomerase inhibitor). This makes the glycopeptide choice clearly distinct among the listed antibiotics.
What is the main side effect of opioid analgesics?
- Bradycardia
- Hypertension
- Respiratory depression
- Hyperglycemia
Explanation: Answer reason: This is the most clinically dangerous dose-related adverse effect and the key toxicity that nurses monitor (respiratory rate, sedation level, oxygenation), especially after dose increases or in opioid-naïve patients. Bradycardia can occur but is not the primary hallmark complication compared with ventilatory suppression. Hypertension and hyperglycemia are not typical principal opioid adverse effects; opioids more often cause hypotension via histamine release and vasodilation.
What is the mechanism of action of heparin?
- Activates antithrombin
- Inhibits platelet aggregation
- Blocks thrombin
- Inhibits vitamin K
Explanation: Answer reason: By enhancing antithrombin activity, it primarily decreases factor Xa and thrombin (IIa) activity, preventing clot propagation rather than dissolving existing clots. “Blocks thrombin” is incomplete because heparin does not directly inhibit thrombin; it requires antithrombin as a cofactor. “Inhibits vitamin K” describes warfarin, and platelet aggregation inhibition is characteristic of antiplatelet agents rather than heparin.
What is the mechanism of action of omeprazole?
- Stimulates gastric motility
- Blocks histamine receptors
- Inhibits carbonic anhydrase
- Inhibits proton pump
Explanation: Answer reason: This produces the most potent suppression of basal and stimulated gastric acid output, supporting ulcer healing and GERD symptom control. In contrast, blocking histamine receptors describes H2 blockers (e.g., famotidine), which reduce but do not fully shut down acid secretion. Carbonic anhydrase inhibition is typical of drugs like acetazolamide, not standard acid-suppressive therapy. Prokinetic activity (stimulating motility) aligns with agents such as metoclopramide rather than PPIs.
Which of the following antituberculosis drugs can damage the 8th cranial nerve?
- Isoniazid (INH)
- Para Aminosalicylic acid (PAS)
- Ethambutol hydrochloride (myambutol)
- Streptomycin
Explanation: Answer reason: Streptomycin is an aminoglycoside used as a second-line antitubercular agent and is classically associated with vestibular toxicity. Monitoring for auditory/vestibular symptoms and renal function is important because impaired clearance increases toxicity risk. In contrast, ethambutol is best known for optic neuritis (CN II), and isoniazid is associated with peripheral neuropathy from pyridoxine deficiency rather than CN VIII injury.
A patient experiencing an acute gout attack is prescribed antigout medication to reduce inflammation and pain. The physician prescribes colchicine, 1.2 mg PO as a loading dose, followed by 0.6 mg every hour (up to 16 doses) until relief is obtained or until adverse reactions develop. When can the patient expect relief from pain and inflammation?
- 3 hours
- 5 hours
- 10 hours
- 12 hours
Explanation: Answer reason: With the oral loading dose followed by hourly dosing, clinically meaningful relief is typically seen around 6 hours, and 5 hours is the closest option. Earlier relief (e.g., 3 hours) is less consistent because the anti-inflammatory effect depends on reaching adequate tissue levels and interrupting leukocyte-driven inflammation. Much later times (10–12 hours) are less typical for the classic acute-dosing regimen and would not match expected onset. Ongoing dosing is limited by dose-limiting GI toxicity (nausea, vomiting, diarrhea), which often appears before prolonged hourly dosing.
A client receiving heparin sodium asks the nurse how the drug works. Which of the following points would the nurse include in the explanation to the client?
- It dissolves existing thrombi.
- It interferes with vitamin K absorption.
- It inactivates thrombin that forms and dissolves existing thrombi
- It prevents the conversion of factors that are needed in the formation of clots.
Explanation: Answer reason: Heparin is an anticoagulant that works by potentiating antithrombin III, which inhibits key activated clotting factors (especially thrombin/IIa and factor Xa) and thereby prevents further fibrin clot formation. Its primary clinical effect is to stop clot propagation and prevent new clots rather than to break down clots already formed. Thrombolysis (dissolving existing thrombi) is the role of fibrinolytics such as alteplase, not heparin. Interfering with vitamin K is the mechanism of warfarin, making that option a common distractor.
Which of the following quinolones is active against Pseudomonas aeruginosa?
- Ciprofloxacin, levofloxacin and moxifloxacin.
- Ciprofloxacin and levofloxacin.
- Only levofloxacin.
- Moxifloxacin only.
- Levofloxacin and moxifloxacin.
Explanation: Answer reason: Anti-pseudomonal activity among fluoroquinolones is limited and is strongest with ciprofloxacin, with levofloxacin also retaining clinically relevant activity. Moxifloxacin has enhanced Gram-positive and anaerobic coverage but lacks reliable activity against Pseudomonas aeruginosa, so options including it are incorrect. This question tests recognition of drug-specific spectrum rather than class-wide assumptions. Choosing the agents with consistent Pseudomonas coverage best matches standard antimicrobial spectrum teaching and clinical use.
Allopurinol (Zyloprim) has been prescribed for a client. The nurse prepares to administer this medication, knowing that which information is accurate regarding it?
- It is used for the lysis of thrombi obstructing coronary arteries.
- It decreases sympathetic outflow from the central nervous system.
- It prevents calcium ion entry across cell membranes of the cardiac smooth muscle.
- It decreases uric acid production and reduces uric acid concentrations in serum and urine.
Explanation: Answer reason: Allopurinol inhibits xanthine oxidase, the enzyme responsible for converting purines to uric acid, thereby lowering uric acid synthesis. This leads to reduced serum urate levels and decreased urinary uric acid, helping prevent gout attacks and uric acid stone formation over time. The thrombolysis statement describes fibrinolytics (e.g., alteplase), not a urate-lowering drug. The sympathetic outflow and calcium-channel blockade statements describe other antihypertensive/antianginal mechanisms unrelated to allopurinol.
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