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NRNP 5110: Advanced Pharmacology Midterm Exam 1 2025
Questions and Revised Correct Answers with Rationales
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- Which of the following drug classes is commonly prescribed for hypertension and works by inhibiting angiotensin-converting enzyme? A. Beta blockers B. Calcium channel blockers C. ACE inhibitors D. Diuretics
ACE inhibitors block the conversion of angiotensin I to angiotensin II,
leading to vasodilation and decreased blood pressure.
- What is the primary mechanism of action of proton pump inhibitors (PPIs)? A. Neutralize gastric acid B. Block histamine H2 receptors C. Inhibit H+/K+ ATPase enzyme in gastric parietal cells D. Increase gastric mucus production
PPIs reduce gastric acid secretion by irreversibly blocking the proton
pump in the stomach lining.
- A black box warning for fluoroquinolone antibiotics includes:
A. Nephrotoxicity B. Hepatotoxicity C. Tendon rupture D. Ototoxicity
Fluoroquinolones carry a risk for tendonitis and tendon rupture,
particularly in older adults.
- Which antidiabetic drug is contraindicated in patients with heart failure? A. Metformin B. Pioglitazone C. Sitagliptin D. Glipizide
Pioglitazone can cause fluid retention, worsening heart failure.
- Which of the following medications requires routine INR monitoring? A. Dabigatran B. Warfarin C. Rivaroxaban D. Apixaban
Warfarin’s narrow therapeutic index requires monitoring to avoid
bleeding or clotting risks.
- The antidote for opioid overdose is: A. Flumazenil B. Atropine C. Naloxone
D. Inhaled corticosteroid
SABAs provide rapid bronchodilation for acute symptom relief.
10.Which of the following is a long-acting insulin? A. Regular insulin B. NPH C. Glargine D. Lispro
Insulin glargine provides basal insulin coverage for 24 hours.
11.Which medication is used to treat neuropathic pain? A. Acetaminophen B. Gabapentin C. Ibuprofen D. Morphine
Gabapentin modulates calcium channels and is effective for neuropathic
pain.
12.Which antibiotic is safe during pregnancy? A. Tetracycline B. Amoxicillin C. Ciprofloxacin D. Doxycycline
Amoxicillin is a category B drug and generally considered safe in
pregnancy.
13.Which drug can cause gingival hyperplasia?
A. Phenytoin B. Carbamazepine C. Valproic acid D. Levetiracetam
Phenytoin is associated with gum overgrowth as a side effect.
14.What lab value should be monitored with ACE inhibitors? A. WBC B. Potassium C. Hemoglobin D. Magnesium
ACE inhibitors can cause hyperkalemia.
15.What is the first-line therapy for generalized anxiety disorder? A. Bupropion B. SSRIs C. Benzodiazepines D. TCAs
SSRIs are preferred due to lower risk of dependency and effective
symptom management.
16.What is the mechanism of action of loop diuretics? A. Inhibit Na-K-2Cl transporter in the ascending loop of Henle B. Inhibit aldosterone in the collecting duct C. Block sodium channels in the distal tubule D. Block carbonic anhydrase
20.Which of the following drugs causes red-orange discoloration of body fluids? A. Isoniazid B. Rifampin C. Ethambutol D. Pyrazinamide
Rifampin causes red-orange urine, sweat, and tears.
21.Which medication is a beta-1 selective blocker? A. Propranolol B. Metoprolol C. Labetalol D. Carvedilol
Metoprolol primarily affects beta-1 receptors in the heart.
22.What is the black box warning for SSRIs in children and adolescents? A. Increased risk of suicidal ideation B. Liver failure C. Seizures D. Serotonin syndrome
SSRIs may increase the risk of suicidal thoughts in young people.
23.Which antipsychotic has the highest risk of metabolic syndrome? A. Haloperidol B. Olanzapine C. Risperidone
D. Ziprasidone
Olanzapine is associated with significant weight gain and insulin
resistance.
24.Which opioid is used for diarrhea? A. Morphine B. Hydromorphone C. Loperamide D. Fentanyl
Loperamide acts on gut opioid receptors to reduce motility.
25.Which anticoagulant is safe in pregnancy? A. Heparin B. Warfarin C. Dabigatran D. Rivaroxaban
Heparin does not cross the placenta and is preferred in pregnancy.
26.Which medication is most appropriate for managing acute gout? A. Allopurinol B. Colchicine C. Probenecid D. Febuxostat
Colchicine is used to treat acute gout attacks due to its anti-
inflammatory properties.
A. Beta-1 receptor antagonist B. Alpha-2 receptor agonist C. Beta-2 receptor agonist D. Muscarinic receptor blocker
Albuterol selectively stimulates beta-2 receptors, causing
bronchodilation.
31.Which medication is a dopamine agonist used to treat Parkinson’s disease? A. Selegiline B. Levodopa C. Pramipexole D. Benztropine
Pramipexole mimics dopamine at the receptor level, improving motor
symptoms.
32.What is a common side effect of SSRIs? A. Weight loss B. Orthostatic hypotension C. Sexual dysfunction D. Bradycardia
SSRIs frequently cause decreased libido and anorgasmia.
33.Which antibiotic inhibits bacterial protein synthesis at the 50S ribosomal subunit? A. Tetracycline B. Azithromycin
C. Gentamicin D. Ciprofloxacin
Macrolides like azithromycin act at the 50S subunit, preventing protein
synthesis.
34.What is the first-line treatment for Clostridioides difficile infection? A. Metronidazole B. Ciprofloxacin C. Oral vancomycin D. Azithromycin
Oral vancomycin is preferred for its high efficacy and low systemic
absorption.
35.Which diuretic increases calcium reabsorption? A. Thiazide diuretics B. Loop diuretics C. Osmotic diuretics D. Potassium-sparing diuretics
Thiazides reduce calcium excretion, which can help in kidney stone
prevention.
36.What is the antidote for benzodiazepine overdose? A. Naloxone B. Atropine C. Flumazenil D. Physostigmine
Alpha-1 blockers like tamsulosin relax the bladder neck and prostate
muscles.
40.Which drug reduces stomach acid by blocking histamine H2 receptors? A. Omeprazole B. Sucralfate C. Ranitidine D. Misoprostol
H2 blockers like ranitidine reduce acid by inhibiting histamine receptors
in parietal cells.
41.What is a major side effect of aminoglycosides? A. Hepatotoxicity B. Constipation C. Neutropenia D. Ototoxicity
Aminoglycosides like gentamicin can cause irreversible hearing loss.
42.What condition is a contraindication to the use of beta-blockers? A. Migraine B. Asthma C. Heart failure D. Atrial fibrillation
Beta-blockers can cause bronchoconstriction in asthma patients.
43.Which of the following drugs is a serotonin-norepinephrine reuptake inhibitor (SNRI)?
A. Fluoxetine B. Venlafaxine C. Bupropion D. Mirtazapine
Venlafaxine blocks the reuptake of both serotonin and norepinephrine.
44.What is the most serious potential side effect of clozapine? A. Insomnia B. Agranulocytosis C. Tardive dyskinesia D. Hypertension
Clozapine requires frequent WBC monitoring due to the risk of life-
threatening neutropenia.
45.Which medication is used to reverse the effects of heparin? A. Vitamin K B. Protamine sulfate C. Idarucizumab D. FFP
Protamine sulfate neutralizes heparin’s anticoagulant effect.
46.Which class of drugs is associated with dry cough? A. Beta-blockers B. ACE inhibitors C. ARBs
50.What is a major concern with combining SSRIs and MAOIs? A. Hypertensive crisis B. Serotonin syndrome C. Addison's disease D. Neuroleptic malignant syndrome
Combining serotonergic agents can lead to serotonin syndrome, a
potentially fatal condition.
