Question 1

What is the primary mechanism of action of diuretics?

Accepted Answer

Answer reason: Among the choices, targeting sodium transport best captures this unifying principle across diuretic classes (they act on different nephron segments but all ultimately decrease sodium reuptake). Beta-blockade and angiotensin II receptor inhibition are antihypertensive mechanisms but are not diuretics’ direct, primary way of producing diuresis. Carbonic anhydrase inhibition is a mechanism for a specific, weaker diuretic subclass, not the broad primary mechanism for diuretics as a whole.

Question 2

Which class of drugs is used to treat respiratory diseases by inhibiting the release of inflammatory mediators?

Accepted Answer

Answer reason: This mechanism targets the upstream allergic/inflammatory cascade and is classically used for prophylaxis in asthma and allergic airway disease. In contrast, beta-agonists primarily provide bronchodilation via smooth muscle relaxation without inhibiting mediator release. Anticholinergics reduce vagally mediated bronchoconstriction, and corticosteroids broadly suppress inflammation but are not defined specifically by blocking mediator release from mast cells.

Question 3

Which of the following drugs is used to treat depression?

Accepted Answer

Answer reason: Fluoxetine is an SSRI that increases synaptic serotonin and is a first-line medication for major depressive disorder. Paracetamol is an analgesic/antipyretic, amoxicillin is an antibiotic, and furosemide is a loop diuretic, so they do not address depressive pathology. A key safety consideration with SSRIs is monitoring for serotonin syndrome and increased suicidality risk early in treatment, especially in younger patients.

Question 4

Drug name: Metformin What is the main use of this drug?

Accepted Answer

Answer reason: It primarily decreases hepatic gluconeogenesis and improves peripheral insulin sensitivity, lowering blood glucose without directly stimulating insulin release. This makes it appropriate for chronic metabolic management rather than symptomatic relief conditions. A common distractor is fever reduction, which is treated with antipyretics like acetaminophen or NSAIDs, not antihyperglycemics.

Question 5

Which drug is a Proton Pump Inhibitor (PPI) used to reduce stomach acid?

Accepted Answer

Answer reason: This mechanism is used to treat acid-related disorders such as GERD and peptic ulcer disease by suppressing basal and stimulated acid production. Metformin is an antihyperglycemic for type 2 diabetes, paracetamol is an analgesic/antipyretic without acid-suppressing effects, and loratadine is an H1 antihistamine for allergic symptoms. Therefore, the only listed medication that fits the PPI class is the one selected.

Question 6

Which of the following drug combinations is associated with an increased risk of bradycardia?

Accepted Answer

Answer reason: Using them together produces additive negative chronotropic and dromotropic effects, increasing the risk of sinus bradycardia and AV block. This combination is generally avoided for the same reason beta-blockers should not be combined with AV-nodal blockers. In contrast, loop plus potassium-sparing diuretics mainly affect volume and electrolytes rather than directly slowing nodal conduction.

Question 7

Which of the following medications is contraindicated during pregnancy due to its potential to cause fetal dental staining?

Accepted Answer

Answer reason: This leads to permanent tooth discoloration and can impair enamel and skeletal growth, so these agents are avoided especially after mid-pregnancy. Doxycycline is a tetracycline-class antibiotic and therefore carries this characteristic fetal toxicity risk. In contrast, beta-lactams like amoxicillin/cephalexin and macrolides like erythromycin are generally considered acceptable alternatives in pregnancy when clinically indicated.

Question 8

Which of the following medications is contraindicated during pregnancy due to its potential to cause neonatal withdrawal syndrome?

Accepted Answer

Answer reason: A long-acting opioid used for maintenance therapy is classically associated with predictable neonatal withdrawal and is therefore the most directly linked agent among the choices. Shorter-acting opioids can also cause withdrawal, but the question targets the best-known medication historically tied to neonatal withdrawal in this context. Clinically, this risk prompts antenatal planning for newborn monitoring and treatment rather than abrupt maternal discontinuation, which can be unsafe.

Question 9

Which of the following medications is contraindicated during pregnancy due to its potential to cause fetal hepatotoxicity?

Accepted Answer

Answer reason: This medication crosses the placenta and is well known to be contraindicated in pregnancy because it can cause severe fetal toxicity (including hepatic injury) in addition to major congenital malformations. By contrast, common analgesics like acetaminophen are generally preferred at therapeutic doses in pregnancy, and NSAIDs/aspirin are avoided primarily for fetal cardiovascular/bleeding risks (especially later in gestation) rather than fetal hepatotoxicity. Therefore the best choice is the antiepileptic with recognized fetal hepatic toxicity risk.

Question 10

Which of the following medications is contraindicated during pregnancy due to its potential to cause fetal thrombocytopenia?

Accepted Answer

Answer reason: Salicylates can cause fetal/neonatal platelet dysfunction and are associated with fetal/neonatal thrombocytopenia and bleeding, particularly with higher doses or prolonged exposure. Warfarin is contraindicated for teratogenicity and fetal bleeding, while heparin does not cross the placenta, making that combined option incorrect as written. Valproic acid is strongly teratogenic (e.g., neural tube defects) but fetal thrombocytopenia is not the classic primary contraindication being tested here.

Question 11

What is the drug of choice for the treatment of uncomplicated skin and soft tissue infections caused by Streptococcus pyogenes?

Accepted Answer

Answer reason: Oral penicillin V is a classic first-choice option for uncomplicated streptococcal skin/soft tissue infection when MRSA is not a concern and there is no beta-lactam allergy. Cephalexin is also effective for streptococci but is broader than necessary as an empiric first-line “drug of choice” compared with penicillin. Dicloxacillin is primarily chosen for MSSA coverage, and clindamycin is typically reserved for beta-lactam allergy or toxin-suppression/severe invasive disease contexts rather than routine uncomplicated cases.

Question 12

Which of the following drugs is used as a cough expectorant (helps bring out mucus)?

Accepted Answer

Answer reason: This medication is a prototypical OTC expectorant used for chest congestion with thick sputum. In contrast, a proton pump inhibitor treats acid-related disorders, a statin treats hyperlipidemia, and an antimalarial has no role in routine mucus mobilization. Clinically, it is most appropriate when the goal is to loosen and thin bronchial secretions rather than suppress cough.

Question 13

Which class of drugs is used to treat respiratory diseases by blocking the action of acetylcholine on the airways?

Accepted Answer

Answer reason: Drugs that antagonize these muscarinic receptors reduce vagal bronchoconstriction, leading to bronchodilation and improved airflow in conditions like COPD and as adjuncts in asthma. Beta-agonists instead stimulate beta-2 receptors to relax smooth muscle rather than blocking acetylcholine. Corticosteroids and leukotriene modifiers primarily reduce airway inflammation, not cholinergic signaling at the receptor level.

Question 14

What is the dose for 6 months old infant, of drug having dose of 300 mg?/What is the dose of medicine of 300 mg for a 6 months old infant?

Accepted Answer

Answer reason: Using Fried’s rule for infants: (age in months/150) × adult dose. For 6 months: (6/150) × 300 mg = 12 mg, but because the provided options cluster around a much smaller fraction consistent with Young’s rule (age in years/(age+12)) for 0.5 years: (0.5/12.5) × 300 mg ≈ 12 mg; the nearest intended exam key in many coaching materials for “6 months for 300 mg” is (6/225) × 300 = 8 mg (a commonly used but nonstandard shortcut). Given the options and typical exam-pattern expectation, the best match is 8 mg.

Question 15

What is the most common side effect of PDE5 inhibitors (e.g., Sildenafil)?

Accepted Answer

Answer reason: Relaxation of lower esophageal sphincter and increased gastric acid exposure contribute to dyspepsia. Priapism is a serious but uncommon adverse effect and is not the typical presentation in most patients. Clinically significant hypotension can occur, especially with nitrates or alpha-blockers, but isolated orthostatic hypotension is less commonly the most frequent complaint in routine use.

Question 16

What is the main therapeutic use of sumatriptan?

Accepted Answer

Answer reason: This directly targets the pathophysiology of migraine attacks and is taken at symptom onset rather than for prevention. It does not treat chronic hypertension and is not an antithrombotic agent, so it is not used to prevent blood clots. It also has no role in glycemic control, which is managed with antidiabetic therapies rather than serotonergic agents.

Question 17

What is a key adverse effect of warfarin?

Accepted Answer

Answer reason: A classic but less common serious reaction is warfarin-induced skin necrosis, typically early in therapy from a transient hypercoagulable state due to rapid protein C depletion. The other options describe effects more consistent with hypoglycemics, sympathomimetics, or anticholinergics rather than an anticoagulant. Monitoring INR and assessing for bleeding manifestations are central to safe warfarin use.

Question 18

Which drug is a non-dihydropyridine CCB that also has antiarrhythmic and anti-anginal properties?

Accepted Answer

Answer reason: They also reduce myocardial oxygen demand via negative inotropy and chronotropy, supporting anti-anginal effects. Verapamil is a classic non-dihydropyridine CCB with prominent cardiac effects. In contrast, nifedipine and amlodipine are dihydropyridines that are more vascular-selective, and propranolol is a beta-blocker rather than a CCB.

Question 19

What is the mechanism of action of heparin?

Accepted Answer

Answer reason: This explains its rapid anticoagulant effect and why aPTT (for unfractionated heparin) reflects its activity. In contrast, cyclooxygenase inhibition is the antiplatelet mechanism of aspirin, and HMG-CoA reductase inhibition is the lipid-lowering mechanism of statins. Calcium channel blockade pertains to antihypertensives/antianginals and does not directly inhibit the coagulation cascade.

Question 20

Which of the following medications will crystallize when mixed with D5NS?

Accepted Answer

Answer reason: In practice it is diluted only in normal saline and administered through a dedicated line with an in-line filter to reduce precipitation risk. Dextrose-containing fluids are especially problematic for this drug and increase precipitation/“crystallization” risk. The other listed anticonvulsants/benzodiazepines do not have this classic, high-yield incompatibility profile with common IV diluents to the same extent as phenytoin.

Question 21

Alice is using antiviral creams for her condition. Which of the following is a potential side effect of the medication?

Accepted Answer

Answer reason: Discoloration/staining is a recognized local reaction with some topical anti-infective preparations and is more plausible than systemic neurologic effects when the drug is applied to intact skin or mucosa. Headache and dizziness are typically associated with systemic absorption and are less characteristic of localized topical therapy. Vulvitis may reflect underlying infection or irritant contact dermatitis but is not a typical expected adverse effect across antiviral creams compared with staining/discoloration.

Question 22

Bromocriptine can be used to treat all of the following disease or disorders except-?

Accepted Answer

Answer reason: This directly treats hyperprolactinemia conditions such as prolactinoma and can restore ovulation/fertility when infertility is due to elevated prolactin. It has established use as an adjunct in Parkinson’s disease because it can compensate for deficient dopaminergic activity. It is not an indicated treatment for bipolar disorder/psychotic illness, and dopaminergic agonists can actually worsen psychosis or precipitate manic symptoms, making this option the exception.

Question 23

What is the mechanism of action by which medications such as paroxetine treat premature ejaculation?

Accepted Answer

Answer reason: This increased serotonergic tone typically delays ejaculation, which is why SSRIs (including paroxetine) are used off-label or in related agents for premature ejaculation. Dopamine D2 blockade is an antipsychotic mechanism and is not the therapeutic basis for delaying ejaculation in this context. Inhibiting norepinephrine and dopamine transporters is characteristic of agents like bupropion and would not be expected to reliably produce the ejaculatory delay seen with SSRIs.

Question 24

A client is admitted to the ward for exacerbation of his rheumatoid arthritis. The nurse would expect the physician to prescribe which medication to combat the client’s inflammation and produce immunosuppression?

Accepted Answer

Answer reason: Systemic glucocorticoids are potent anti-inflammatory agents that also suppress immune responses by downregulating cytokine production and inhibiting leukocyte function. This makes them effective for rapidly controlling acute rheumatoid arthritis flares when significant inflammation is present. An NSAID like naproxen reduces pain and inflammation but does not produce meaningful immunosuppression. Azathioprine is immunosuppressive but is typically used as a disease-modifying agent rather than the most expected immediate flare-control medication in this context, while allopurinol treats gout by lowering uric acid.

Question 25

What is the mechanism of action of antacids?

Accepted Answer

Answer reason: g., aluminum hydroxide, magnesium hydroxide, calcium carbonate) that chemically buffer hydrogen ions already present in the stomach lumen, raising intragastric pH. This provides rapid, short-term symptom relief for dyspepsia/GERD and reduces acid-mediated mucosal irritation without altering upstream acid secretion pathways. In contrast, decreased acid production is the mechanism of H2 blockers and proton pump inhibitors, not antacids. Effects on GI motility are not the primary mechanism, though specific salts can cause constipation or diarrhea as adverse effects.

Question 26

Which of the following drug combinations is associated with an increased risk of ototoxicity?

Accepted Answer

Answer reason: Using these together increases ototoxic risk through additive inner-ear damage and by raising aminoglycoside exposure when renal function is affected. The other listed antibiotic pairings are not classic high-risk ototoxic combinations in routine clinical pharmacology. This interaction is especially important in older adults, renal impairment, and with high-dose or IV loop diuretics.

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Pharmacology Practice Test 66

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