Chapter 1: Pharmacology An Introduction

1. The study of drug absorption, distribution, metabolism, and 6. A drug that has the potential for abuse and is regulated by the
excretion is known as (LO 1.1) Drug Enforcement Agency is classified as a (LO 1.7)
A. pharmacotherapeutics A. poison
B. pharmacodynamics B. OTC drug
C. pharmacokinetics C. prescription drug
D. pharmacy D. controlled substance
E. posology E. nonproprietary drug
2. The medical situation when a particular drug should not be
7. Select the term that relates to the amount of drug administered
administered is referred to as (LO 1.2)
to produce a therapeutic effect. (LO 1.1)
A. side effect
A. posology
B. adverse effect
B. toxicology
C. drug allergy
C. pharmacodynamics
D. contraindication
D. pharmacotherapeutics
E. antagonism
E. pharmacy
3. An unusual or unexpected drug reaction by an individual is 8. A medication that does not require a physician’s service to
known as (LO 1.5) obtain is referred to as (LO 1.6)
A. toxic effect A. trade
B. antagonism B. nonproprietary
C. idiosyncrasy @ C. nonprescription
D. side effect D. brand
E. drug allergy E. generic
4. The proprietary drug name supplied by a pharmaceutical 9. Which of the following could be categorized as an adverse
company is also referred to as the (LO 1.6) reaction? (LO 1.5)
A. generic name A. idiosyncrasy
B. over-the-counter name B. drug allergy
C. trade name C. teratogenicity
D. chemical name D. carcinogenicity
E. none of these E. all of these
5. The time from drug administration to the first observable drug 10. The time a drug continues to produce its effect is its (LO 1.4)
effect is known as the (LO 1.4) A. ED50
A. duration of action B. maximal response
B. onset of action C. ceiling effect
C. ceiling effect D. onset of action
D. maximal response E. duration of action @
E. ceiling effect

Chapter 2: Pharmacokinetics and Factors of Individual Variation

1. The drug administration route demonstrating the slowest onset 6. When a drug increases the rate of drug metabolism of other
of action is (LO 2.1) drugs, the process is termed (LO 2.2)
A. inhalation A. first-pass metabolism
B. transdermal B. enzyme induction
C. intramuscular C. enzyme inhibition
D. sublingual D. enterohepatic cycling
E. intravenous E. microsomal inhibition
2. For drugs to cross the blood–brain barrier, they must be (LO 7. The rate of drug absorption would be increased by which of the
2.2) following? (LO 2.2)
A. ionized A. drug ionization
B. positively charged B. water solubility
C. water soluble C. positively charged drug
D. lipid soluble D. negatively charged drug
E. negatively charged E. lipid solubility @
3. First-pass metabolism refers to the metabolism of drugs in the  8. Which factor of individual variation is dependent upon the
(LO 2.2) patient’s attitude toward treatment? (LO 2.4)
A. kidney A. weight
B. blood vessels B. age
C. liver C. genetic variation
D. heart D. placebo effect
E. adipose tissue E. gender
4. Drug X has a half-life of 6 hours. How much drug is left in the 9. Which FDA pregnancy category would appear to be the safest
body 18 hours after an IV injection of 1200 mg? (LO 2.3) for a developing fetus? (LO 2.5)
A. 75 mg A. Category A
B. 150 mg B. Category B
C. 300 mg C. Category C
D. 600 mg D. Category D
E. 900 mg E. Category X
5. Drugs that have demonstrated teratogenic effects in women are 10. Which type of drug interaction describes a combined effect
classified as Pregnancy Category (LO 2.5) equal to the sum of the individual effects of two drugs? (LO 2.6)
A. B A. summation
B. C B. synergism
C. D C. antagonism
D. X D. incompatibility
E. NR @ E. none of these

Chapter 5: Introduction to the Autonomic Nervous System

1. Select the nerve–function combination that is correctly
5. Somatic nerves send nerve impulses to
matched.
A. smooth muscle
A. afferent nerve—conducts nerve impulses to peripheral organs
B. skeletal muscle
B. efferent nerve—conducts sensory nerve impulses
C. cardiac muscle
C. autonomic nerve—conducts nerve impulses to visceral organs
D. visceral organs
D. adrenergic nerve—conducts nerve impulses to skeletal muscle
E. intestinal tract
E. somatic nerve—conducts nerve impulses to smooth muscle
2. Sympathetic activation produces all of the following effects 6. During the fight or flight reaction, the adrenal medulla
except predominately releases
A. relaxation of urinary bladder A. acetylcholine
B. increased heart rate B. norepinephrine
C. pupillary dilation C. epinephrine
D. bronchoconstriction D. dopamine
E. constriction of urinary sphincter E. serotonin
7. Choose the body function that is increased during the fight or
3. The sympathetic postganglionic nerve ending releases
flight reaction.
A. epinephrine
A. digestion
B. norepinephrine
B. urination
C. acetylcholine
C. elimination
D. dopamine
D. bronchoconstriction
E. none of these
E. heart rate
4. The neurotransmitter released at both sympathetic and 8. Which of the following neurotransmitters is released from
parasympathetic ganglia is cholinergic nerves?
A. acetylcholine A. norepinephrine
B. dopamine B. epinephrine
C. epinephrine C. catecholamine
D. norepinephrine D. acetylcholine
E. serotonin E. serotonin

Chapter 6: Drugs Affecting the Sympathetic Nervous System

1. The main pharmacologic effect of norepinephrine on alpha-1
6. Metoprolol is classified as a(n)  (LO 6.7)
receptors is (LO 6.2)
A. alpha-blocker
A. increased heart rate
B. nonselective beta-blocker
B. bronchodilation
C. selective beta-1 blocker
C. vasoconstriction
D. adrenergic neuronal blocker
D. contraction of urinary bladder
E. selective beta-2 blocker
E. increased force of myocardial contraction
2. The pharmacologic effect of IV metaraminol is (LO 6.4) 7. The mechanism of action of methyldopa is  (LO 6.8)
A. vasodilation A. increased release of NE from adrenergic nerve ending
B. vasoconstriction B. alpha-1 receptor blocker
C. cardiac stimulation C. beta-1 receptor blocker
D. cardiac depression D. formation of a false transmitter in adrenergic nerve ending
E. bronchodilation E. none of these
 8. The drug of choice to treat acute allergic reactions is  (LO 6.4,
3. Epinephrine stimulates (LO 6.2)
6.5)
A. alpha-1 receptors
A. norepinephrine
B. alpha-2 receptors
B. phenylephrine
C. beta-1 receptors
C. pseudoephedrine
D. beta-2 receptors
D. epinephrine
E. all of these
E. propranolol
9. Which of the following are actions of nonselective beta-
4. At therapeutic doses, albuterol stimulates  (LO 6.5)
adrenergic blocking drugs?  (LO 6.7)
A. alpha-1 receptors
A. decreasing heart rate
B. alpha-2 receptors
B. decreasing force of myocardial contraction
C. beta-1 receptors
C. vasoconstriction of skeletal muscle blood vessels
D. beta-2 receptors
D. lowering of blood pressure
E. all of these
E. all of these
10. The actions of epinephrine (EPI) include which of the
5. Tamsulosin is indicated for treatment of  (LO 6.6)
following? (LO 6.3, 6.5)
A. hypertension
A. bronchodilation
B. benign prostatic hyperplasia
B. vasoconstriction
C. slow heart rate
C. relaxation of uterus
D. cardiac arrhythmias
D. increased heart rate
E. asthma
E. all of these

Chapter 7: Drugs Affecting the Parasympathetic Nervous System

1. Parasympathetic receptors located on the membranes of the
6. The antidote for atropine poisoning is (LO7.3)
internal organs are classified as (LO 7.2)
A. scopolamine
A. alpha-1
B. bethanechol
B. nicotinic-neural (Nn)
C. neostigmine
C. nicotinic-muscle (Nm)
D. physostigmine
D. muscarinic
E. dicyclomine
E. ganglionic
2. Select the pharmacologic effect produced by cholinergic drugs.
7. Tolterodine (Detrol) is indicated for the treatment of (LO 7.5)
(LO 7.3)
A. motion sickness
A. increased heart rate
B. relief of urinary incontinence
B. increased gastrointestinal motility
C. ophthalmic examinations
C. decreased urination
D. glaucoma
D. pupillary dilation
E. Alzheimer’s disease
E. bronchodilation
8. Select the effect(s) produced by anticholinergic drugs such as
3. Physostigmine (Eserine) is classified as a(n) (LO7.3)
atropine. (LO 7.5)
A. direct-acting cholinergic drug
A. mydriasis
B. reversible acetylcholinesterase inhibitor
B. bronchodilation
C. irreversible acetylcholinesterase inhibitor
C. cycloplegia
D. anticholinergic
D. sedation
E. ganglionic blocker
E. all of these
9. Pick the correct pharmacologic effect(s) of direct-acting
4. Symptoms of cholinergic drug overdosage include (LO7.3)
cholinergic drugs. (LO 7.3)
A. slow pulse rate
A. respiratory paralysis
B. increased urination
B. urinary retention
C. diarrhea
C. increased heart rate
D. sweating
D. bronchodilation
E. all of these
E. none of these
5. Anticholinergic effects include all of the following except (LO 10. Which of the following would be a preferred treatment for
7.5) overactive bladder? (LO 7.6)
A. bronchodilation A. neostigmine
B. increased heart rate B. tolterodine
C. increased gastrointestinal activity C. physostigmine
D. decreased respiratory secretions D. bethanechol
E. dry mouth E. donepezil

Chapter 8: Drugs Affecting the Autonomic Ganglia

1. The receptors located on the ganglia of both autonomic nerve 5. The drug that blocks nicotinic receptors in the brain is (LO 8.2)
divisions are (LO 8.1)
A. trimethaphan
A. nicotinic-neural (Nn)
B. atropine
B. nicotinic-muscle (Nm)
C. varenicline
C. muscarinic
D. mecamylamine @
D. anticholinergic
E. adrenergic E. bupropion
6. Which of the following is an effect of ganglionic blockade? (LO
2. The effects produced by nicotine include (LO 8.1)
8.3)
A. increased heart rate
A. decreased blood pressure
B. increased intestinal activity
B. reduced urination
C. increased blood pressure
C. bradycardia
D. CNS effects
D. impotence
E. all of these
E. all of these
3. Pharmacologic effects produced by mecamylamine (Inversine) 7. Ganglionic blocking drugs interact with which types of drugs? 
include (LO 8.3) (LO 8.4)
A. increased urination A. cholinergic
B. decreased blood pressure B. anticholinergic
C. diarrhea C. adrenergic
D. increased heart rate D. antiadrenergic
E. all of these E. all of these
8. The most common side effect(s) of ganglionic blockers would
4. At high or toxic doses, nicotine may cause (LO 8.2)
be (LO 8.3)
A. ganglionic stimulation
A. hypertension
B. ganglionic blockade
B. dry mouth
C. skeletal muscle contraction
C. decreased ocular pressure
D. increased respiration
D. diarrhea
E. increased heart rate
E. increased heart rate

Chapter 9: Skeletal Muscle Relaxants

1. Which of the following is correct about skeletal muscle
7. Skeletal muscle relaxants may alter control of respiration
relaxants?
because:
A. intubation for emergency airway management may be
A. the diaphragm is a skeletal muscle
accomplished quickly
B. succinylcholine stimulates the respiratory centers in the brain @
B. the clinical indication for these drugs is to prolong surgical
C. like dantrolene, all muscle relaxants inhibit the action of
procedures
norepinephrine at the neuromuscular junction
C. centrally acting skeletal muscle relaxants must inhibit nicotinic
D. relaxation of the muscles in the lower extremities pulls blood
receptors
away from the lungs
D. their use is limited by the amount of histamine released from
E. all skeletal muscle relaxants interfere with calcium ion storage in
mast cells
the muscle
E. the class does not include botulinumtoxin A/B
2. Which of the following is correct about the nicotinic-muscle
(Nm) receptor blocking drugs?
8. Select the drug or condition(s) that decrease the effects of
A. the mechanism of action is the same as represented by
neuromuscular blockers:
dantrolene
A. neomycin
B. all of these drugs depolarize the muscle fiber before blockade
B. corticosteroids @
occurs
C. general anesthetics like isoflurane
C. calcium ions are released from the storage sites
D. alcohol
D. there are two groups in this class: either depolarizing agents or
E. myasthenia gravis and spinal cord lesions
nondepolarizing agents
E. botulinumtoxin A rapidly attaches to these receptors
9. Which of the following is a way in which skeletal muscles are
3. Vercuronium and rocuronium are used to ?
relaxed?
A. relax muscle spasms from “weekend warrior” back strain
A. blockage of conduction in the spinal cord
B. block acetylcholine at the nicotinic-muscle (Nm) receptor
B. inhibiting nerve transmission
C. stimulate the nicotinic-muscle (Nm) receptors
C. blockage of the Nm receptors
D. produce muscle fasciculations in surgery @
D. decreasing ACH in the neuromuscular junction
E. rejuvenate facial appearance by relaxing muscles
E. all of these
4. Succinylcholine is associated with which of the following 10. Which of the following drugs is a preferred treatment in
actions? chronic spastic muscle disorders?
A. stimulation of the actin and myosin muscle fibrils directly A. metaxolone
B. liver damage because the drug is metabolized only by the liver
B. vecuronium
C. peripheral neuromuscular receptor blockade after stimulating the
C. baclofen
Nm receptors
D. methocarbamol
D. longer duration of action than vecuronium
E. neostigmine
E. stimulation of presynaptic ACH release
5. Centrally acting skeletal muscle relaxants: 11. Select reasons for using muscle relaxants during surgical or
A. include dantrolene and cisatracurium diagnostic procedures:
B. inhibit or reduce activity within the spinal cord (intraneuronal), A. reduce muscle tear @
interrupting the central stimulus to muscle contraction B. decrease body temperature
C. can only be given parenterally C. potentiate vasodilators
D. cause systemic release of histamine, leading to hypotension D. increase muscle tone
E. counteract the effect of botulinumtoxinB E. depress respiration
12. Which of the following is NOT a potential adverse effect of
6. Which of the drugs is correctly paired with its effect?
peripherally acting skeletal muscle relaxants?
A. succinylcholine: life-threatening cardiac arrest in children @
A. difficulty swallowing (dysphagia) @
B. tizanidine: hypertension and increased salivation
B. skeletal muscle weakness
C. cyclobenzaprine/metaxolol: antagonized by alcohol and sedatives
C. decreased respiration
D. vecuronium: increased blood pressure and heart rate
D. bronchospasm
E. botulinumtoxin: increased respiration
E. muscle fasciculations

Chapter 10: Local Anesthetics

1. Which of the following is a significant therapeutic effect of the 7. Which of the following local anesthetics is used to treat cardiac
ester local anesthetics? (LO 10.1) arrhythmias? (LO 10.4)
A. increase in diastolic blood pressure A. prilocaine
B. itching at the site of application B. lidocaine
C. loss of sensation to touch and warmth C. tetracaine
D. depression of motor neuron function D. cocaine
E. loss of consciousness E. benzocaine
8. Which of the following statements is correct about the local
2. The duration of action of a single administration of amide local anesthetic? (LO 10.2)
anesthetic bupivacaine (LO 10.2) A. topical application of procaine establishes a caudal nerve block
A. is shorter than the duration of action of chloroprocaine B. tetracaine can only be administered by injection
B. is longer than 30 minutes C. injection of bupivacaine at the spinal nerve root such as at T4
C. is decreased by adding epinephrine to the local anesthetic establishes a regional nerve block @
D. depends on the amount of cholinesterase in the blood D. articaine is administered with epinephrine to enhance
E. lasts up to 24 hours vasodilation
E. benzocaine produces cryoanesthesia
3. Any local anesthetic decreases the response to pain (mechanism
9. Which of the following anesthetics are given by injection? (LO
of action) (LO10.1)
10.2)
A. by binding and inactivating membrane ion channels that affect
A. dibucaine
sodium movement
B. ropivacaine
B. after the drug reacts with receptors in the brain
C. Solarcaine
C. by removing sodium and potassium ions from the cells
D. benzocaine
D. by increasing nerve conduction of painful stimuli
E. all of these
E. by increasing calcium ion flow in smooth muscle
4. Local anesthetic therapeutic effect to block nerve conduction 
10. Lidocaine can be given to treat which condition? (LO 10.5)
(LO 10.2)
A. glaucoma
A. only happens if the local anesthetic is injected
B. cardiac arrhythmias
B. causes irritation and redness at the site of application
C. vasoconstriction
C. reversibly binds chloride and magnesium ions in the skin
D. fungal infection
D. can be achieved with topical creams, sprays, and ointments.
E. depression
E. affects motor nerve endings first @
5. Local anesthetics other than cocaine (LO 10.2) 11. The mechanism of action for local anesthetics includes (LO
A. are weak acids 10.1)
B. are schedule-restricted drugs because of their similarity to A. altering skeletal muscle function @
cocaine B. blocking sensory nerve conduction
C. can only be metabolized by the liver to remove their effect C. inhibiting calcium ion movement in smooth muscle
D. produce vasodilation D. depolarizing nerves
E. irreversibly block nerve conduction E. blocking ion flow in the brain
6. Which of the following is a local anesthetic? (LO 10.2) 12. What are the early signs of CNS toxicity from injected local
A. ropivacaine anesthetics? (LO 10.4)
B. norepinephrine A. restlessness, nervousness, dizziness
 B. corneal scarring
C. succcinylcholine
C. increase in blood glucose levels
D. adrenaline
D. increased clearance from the body
E. pilocarpine
E. all of these

Chapter 11: Introduction to the Central Nervous System

5. The area of the brain that is involved with emotional and
1. Select the structure located within the brainstem. (LO 11.2)
behavioral responses is the (LO 11.5)
A. hypothalamus
A. reticular formation
B. cerebral cortex
B. limbic system
C. cerebral white matter
C. basal ganglia
D. medulla oblongata
D. occipital lobe
E. basal ganglia
E. reticular formation
2. Body temperature, appetite, and water balance are regulated by
6. The occipital lobe is involved with (LO 11.1)
the (LO 11.2)
A. posture
A. pons
B. sleep
B. cerebellum
C. equilibrium
C. medulla oblongata
D. water balance
D. hypothalamus
E. vision
E. cerebral cortex
3. Sensory sensations such as touch, pressure, and pain are
7. Select the correct function of the cerebellum. (LO 11.3)
perceived in the (LO 11.1)
A. equilibrium
A. frontal lobe
B. vision
B. temporal lobe
C. temperature control
C. parietal lobe
D. water balance
D. occipital lobe
E. sleep
E. basal ganglia
4. The vital centers are regulated by the (LO 11.2) 8. The basal ganglia are involved with regulating (LO 11.1)
A. hypothalamus A. the vomiting reflex
B. reticular formation B. body temperature
C. cerebral cortex C. muscular activity
D. medulla oblongata D. sensory impulses
E. pons E. sleep

Chapter 12: Sedative-Hypnotic Drugs and Alcohol

[Link] and benzodiazepine hypnotics both (LO 12.3, 12.4) 6. Eszopiclone (LO 12.5)
A. increase NREM stage 2 sleep A. is classified as a benzodiazepine
B. increase REM sleep B. has a half-life of 1 to 2 hours
C. increase NREM stage 4 sleep @ C. increases total sleep time
D. cause REM rebound D. is used as an antianxiety agent
E. all of these statements are true E. is also used as an anticonvulsant
2. Disadvantages to the use of barbiturate hypnotics include (LO
7. Zolpidem (LO 12.5)
12.3)
A. binds to the benzodiazepine-1 (BZD1) receptor
A. development of drug tolerance
B. is useful as a muscle relaxant
B. risk of drug dependency
C. has a slow onset of action
C. disruption of normal stages of sleep
D. is useful as an anticonvulsant
D. suppression of REM sleep
E. is chemically classified as a benzodiazepine
E. all of these statements are true
3. The correct statement concerning the use of hypnotic drugs is  8. Which stage of the sleep cycle is most important for physical
(LO 12.3, 12.4, 12.5) rest and restoration? (LO 12.1)
A. zolpidem binds to the GABA receptor A. stage 1 NREM
B. benzodiazepines increase chloride channel opening B. stage 2 NREM
C. barbiturates block the GABA receptor C. stages 3 and 4 NREM
D. ramelteon is a melatonin antagonist D. REM
E. flumazenil is a benzodiazepine receptor agonist E. during dreaming
4. Flurazepam (LO 12.4) 9. The adverse effects of barbiturates include (LO 12.3)
A. is classified as long-acting A. slurred speech
B. forms active metabolites B. ataxia
C. may cause next-day residual effects C. irritability
D. increases chloride ion influx D. automatism
E. all of these statements are true E. all of these
10. Alcohol has pharmacologic effects on which body systems? 
5. Triazolam (LO 12.4)
(LO 12.6)
A. forms active metabolites
A. central nervous system
B. may cause next-day residual effects
B. gastrointestinal system
C. may cause early-morning awakenings @
C. renal system
D. is classified as long-acting
D. vascular system
E. is a melatonin antagonist
E. all of these

Chapter 13: Antipsychotic and Antianxiety Drugs

6. Flumazenil (Romazicon) is used to reverse the depressant effects
1. The main action of phenothiazines in the treatment of
of (LO 13.6)
schizophrenia is:
A. clozapine
A. stimulation of 5HT2A receptors
B. alprazolam
B. stimulation of D2 receptors
C. haloperidol
C. blockage of 5HT2A receptors more than D2 receptors
D. chlorpromazine
D. blockage of D2 receptors more than 5HT2A receptors
E. thiothixene
2. Extrapyramidal symptoms (EPS) are caused mainly by: 7. Olanzapine is classified as a(n)
A. stimulation of GABA receptors A. phenothiazine
B. stimulation of dopamine receptors B. butyrophenone
C. blockage of dopamine receptors C. thickanthene
D. blockage of serotonin receptors D. atypical antipsychotic
E. stimulation of serotonin receptors E. benzodiazepine
3. Increased triglycerides, weight gain, and diabetes are adverse
8. Select the additional effects of phenothiazine drugs.
effects associated with
A. antiemetic
A. phenothiazines
B. anticholinergic
B. butyrophenones
C. antihistamine
C. thioxanthenes
D. alpha-adrenergic blockade
D. atypical drugs
E. all of these
E. benzodiazepines
9. The atypical drug associated with causing agranulocytosis and
4. The site of action of diazepam (Valium) to relieve anxiety is the:
decreased WBCs is:
A. spinal cord
A. chlorpromazine
B. limbic system
B. buspirone
C. reticular formation
C. clozapine
D. basal ganglia
D. haloperidol
E. cerebellum
E aripiprazole
10. What are the main areas at which benzodiazepines exert their
5. The antianxiety effect of buspirone (BuSpar) is associated with:
effects?
A. stimulation of DA receptors
A. limbic system
B. stimulation of serotonin receptors
B. cerebral cortex
C. blockage of serotonin receptors @
C. reticular formation
D. blockade of dopamine receptors
D. spinal cord
E. blockage of GABA receptors
E. all of these

Chapter 14: Antidepressants, Psychomotor Stimulants, and Lithium

1. The main pharmacologic effect of the SSRIs is 6. Clinical uses of bupropion (Wellbutrin) include
A. increase levels of norepinephrine A. treatment of depression
B. increase levels of serotonin @ B. treatment of bipolar disorder
C. decrease levels of norepinephrine C. cessation of smoking
D. decrease levels of serotonin D. treatment of obesity
E. decrease levels of dopamine E. all of these
2. The pharmacologic effects of TCAs include 7. Adverse effects of TCAs include
A. alpha-adrenergic blockade A. liver toxicity
B. antihistaminic B. cardiac arrhythmias
C. anticholinergic C. convulsions
D. sedation D. postural hypotension
E. all of these E. all of these
8. Which of these represents the drug that is not correctly matched
3. The serotonin syndrome is mainly associated with overdosage of
with its drug classification?
A. tricyclic antidepressants
A. paroxetine—SSRI
B. monoamine oxidase inhibitors
B. amitriptyline—TCA
C. selective serotonin reuptake inhibitors
C. methylphenidate—MAO inhibitor
D. psychomotor stimulants
D. duloxetine—SNRI
E. lithium
E. phenelzine—MAO inhibitor
4. The main pharmacologic effects of TCAs on neurotransmitter 9. Which drug requires a dietary restriction for foods containing
activity is tyramine?
A. increase norepinephrine A. nortriptyline
B. increase acetylcholine B. tranylcypromine
C. increase serotonin C. venlafaxine
D. increase norepinephrine and serotonin only D. fluoxetine
E. increase norepinephrine, acetylcholine, and serotonin E. methamphetamine
5. Venlafaxine (Effexor) is classified as 10. The adverse effects of lithium include
A. MAO inhibitor A. vomiting
B. TCA B. diarrhea
C. SSRI C. increased urination
D. SNRI @ D. ringing in the ears
E. psychomotor stimulant E. all of these

Chapter 15: Psychotomimetic Drugs of Abuse 

1. Select the neurotransmitter receptor interaction that explains 5. Select the statement(s) that are true concerning the use of
the mechanism of action of LSD and other hallucinogens. (LO 15.1) marijuana. (LO 15.4)
A. norepinephrine A. active ingredient referred to as THC
B. dopamine B. believed to bind to a specific receptor in the brain
C. serotonin C. frequent use associated with development of drug tolerance
D. acetylcholine D. psychic effects involve release of dopamine
E. GABA E. all statements are true
2. LSD is associated with the following pharmacologic effect when
6. What are the signs of PCP intoxication? (LO 15.3)
taken repeatedly: (LO 15.1)
A. muscular rigidity
A. rapid development of drug tolerance @
B. catatonia
B. drug dependency
C. convulsions
C. no cross-tolerance with other hallucinogens
D. nystagmus
D. intense withdrawal symptoms
E. all of these
E. all of these
3. Intravenous administration and abuse of psychomotor
7. Which phase of dose-related effects would include true
stimulants, such as methamphetamine, are associated with the
hallucinations and be classified as a “bad LSD trip”? (LO 15.1)
following: (LO 15.2)
A. somatic phase
A. increased sympathomimetic actions
B. sensory phase
B. development of drug tolerance
C. flashback phase
C. behavioral and psychotomimetic effects
D. psychic phase
D. activation of mesolimbic dopamine
E. synesthesia phase
E. all of these
4. The drug that possesses anesthetic properties and that acts by 8. The sympathetic and behavioral actions of cocaine in the brain
blocking glutamate receptors is (LO 15.3) are due to increases in (LO 15.2)
A. cocaine A. norepinephrine
B. methamphetamine B. serotonin
C. phencyclidine C. dopamine
D. MDMA D. norepinephrine and dopamine
E. marijuana E. all of these

Chapter 16: Antiepileptic Drugs

1. The type of seizure characterized by sustained full-body muscle 6. Carbamazepine, phenytoin, and valproic acid all share a
spasms is (LO16.1) common mechanism of action to (LO16.2)
A. absence A. decrease the release of GABA
B. clonic B. prolong inactivation of Na+ channels
C. tonic C. increase T-type calcium currents
D. simple partial D. increase influx of Ca++ ions
E. complex partial E. increase glutamate activity
7. A brief impairment of consciousness with staring or rapid eye
2. The preferred drug for treatment of absence seizures is (LO16.4)
blinking would be considered (LO16.1)
A. primidone
A. tonic seizure
B. ethosuximide
B. partial seizure
C. phenobarbital
C. absence seizure
D. trimethadione
D. atonic seizure
E. phenytoin
E. myoclonic seizure
3. Hirsutism, gingival hyperplasia, and rash are adverse effects 8. What is the primary mechanism of action of phenobarbital?
associated with (LO16.2) (LO16.2)
A. valproic acid A. increase inhibitory effects of GABA
B. carbamazepine B. prolong inactivation of sodium channels
C. lamotrigine C. block excitatory glutamate receptors
D. phenytoin D. increase neuronal influx of Na+
E. phenobarbital E. block calcium T-type currents
4. The drug of choice for treatment of status epilepticus is usually 9. The drug whose mechanism of action involves interference with
(LO16.5) calcium T-type currents is (LO16.4)
A. ethosuximide A. valproic acid
B. phenobarbital B. ethosuximide
C. lorazepam C. carbamazepine
D. valproic acid D. phenytoin
E. carbamazepine E. diazepam
10. The drug indicated for treatment of partial seizures whose
5. Fetal hydantoin syndrome is associated with (LO16.2) adverse effects profile includes aplastic anemia and liver failure is
A. diazepam (LO16.3)
B. topiramate A. phenytoin
C. ethosuximide B. valproic acid
D. phenytoin C. phenobarbital
E. trimethadione D. felbamate
E. pregabalin

Chapter 17: Antiparkinson Drugs and Alzheimer’s Disease Drugs

1. Symptoms of Parkinson’s disease would be increased by (LO 6. The COMT inhibitor that has been associated with causing liver
17.1) toxicity is (LO 17.3)
A. excess levels of acetylcholine A. ropinirole
B. treatment with some antipsychotic drugs B. entacapone
C. decreased levels of dopamine C. pramipexole
D. drug administration after a high-protein meal D. tolcapone
E. all of these E. benztropine
2. The drug classified as a dopamine receptor agonist is (LO 17.4) 7. Select the symptoms of Parkinson’s disease. (LO 17.1)
A. amantadine A. muscular rigidity
B. benztropine B. increased sweating
C. ropinirole C. salivary drooling
D. entacapone D. movement disturbances
E. carbidopa E. all of these
3. Select the drugs that increase the duration of action of DA 8. Which of the following drugs would be used to decrease the
and/or the amount of levodopa that enters the brain. (LO 17.3) actions of ACH? (LO 17.5)
A. carbidopa A. amantadine
B. tolcapone B. levodopa
C. selegiline C. bromocriptine
D. rasagiline D. procyclidine @
E. all of these @ E. carbidopa
4. In Parkinson’s disease, slowed movements are defined as (LO 9. Select the mechanisms by which levodopa works. (LO 17.2)
17.1) A. crosses blood–brain barrier by an amino acid transporter
A. rigidity B. converted to dopamine in the substantia nigra neurons
B. bradykinesia C. increases level of dopamine in the brain
C. tremor D. peripheral metabolism to DA inhibited by carbidopa
D. dystonia E. all of these
E. postural instability
5. Sinemet is the trade name of a drug combination that contains
10. Apomorphine is classified as (LO 17.4)
levodopa and (LO 17.2)
A. MAO-B inhibitor
A. carbidopa and entacapone
B. dopamine receptor agonist
B. entacapone
C. COMT inhibitor
C. carbidopa
D. anticholinergic drug
D. selegiline
E. DOPA decarboxylase inhibitor
E. amantadine

Chapter 18: General Anesthetics

7. Which of the following is NOT correct? (LO 18.3)
A. ketamine causes chloride ions to flow out of the nerve cell by
1. Which of the following general anesthetics exhibits potent binding to GABA
analgesic properties? (LO 18.4) B. propofol binds to the GABAA receptor and enhances
A. lidocaine hyperpolarization of the neuron
B. methohexital C. barbiturates and propofol act on the receptor and directly on the
C. ketamine chloride channel
D. nitrous oxide and ketamine D. potent anesthetics enhance GABAA and glycine receptors
E. propofol E. general anesthetics interact with neurotransmitter-gated ion
channels
2. What is the best reason for using a balanced anesthesia
strategy? (LO 18.1)
A. producing complementary effects using a few drugs avoids 8. Which of the following major routes remove etomidate and
unnecessary intense (deep) CNS depression with one anesthetic to midazolam from the body? (LO 18.4)
achieve the same effect A. hepatic metabolism and renal excretion
B. the concentration of volatile anesthetic in the alveoli is balanced B. excretion through the lungs and sweating
against the amount of anesthetic C. accumulation in fat tissue and redistribution
in the blood D. increased salivation and bile production
C. less monitoring of anesthesia is required E. gastrointestinal reabsorption
D. fewer patients experience emergence delirium
E. there is less chance of aspirating saliva
3. Why is propofol a drug of choice for induction and maintenance
of anesthesia? (LO 18.8) 9. Select the types of anesthesia in which there is no loss of
A. it is a potent analgesic at all doses consciousness. (LO 18.1)
B. it slowly brings the patient to the stage of surgical anesthesia A. local anesthesia @
C. it is a complete anesthetic with a quick onset of action and B. monitored anesthesia care @
recovery period uncomplicated by nausea and C. general anesthesia
vomiting D. balanced anesthesia
D. it is administered by special vaporizer to avoid mask delivery E. maintenance anesthesia
E. its preparation does not require special handling technique
4. Which of the following drugs is associated with its correct
10. Choose the correct class of general anesthetics. (LO 18.2)
nonanesthetic effect? (LO 18.5)
A. intravenous
A. ketamine: antiemesis
B. dissociative anesthesia
B. sevoflurane: skeletal muscle relaxation
C. oral
C. methohexital: hallucinations and colorful dreams
D. topical
D. etomidate: hepatitis
E. epidural
E. sevoflurane: stimulate mucous secretion
5. Which of the following is true about laryngospasms? (LO 18.5)
11. Which of the following is used to produce conscious sedation? 
A. they rarely occur because volatile anesthetics depress the CNS
(LO 18.3)
B. they involve stimulation of the bronchiolar smooth muscle
A. midazolam (Versed)
C. drug-induced increased salivary secretion can trigger them in
B. etomidate (Amidate)
pediatric patients
C. isofurane (Forane)
D. they can be avoided by using a volatile anesthetic with ketamine
D. flumazenil
E. barbiturates do not produce conditions that support
E. ketorolac
laryngospasms
6. Which of the following drugs is matched correctly with its use or 12. Which drugs would be used as adjunct therapy to anesthesia? 
action? (LO 18.4) (LO 18.6)
A. chlorpropamide: induction anesthesia A. analgesics
B. ondansetron: maintenance anesthesia B. antiarrhythmics
C. droperidol: maintenance anesthesia C. antianxiety, short-acting CNS depressants like midazolam
D. ketamine: dissociative anesthesia D. anticholinergics
E. midazolam: inhalation anesthetic E. all of these

Chapter 19: Opioid Analgesics

1. Which of the following is a correct statement? (LO 19.3, 19.4,
7. All opioid analgesics are associated with which of the
19.5)
following? (LO 19.8, 19.9)
A. opioid analgesics produce little or no respiration depression with
A. reversal of respiratory depression from barbiturates
long-term use of analgesic doses
B. use only for the relief of acute pain
B. opioid antagonists include endorphins
C. cough suppression alone or in combination with other analgesics
C. all drugs in the opioid analgesic group are controlled substances,
over-the-counter
Schedule III
D. tolerance develops to the analgesic response
D. in low doses, opioids produce nausea and vomiting @
E. drug of choice in treating biliary obstruction
E. fentanyl is a partial opioid antagonist
8. Fentanyl is an opioid analgesic that (LO 19.2, 19.7)
2. Oxycodone in therapeutic doses can stimulate mu receptors to
A. can be used for relief of cancer pain
cause (LO 19.4, 19.5)
B. has many formulations (lozenge, film) because it is used routinely
A. hyperventilation and deep breathing
in dental surgery
B. bronchospasms
C. induces neuropathic pain
C. spasmogenic activity in the ureters and sphincter muscle @
D. primarily works on peripheral nerve endings rather than higher
D. relaxation of the skeletal muscles controlling posture
centers
(spasmolytic)
E. does not have a black box warning because of its low addiction
E. suppression of coughing
potential
3. Opioid analgesics are used in which of the following settings? 
9. Sharp pain is transmitted through which type of nerve fibers? 
(LO 19.2)
(LO 19.1)
A. induction of monitored anesthesia care and treatment of chronic
A. unmyelinated
severe pain
B. myelinated A-delta
B. routine treatment of migraine
C. CTZ
C. unmonitored treatment of chronic severe pain
D. C fibers
D. analgesia for patients with paralytic ileus
E. mu fibers in the intestine
E. chronic osteoarthritis
4. Which of the following are not a pure opioid agonist analgesic? 
10. Which opioid is used as an antitussive? (LO 19.3)
(LO 19.4, 19.8)
A. sufentanil
A. nalbuphine @
B. fentanyl
B. butorphanol (Stadol) @
C. buprenorphine
C. fentanyl transmucosal (Actiq)
D. dextromethorphan
D. sufentanil (Sufenta)
E. oxymorphone
E. morphine
11. Opioid drugs are derived from which of the following? (LO
19.3)
5. Which of the following is a correct statement? (LO 19.4, 19.8) A. poppy @
A. endorphin is an abbreviation from the terms meaning “inside the B. opium
organ” C. chemical synthesis
B. endogenous opioid receptors include mu, alpha-2 adrenergic, and D. alkaloids
delta receptors
C. agonism means the drug occupies the receptor and causes a E. all of these
response 12. Select the adverse effects of opioid analgesics. (LO 19.5)
D. opioid agonism means the drug occupies the receptor and A. constipation
stimulates the release of endorphins B. polyuria
C. convulsions
E. tolerance is a characteristic of chronic opioid antagonism D. mydriasis
E. excessive tearing
13. During tolerance to opioid analgesics, which of the following is
6. Which of the following drugs has a recognized medical therapy
happening? (LO 19.7)
and does not interact with opioid receptors?  (LO 19.2, 19.3)
A. fewer receptors are available to produce a response @
A. heroin
B. increased pain by the patient requires greater doses of
B. codeine
medication @
C. methadone
C. the body reacts to removal of the opioid analgesic @
D. acetaminophen
D. histamine release causes hypotension
E. tramadol (Ultram)
E. signals from nocieocptors are reduced
Chapter 20: Nonopioid Analgesics, Nonsteroidal Anti-inflammatories, and
Antigout Drugs
1. Which of the following is pharmacologically considered an all-
7. The COX-2 selective NSAID celecoxib (Celebrex) (LO 20.4)
around anti-inflammatory drug? (LO 20.4)
A. produces more effective analgesia than older NSAIDs
A. febuxostat
B. is used for its effectiveness in relieving minor headache
B. allopurinol
C. inhibits xanthine oxidase to relieve pain and inflammation
C. ibuprofen
D. is primarily an anti-inflammatory drug
D. probenecid
E. is used as a blood thinner before surgery
E. pamabron
8. Anti-inflammatory drugs (LO 20.4)
2. Cyclooxygenase (COX) is a family of enzymes that (LO 20.1)
A. include acetaminophen
A. increase uric acid production and deposition
B. vary in their ability to reduce all types of inflammation
B. make various prostaglandins from arachidonic acid
C. have no effect on uterine contraction or vasoconstriction
C. metabolize NSAIDs
associated with dysmenorrhea
D. are inhibited by allopurinol and febuxostat
D. do not require special cautionary warnings about likely adverse
E. are the final products causing platelet adhesion and clot
effects with their use
formation
E. are habit forming with chronic use
3. Which of the following is correct about NSAIDs? (LO 20.4)
9. Which of the following is NOT part of the inflammatory
A. they are a large class of anti-inflammatory drugs that inhibit more
process? (LO 20.1)
than one type of cyclooxygenase (COX-1, 2)
A. prostaglandins are released
B. gastrointestinal side effects associated with this group of drugs
B. phagocytes migrate to area
are rare
C. inhibition of cyclooxygenase-1, -2
C. the class includes cortisone
D. proteins leak out of injured cells
D. they cause tinnitus with the recommended dose regimen
E. vasodilation
E. they are not effective in managing degenerative joint diseases
10. Under which circumstances would ketorolac tromethamine be
4. Acetaminophen (LO 20.4)
the appropriate treatment? (LO 20.3)
A. is an aspirin substitute for the management of severe arthritis
A. for pain from broken bones
B. is an aspirin substitute for analgesia and antipyresis in children @
B. in the elderly with moderate to severe chronic back pain
C. has no associated liver toxicity with chronic use of large doses
C. for treatment of pain from cancer
D. is not given to children because it causes flulike symptoms
D. for acute postoperative pain
E. is primarily found in OTC topical pain patches
E. for treatment of osteoarthritis
5. NSAIDs are (LO 20.4) 11. Which of the following is not a reason to choose
A. represented by probenecid acetaminophen? (LO 20.4)
B. used for the clinical management of hyperprostaglandinemia A. for aspirin-sensitive patients
C. not to be used in the management of rheumatoid arthritis B. for low GI irritation
D. highly bound to plasma proteins @ C. for its analgesic effects @
D. the patient is an adult
E. have no significant drug interactions E. it doesn’t produce ulcers
6. Which of the following is correct? (LO 20.6)
A. gout is a condition of oxalate crystal deposition in the joints 12. Choose the reasons why probenecid is useful in treating gout. 
B. uricosuric drugs can be given with hypouricemic drugs to lower (LO 20.6)
uric acid concentrations @ A. enhances the renal excretion of uric acid @
C. aspirin does not causes petechial hemorrhages B. decreases the uric acid clearance from the blood
D. COX-1 inhibitors (celecoxib) have greater antiplatelet activity C. increases reabsorption of uric acid
than aspirin and NSAIDs D. alters the formation of uric acid
E. NSAIDs are considered not safe enough to be available as an OTC E. dissolves uric acid crystals
drug
13. Which is NOT an indication for aspirin? (LO 20.2)
A. analgesia
B. antipyresis
C. fever reduction in children @
D. dysmenorrhea
E. anticoagulation

Chapter 21: Review of Cardiac Physiology and Pathology

1. Select the direction of normal blood flow that is correct. (LO 6. Select the correct statement that applies to cardiac conduction
21.1) tissue. (LO 21.2)
A. left ventricle to pulmonary artery A. it is nervous tissue
B. left atrium to pulmonary veins B. its electrical activity can be recorded on an ECG @
C. left ventricle to aorta @ C. it coordinates contractions of the atria and ventricles @
D. right ventricle to pulmonary veins D. it possesses autorhythmicity @
E. right atrium to pulmonary arteries E. all statements are true
7. The cardiac functions of the sympathetic nervous system
2. The QRS wave on the ECG represents (LO 21.3)
include (LO 21.4)
A. depolarization of the atria
A. increase in heart rate
B. depolarization of the ventricles
B. increased coronary vasoconstriction
C. repolarization of the atria
C. increased contractility
D. repolarization of the ventricles
D. increase in heart rate and increased contractility
E. depolarization of the SA node
E. all of these
8. Which of the following is true of an electrocardiogram? (LO
3. Increased heart rate is caused by (LO 21.4) 21.3)
A. sympathetic stimulation of the SA node A. the P wave is measuring the depolarization of the atria
B. parasympathetic stimulation of the ventricles B. the PR interval measures the time of impulse passage from SA
C. sympathetic stimulation of the ventricles node through the AV node
D. parasympathetic stimulation of the SA node C. the QRS wave is measuring the depolarization of the ventricles
E. parasympathetic stimulation of the AV node D. the T wave represents the repolarization of the ventricles
E. all statements are true
4. Angina pectoris can be caused by (LO 21.5) 9. Select the clinical features of chronic heart failure. (LO 21.5)
A. arteriosclerosis A. fluid retention and edema
B. atherosclerosis B. arteriosclerosis
C. coronary artery spasm C. blood accumulation in the heart
D. coronary plaque deposits D. fluid retention, edema, and blood accumulation in the heart
E. all of these E. all of these
10. Which of the following are symptoms or consequences of a
5. Select the true statement concerning the conduction system. 
myocardial infarction? (LO 21.5)
(LO 21.2)
A. decreased blood flow to heart muscle
A. the SA node is located in the wall of the right atrium
B. area of dead heart tissue
B. the Purkinje fibers are located in the atria
C. development of cardiac arrhythmias
C. the AV node is located in the upper wall of the left atrium
D. decreased blood flow to heart muscle and development of
D. the bundle branches are located between the atria
cardiac arrhythmias
E. none of these statements are true
E. all of these

Chapter 22: Treatment of Heart Failure

1. The therapeutic actions of angiotensin-converting enzyme (ACE)
6. The causes of heart failure include (LO 22.1)
inhibitors include (LO 22.3)
A. untreated hypertension
A. arterial dilation
B. weakening of contractile force
B. elimination of sodium
C. myocardial infarction
C. venous dilation
D. valvular defects
D. increased bradykinin
E. all of these
E. all of these
2. The mechanism of action of triamterene (Dyrenium) is to (LO 7. Which medication reduces edema by blocking the reabsorption
22.2) of sodium in the distal tubules? (LO 22.2)
A. block aldosterone receptors A. eplerenone
B. increase sodium excretion at loop of Henle B. torsemide
C. block sodium channels at nephron collecting ducts C. triamterene
D. increase the release of aldosterone D. chlorothiazide
E. decrease the release of ADH E. lasix
3. The actions of digoxin (Lanoxin) include (LO 22.5) 8. Vasodilators decrease afterload by affecting (LO 22.3
A. decreased heart rate A. veins
B. inhibition of Na/K ATPase B. arteries
C. increased calcium inside heart muscle C. the SA node
D. increase formation of actinomyosin D. myocardial contraction
E. all of these E. venous return
4. The actions of carvedilol (Coreg) include (LO 22.4) 9. Select the adverse effects of digoxin. (LO 22.5)
A. blockade of beta receptors A. nausea and vomiting
B. increased force of myocardial contraction B. visual disturbances
C. blockade of alpha-1 receptors C. ectopic beats
D. blockade of beta receptors and blockade of alpha-1 receptors D. only nausea and vomiting and visual disturbances
E. all of these E. all of these
5. The most effective drug to relieve edema and congestion in
10. The main effects of beta-blockers include (LO 22.1, 22.4)
acute heart failure would be (LO 22.2)
A. slowing the heart rate
A. hydralazine (Apresoline)
B. increasing the release of renin
B. furosemide (Lasix)
C. increasing ADH
C. metoprolol (Lopressor)
D. increasing aldosterone
D. hydrochlorothiazide (HyroDIURIL)
E. increasing sodium retention
E. digoxin (Lanoxin)

Chapter 23: Antiarrhythmic Drugs

1. Select the ion movement that is associated with depolarization 6. Select the ion that enters the cardiac cell during Phase 2 of the
of ventricular muscle. (LO 23.2) cardiac cycle. (LO 23.2)
A. Na ions move out of the cell A. Cl
B. K ions move out of the cell B. Ca
C. Na ions move into the cell C. Na
D. Ca ions move into the cell D. K
E. K ions move into the cell E. Li
2. According to Vaughn-Williams, procainamide is classified as 7. A class IB antiarrhythmic drug, like lidocaine, does which of the
class (LO 23.3) following? (LO 23.3)
A. IA A. moderate decrease in Phase 0 depolarization
B. IB B. prolongation of ventricular repolarization
C. IC C. decrease in AV conduction
D. II D. increase in PR interval
E. IV E. decrease Phase 4 automaticity
3. The antiarrhythmic drug with the shortest duration of action
8. Which of the following are types of supraventricular
that is administered IV in the emergency treatment of
arrhythmias? (LO 23.1)
supraventricular tachycardia is (LO 23.6)
A. premature atrial contractions
A. lidocaine
B. premature ventricular contractions
B. adenosine
C. paroxysmal atrial tachycardia
C. propranolol
D. premature atrial contractions and paroxysmal atrial tachycardia
D. amiodarone
E. all of these
E. verapamil
4. Ataxia, pulmonary fibrosis, skin discoloration, and thyroid 9. Select the actions of beta-blockers. (LO 23.4)
disturbances are potential adverse effects of (LO 23.5) A. decrease heart rate
A. verapamil B. increase AV conduction
B. procainamide C. decrease automaticity of ventricular muscle
C. amiodarone D. decrease heart rate and decrease automaticity of ventricular
D. disopyramide muscle
E. diltiazem E. all of these
5. The pharmacologic effects of verapamil may include (LO 23.6) 10. Select the adverse effects of amiodarone (LO 23.5)
A. decreased heart rate A. pulmonary fibrosis
B. decreased force of myocardial contraction B. torsade de pointes
C. slowed AV conduction C. blue-gray skin discoloration
D. vasodilation D. corneal microdeposits
E. all of these E. all of these

Chapter 24: Antianginal Drugs

1. The nitroglycerin dosage form providing the longest duration of 5. The drug that is best described as a venodilator that decreases
action is (LO 24.2) preload (venous return) in the treatment of angina is (LO 24.2)
A. sublingual nitroglycerin tablets A. propranolol
B. nitroglycerin ointment B. verapamil
C. transdermal nitroglycerin C. nifedipine
D. IV nitroglycerin (bolus injection) D. isosorbide dinitrate
E. sublingual spray E. amlodipine
2. The therapeutic actions of propranolol to prevent anginal
6. The main mechanisms of action of nitrates include (LO 24.2)
attacks include (LO 24.3)
A. increasing the venous return to the heart
A. decreased heart rate
B. reducing atherosclerosis in the arteries
B. reduced force of myocardial contraction
C. increasing cardiac work
C. decreased oxygen consumption
D. relaxation of systemic veins and arteries
D. decreased cardiac work
E. increasing oxygen consumption
E. all of these
3. The pharmacologic actions of verapamil include (LO 24.4) 7. Propranolol works by doing which of the following? (LO 24.3)
A. decreased AV conduction A. decreasing heart rate
B. increased myocardial contraction B. decreasing cardiac work
C. decreased heart rate C. decreasing force of contractions
D. only decreased AV conduction and decreased heart rate D. decreasing oxygen consumption
E. all of these E. all of these
4. In the treatment of variant angina, the drug that is an arterial 8. Variant angina is best treated with what types of medication? 
dilator without direct effects on the heart is (LO 24.4) (LO 24.5)
A. nitroglycerin A. calcium channel blockers
B. metoprolol B. beta-blockers
C. nifedipine C. nitrates
D. verapamil D. only calcium channel blockers and nitrates @
E. diltiazem E. all of these

Chapter 25: Diuretics

1. Diuretics like organic acids and thiazides are therapeutically
useful because they (LO 25.5, 25.6) 8. Loop diuretics increase the excretion of all of the following
A. can be used in the treatment of refractory heart failure @ EXCEPT (LO 25.6)
B. antagonize antidiuretic hormone at the receptors in the collecting A. sodium
duct B. uric acid @
C. block carbonic anhydrase in the loop of Henle, causing C. water
hypochloremic alkalosis D. potassium
D. waste potassium at doses that cause diuresis E. glucose @
E. inhibit sodium excretion in the glomerulus
2. Ototoxicity is a unique side effect of which group of diuretics?  9. All of the following are true EXCEPT (LO 25.2)
(LO 25.6) A. anuria is a state where no urine is formed
A. loop/organic acid diuretics B. the major tubular secretory function of the nephron involves
B. thiazide diuretics hydrogen and potassium ions
C. potassium-sparing diuretics C. uremia is an accumulation of nitrogen waste products
D. osmotic diuretics D. tubular reabsorption of water is diuresis
E. ADH antagonist conivaptan E. diuretics are a significant drug therapy for hypertension
3. Which of the following actions is related to thiazide diuretics? 
10. All potassium-sparing diuretics (LO 25.7)
(LO 25.5)
A. produce a mild diuresis without acid/base disturbance @
A. hyperuricemia
B. inhibit aldosterone receptors
B. hyperkalemia
C. produce hypokalemia
C. hypernatremia
D. produce similar adverse effects to thiazide diuretics
D. hypercalcemia
E. increase the excretion of potassium ions
E. aquaresis
4. Which of these is NOT true with regard to loop diuretics? (LO 11. Tubular reabsorption involves which of the following? (LO
25.6) 25.2)
A. can cause hyperuricemia A. movement of small molecules into the glomerulus
B. can cause hyperglycemia B. nephron production of calcium carbonate
C. can be used to reduce ascites due to malignancy C. transport of ions into the blood
D. can cause metabolic acidosis @ D. movement of sodium ions into circulation
E. the diuresis is not refractory E. increased glucose concentration in the urine
5. The primary site of action of thiazide diuretics in the nephron is  12. Select the areas of the kidneys where water is reabsorbed. (LO
(LO 25.5) 25.2)
A. the proximal tubule A. glomerulus
B. the loop of Henle B. proximal convoluted tubule and collecting ducts
C. the distal tubule C. distal convoluted tubule
D. the capsule area of glomerular filtration D. uremic channel
E. the osmotic urea channel E. zona glomerulosa
6. Which diuretic is useful in reducing intraocular pressure during 13. Kidneys maintain acid balance in the body by which of the
acute attacks of glaucoma? (LO 25.4) following actions? (LO 25.2)
A. loop diuretic ethacrynic acid A. tubular secretion of hydrogen ions
B. thiazide diuretic indapamide B. increasing the pH of the urine
C. potassium-sparing diuretic amiloride C. neutralizing cell waste products
D. osmotic diuretic mannitol D. decreasing the production of bicarbonate ions
E. furosemide E. excreting excess silenium ions
14. When a diuretic is refractory, it does which of the following? 
(LO 25.5)
7. Which drugs are NOT routinely used in the clinical management
A. produces a decreased response to a decreased amount of drug
of hypertension? (LO 25.3, 25.5)
B. produces an increased response to an increased amount of drug
A. thiazide diuretics
C. doesn’t produce a greater response to an increased amount of
B. chlorthalidone
drug @
C. isosorbide
D. doesn’t produce any response to a decrease in the amount of
D. triamterene
drug
E. metolazone E. inhibits the secretion of antidiuretic hormone
 
15. Which of the following are side effects of osmotic diuretics? (LO 25.3)
A. nausea
B. dizziness
C. headache
D. chills
E. all of these

Chapter 26: Antihypertensive Drugs

1. The desired antihypertensive effects of adrenergic beta-blocking
6. The release of renin causes which of the following? (LO 26.2)
drugs include (LO 26.4)
A. activation of RNA mechanism
A. decrease in heart rate
B. vasodilation
B. decrease in release of renin
C. water excretion
C. decrease in cardiac output
D. decreased blood pressure
D. only decrease in heart rate and decrease in cardiac output
E. activation of angiotensin I
E. all of these
2. The antihypertensive action of hydrochlorothiazide includes (LO
7. Thiazide diuretics help treat hypertension by (LO 26.3)
26.3)
A. only decreasing peripheral resistance
A. reduction of blood volume
B. increasing cardiac output
B. blockade of alpha adrenergic receptors
C. only increasing the excretion of sodium
C. relaxation of vascular smooth muscle
D. both decreasing peripheral resistance and increasing excretion of
D. only reduction of blood volume and relaxation of vascular smooth
sodium
muscle
E. all of these
E. all of these
3. A decrease in the formation of angiotensin II and an increase in
8. Clonidine works to reduce blood pressure by which of the
the concentration of bradykinin explains the vasodilator action of 
following actions? (LO 26.4)
(LO 26.6)
A. decreasing sympathetic nerve activity
A. alpha-blockers
B. stimulating inhibitory alpha-2 receptors
B. beta-blockers
C. decreasing release of renin
C. angiotensin-converting enzyme inhibitors
D. decreasing heart rate and cardiac output
D. angiotensin receptor blockers
E. all of these
E. renin inhibitors
4. The drug that is classified as an arterial vasodilator and that also
9. Verapamil would be useful to treat hypertension in individuals
has a direct effect to decrease heart rate and cardiac contractility
who also suffer from (LO 26.5)
is (LO 26.5)
A. coronary artery disease
A. verapamil
B. CHF
B. propranolol
C. supraventricular arrhythmias
C. prazosin
D. only coronary artery disease and supraventricular arrhythmias
D. captopril
E. all of these
E. nifedipine
5. The antihypertensive drug that decreases sympathetic activity
10. Select the medication administered IV that is primarily
by an action on the vasomotor center in the medulla oblongata is 
indicated for the treatment of malignant hypertension. (LO 26.7)
(LO 26.4)
A. guanabenz
A. hydralazine
B. diazoxide
B. clonidine
C. carvedilol
C. diltiazem
D. terazosin
D. losartan
E. chlorothiazide
E. captopril

Chapter 27: Anticoagulants and Coagulants

1. All of the following are correct about coagulation EXCEPT (LO
27.1) 8. Which of the following is correct? (LO 27.3, 27.4, 27.6)
A. calcium ions are required for clotting factors to be activated A. heparin is a peripherally acting anticoagulant
B. platelets adhere to the epithelial cells in the walls of blood vessels B. LMW heparins can be taken by mouth with food
C. there is no process for clot resolution in the body C. standard heparin can be added to other intravenous lines
D. chelators (EDTA) bind calcium ions and inhibit coagulation in (piggyback)
blood samples D. heparins may produce extreme hemorrhage in the fetus
E. inhibition of factor Xa blocks the coagulation cascade from E. the onset of action of heparins is 10 to 14 days
occurring
2. Warfarin is therapeutically useful because it (LO 27.4) 9. Each of the following is correctly matched to its therapeutic
A. can be used to prevent the formation of venous thrombi effect EXCEPT (LO 27.3, 27.4, 27.5)
B. has a quick onset of action within 2 hours A. heparin: stop bleeding in ulcer patients
C. does not synergize with aspirin to increase the anticoagulant B. LMWH: knee and hip replacement surgery
response C. fibrinolytic alteplase: coronary artery disease
D. can be given intravenously D. warfarin: treatment of deep venous thrombosis
E. inhibits the same site of action as dabigatran E. clopidogrel: decrease reinfarction or stroke
10. Which mechanism of anticoagulant action is correct? (LO 27.3,
3. Which of the following is classified as a fibrinolytic? (LO 27.4, 27.4, 27.5)
27.7) A. warfarin blocks vitamin K from the biochemical path that
A. enoxaparin activates factors II, VIII, IX, and X
B. warfarin B. dalteparin lyses the thrombi within a few hours of symptom
C. ticlopidine onset
D. alteplase, tissue plasminogen activator C. warfarin binds to factors II, VIII, IX, and X
E. apixaban D. heparin complexes with tissue plasminogen @
E. dipyridamole and clopidogrel are DOAC that bind factor Xa
4. All of the following are correct about heparins EXCEPT (LO 27.3) 11. The process of clot formation includes all of the following steps
A. they are a chain of mucopolysaccharides EXCEPT (LO 27.1)
B. LMW heparins stand for low molecular weight A. a thrombocyte is formed
C. they complex with vitamin K B. platelets migrate to area
D. they are recommended when anticoagulation is required during C. injury to an area
pregnancy D. a plug is formed
E. they are peripheral anticoagulants E. accelerated thrombin activation
5. Which of the following is correct? (LO 27.4, 27.7)
A. tissue plasminogen activator is the third step in the coagulation 12. Choose the ways in which oral anticoagulants inhibit clot
cascade formation. (LO 27.2)
B. local hemorrhage does not occur with the oral anticoagulants A. interfering with plasma clotting factors
C. hemorrhagic disease of the newborn occurs with fibrinolytic B. enhancing platelet aggregation
drugs C. making platelets less sticky
D. any anticoagulant is contraindicated in patients with active D. increasing adenosine diphosphate function
bleeding disorders E. dissolving emboli in the initial formation
E. DOAC do not produce bleeding as an adverse effect
6. Which of the following makes the platelets less sticky so a clot 13. Which of the following is NOT true of standard heparin? (LO
cannot form? (LO 27.4, 27.7, 27.8) 27.2, 27.3)
A. warfarin A. binds to clotting factors
B. clopidogrel and aspirin B. gastric acid destroys its mucopolysaccharides
C. standard (unfractionated) heparin C. is administered subcutaneously
D. recombinant DNA thrombin D. has a long onset of action (2–12 hours)
E. rivaroxaban E. is effective only after a portion of the molecule is taken off
7. Which of the following is not an adverse effect of heparins? (LO 14. Select the adverse effects of warfarin. (LO 27.4)
27.3) A. osteoporosis
A. hematuria B. thrombocytopenia
B. petechiae C. hematuria, petechiae
C. increased urination
D. agranulocytosis
D. thrombocytopenia
E. premature uterine contractions
E. bruising at the injection site, hematomas @
15. Thrombolytic enzymes are NOT used to treat which condition? (LO 27.7)
A. pulmonary embolism
B. acute ischemic stroke
C. acute myocardial infarction
D. deep vein thrombosis
E. bleeding into the joints @

Chapter 28: Nutrition and Therapy

1. Pellagra is common in people whose diet consists primarily of
10. Fat-soluble vitamins include (LO 28.4)
corn. Which vitamin deficiency causes pellagra? (LO 28.5)
A. B, A, C, K
A. niacin
B. D, A, K, E
B. B12
C. C, A, K, E
C. vitamin C
D. B1, B6, B12, E
D. folic acid
E. niacin, cyanocobalamin, ascorbate, pantothenate
E. isotretinoin
11. Which of the following is the term for vitamin involvement in
2. A good food source of ascorbic acid is (LO 28.5)
biochemical reactions? (LO 28.1, 28.2)
A. meat
A. coenzyme
B. lettuce @
B. modifier
C. black beans
C. precursor
D. citrus fruits
D. obligatory
E. lean red meat
E. doconate
3. Which of the following are correct categories of vitamins? (LO
12. This vitamin is essential to absorb calcium. (LO 28.3, 28.4)
28.3)
A. beta-carotene
A. water soluble and water insoluble @
B. vitamin E
B. antioxidant and prodrug @
C. cholesterol
C. synthetic and natural @
D. vitamin D
D. low molecular weight and fat soluble
E. lipoprotein A
E. essential and balanced @
13. Under the influence of sunlight (UV), which of the following
4. Which of the following vitamins is essential for vision? (LO 28.4)
occurs? (LO 28.3, 28.4)
A. vitamin D
A. vitamin B6 generates nucleic acids
B. vitamin D3
B. vitamin D is formed from cholesterol in the skin
C. vitamin A
C. vitamin C reduces carbohydrates
D. vitamin B6
D. vitamin A generates retinol
E. vitamin C
E. vitamin D generates ascorbic acid
14. Which of the following is NOT associated with vitamin E? (LO
5. Which of the following vitamin preparations is contraindicated
28.4)
in pregnancy? (LO 28.4)
A. cofactor and antioxidant
A. ergocalciferol
B. essential to maintenance of red blood cell membrane
B. phytonadione
C. hypervitaminosis produces nausea, weakness, and diarrhea
C. retinoic acid
D. hypervitaminosis produces dry cracked skin, desquamation, and
D. pyridoxine
cirrhotic-like liver @
E. vitamin B12
E. found in OTC creams and ointments
6. Which of the following cations are lost (taken out of the body) in 15. Which of the following are energy-producing substances? (LO
metabolic acidosis? (LO 28.7) 28.1)
A. chloride @ A. proteins and fats
B. calcium B. electrolytes
C. iron C. water
D. potassium D. fats
E. phytonadione E. calcium supplements
16. Choose the true statements about vitamins. (LO 28.3, 28.4,
7. Which of the following is correct? (LO 28.8)
28.5)
A. parenteral nutrition provides protein and calories
A. water-soluble vitamins are stored in the liver
B. saline solution provides carbohydrate calories
B. vitamins cannot be absorbed without cofactors
C. plasma expanders are used to immediately replace sodium and
C. fat-soluble vitamins are metabolically converted in the intestines
chloride @
@
D. parenteral fluid therapy requires intra-arterial administration
D. water-soluble vitamins are influenced by biliary function
E. vitamins A and E are not stored in the body
E. there is no need for parenteral administration
8. Antibiotics can kill bacteria living in the gut that synthesize 17. Which of the following are ways in which fat-soluble vitamin
vitamin (LO 28.5) deficiency can occur? (LO 28.4)
A. C A. antibiotic therapy
B. B12 B. pancreatic disease
C. D C. hypoparathyroidism
D. K @ D. cystic fibrosis
E. F E. all of these
9. Which of the following vitamins is required for collagen
18. Select all of the fat-soluble vitamins. (LO 28.4)
synthesis? (LO 28.5)
A. thiamine
A. K
B. ascorbic acid
B. D
C. pyridoxine
C. C
D. phytonadione
D. B1
E. niacin
E. K1
19. Select the main electrolytes present in intracellular fluid. (LO 28.6)
[Link]
[Link]
[Link]
[Link]
E. selenium

Chapter 29: Hypolipidemic Drugs

1. Which of the following is correct: 75 to 80 percent of total 8. Which of the following is NOT correctly matched to its adverse
cholesterol in the body (LO 29.2) effect? (LO 29.4, 29.5, 29.6, 29.7)
A. is synthesized in the liver A. niacin/nicotinic acid causes cutaneous vasodilation (flushing)
B. enters the body as dietary cholesterol B. fenofibrate (Tricor) causes nausea and flatulence
C. is transported as chylomicrons in the blood C. cholestyramine (Questran) causes rhabdomyolysis
D. is transported as HDL D. rosuvastatin (Crestor) causes muscle pain, weakness
E. causes hyperlipidemia E. ezetimibe (Zetia) causes abdominal pain, diarrhea
9. Which of the following is correct? (LO 29.4, 29.8)
2. All of the following are correct about “bad” cholesterol EXCEPT  A. TC (total cholesterol) @
(LO 29.1, 29.2) B. periodic monitoring of liver enzymes (AST, ALT) appropriate to
A. it is a high-density lipoprotein the clinical situation is not recommended with
B. high levels of LDL contribute to atherosclerosis systemic hypolipidemic drugs
C. it is a lipoprotein C. grapefruit consumption may reduce the blood level of the statin
D. it contains more fat and less protein than “good cholesterol” drugs
E. the liver produces more LDL to transport cholesterol as the D. grapefruit inhibits the same enzyme in the cholesterol pathway
cholesterol level rises as the statin drugs
E. all statins are contraindicated for use with azole antifungal drugs
10. All of the following are correct EXCEPT (LO 29.1, 29.2)
3. Chronically elevated blood lipid levels may cause (LO 29.1, 29.2) A. LDL pulls cholesterol out of plaque and returns it to the liver
A. pancreatitis when cholesterol is 80 to 100 mg/dl B. VLDL transports triglycerides
B. plaque when HMG-CoA reductase is 80 to 100 mg/dl C. apolipoproteins B and E contain a cholesterol core to form LDL
C. plaque when LDL cholesterol exceeds 160 mg/dl and HDL, respectively
D. arthritis and edema D. foam cells are cholesterol-rich macrophages
E. hematomas E. cholesterol is essential for production of myelin sheaths and bile
salts
4. All of the following are correct about cholesterol or these
11. All of the following make cholesterol so important for the body
hypolipidemic drugs EXCEPT (LO 29.2, 29.7)
EXCEPT (LO 29.1)
A. cholesterol is lowered by a diet rich in saturated fats
A. building block for glucocorticoids
B. cholesterol is elevated in people with primary
B. essential for building cell membranes
hypercholesterolemia
C. needed to help form myelin sheath
C. nicotinic acid is used to treat hypercholesterolemia
D. helps in digestion of dietary fats
D. fenofibrate primarily affects VLDL and triglycerides
E. inhibits formation of nerve covering
E. macrophages consume LDL to form cholesterol-rich foam cells
5. Which of the following mechanisms of action is correct? (LO 12. Which of the following are not risk factors for
29.4, 29.5, 29.6, 29.7) atherosclerosis? (LO 29.2)
A. ezetimibe (Zetia) acts in the intestinal lumen to bind and trap A. male over the age of 45
cholesterol B. smoker
B. fibric acid derivatives act at the brush border of the intestine wall C. hypothyroidism
C. nicotinamide stimulates lipoprotein lipase to lower triglycerides D. low HDL levels
D. lovastatin (Mevacor) inhibits an enzyme in the cholesterol E. elevated HDL levels
synthetic pathway
E. niacin interrupts the cholesterol synthetic pathway
6. All of the following are correct about the statin drugs EXCEPT 
(LO 29.4) 13. Which of these medications is NOT used to treat
A. all drugs in this class have the same mechanism of action hyperlipidemia? (LO 29.3, 29.4, 29.7)
B. dosing is recommended for the evening because the patient A. statins
won’t experience adverse effects while sleeping @ B. thiazides
C. these are systemic drugs meaning they have to be absorbed into C. nicotinic acid
the blood D. fibric acid derivatives
D. they are used as adjunct treatment to diet adjustment E. gemfibrozil (Lopid) and fenofibrate (Tricor)
E. they may cause mental confusion and memory loss
7. The greatest reduction in circulating LDL is associated with 14. HMG-CoA reductase inhibitors (statins) work by doing which of
which hypolipidemic drug?  the following? (LO 29.4)
(LO 29.4, 29.5, 29.7) A. blocking the intestinal absorption of cholesterol
A. gemfibrozil (Lopid) B. inhibiting triglyceride lipase
B. nicotinic acid (Niacor) C. inhibiting the production of mevalonic acid
C. atorvastatin (Lipitor) D. decreasing hepatic VLDL-triglyceride synthesis
D. colesevelam (Welchol)
E. clopidogrel (Plavix) E. blocking the reabsorption of cholesterol in the kidney  
15. The main therapeutic effects of the statins include (LO 29.4)
A. reducing LDL and CRP levels
B. reducing HDL levels
C. reducing hepatic CYO3A4 levels
D. reducing acetyl CoA levels
E. reducing triglyceride secretion at the intestine’s brush border

Chapter 30: Hematinics

1. Which of the following is correct about developing iron
deficiency anemia? (LO 30.1, 30.2) 7. Which of the following is correct? (LO 30.4, 30.5)
A. iron is lost through internal bleeding (ulcers, NSAID-induced A. folic acid is a B vitamin found in green vegetables and meats @
bleeding, carcinoma) B. methotrexate is a rescue factor for megaloblastic anemia
B. it cannot occur in middle-age men C. folic acid reverses aplastic anemia
C. megaloblastic red blood cells are typically present D. cyanocobalamin can only be given by injection (IV or SC)
D. hemoglobin is not affected, so there is no blood test to confirm E. anticonvulsants and oral contraceptives increase folic acid
the diagnosis absorption
E. it does not occur in elderly adults
8. Anemia cannot be caused by which of the following? 
2. Which blood plasma protein delivers iron to the cells? (LO 30.2)
(LO 30.1)
A. ferritin
A. lack of iron
B. creatinine
B. genetic heredity
C. hemoglobin
C. increase in folic acid
D. transferrin @
D. bleeding stomach ulcers
E. erythropoietin
E. CERA, MIRCERA
3. What is the cause of pernicious anemia? (LO 30.3)
9. Select the term that relates to RBC shape. (LO 30.1)
A. folic acid deficiency
A. hypochromic
B. vitamin B12
B. microcytic
C. overproduction of intrinsic factor
C. megalochromic
D. gastrectomy removing the secretory portion of the stomach and
D. hypochronic
intrinsic factor @
E. fenistration
E. excessive activity of specialized transport proteins in the gut
4. Which of the following is correct about deficiency anemias? (LO
30.1)
10. In males, what are the most common causes of iron deficiency
A. megaloblasts are immature RBCs produced in folic acid and
anemia? (LO 30.2)
cyanocobalamin deficiency
A. internal bleeding and carcinoma
B. vitamin B4 can be substituted for cyanocobalamin and reverse the
B. poor diet
anemia
C. defective hemoglobin synthesis
C. deferoxamine is a chelator used to treat iron deficiency
D. menstruation
D. microcytic means large RBCs that carry extra oxygen
E. testosterone surges
E. inherited anemias are successfully treated with vitamin
replacement
5. All of the following are correct about erythropoietin EXCEPT (LO 11. Select the common symptoms of toxic levels of iron in
30.6) children. (LO 30.2)
 A. it is produced in kidneys
B. severe deficiencies of iron or folic acid are reversed by synthetic
A. pain, bleeding, and vomiting
erythropoietin
B. hair loss
C. the primary use is clinical management of cancer chemotherapy
C. hypertension
or chronic renal failure
D. metabolic alkalosis
D. an objective of treatment is to reduce the need for blood
E. red-colored nail beds
transfusion
E. shaking or freezing destroys erythropoietin
6. All of the following are correct about ESA or CERA EXCEPT (LO 12. Which of the following is true in the use of folic acid to treat
30.6) anemia? (LO 30.5)
A. ESAs are erythropoietin stimulating agents A. it is useful in the treatment of aplastic anemia
B. CERA cannot be used in chronic renal failure anemia B. it stimulates erythropoietin secretion
C. ESAs and CERA increase hemoglobin levels in chronic renal failure C. it increases the synthesis of myelin
patients D. it decreases the production of megaloblastic cells
D. ESAs are synthetic erythropoietins E. it shifts the production of RBCs from the bone marrow to the
E. long-term aspirin use increases their absorption kidneys

Chapter 31: Antihistamines and Mast Cell Stabilizers

8. Which of the following is correct about drugs used to treat
1. Histamine (LO 31.1) allergy? (LO 31.3, 31.4)
A. is classified as a mast cell release inhibitor A. oral cromolyn cannot be taken with fruit juices or food
B. is one of the substances released during an allergic response B. first-generation antihistamines are selective for H2-receptor
C. is found in white blood cells known as neutrophils interaction
D. does not cause skin reactions C. meclizine is also effective in reducing anxiety
E. is clinically limited to interacting with H1-receptors D. antihistamines should not be used during pregnancy
E. tolerance does not develop to the drowsiness
9. Which of the following is NOT a correct statement? (LO 31.3)
2. Mast cells (LO 31.1) A. promethazine is the only antihistamine with a cautionary (black
A. are only found in the bloodstream box) warning
B. are coated with immunoglobulins that recognize antigens B. antihistamines reduce itching and pain at the sensory nerve
C. have no other role than antiallergy in the body endings
D. degranulate when the H1-receptor is stimulated C. histamine causes relaxation of bronchiolar smooth muscle
E. degranulation results in hypertension D. hypersensitivity can develop to antihistamines
E. antihistamines are found in multiple ingredient OTC products
10. Which of the following is NOT a correct statement? (LO 31.3,
31.4)
3. An acute allergic response (LO 31.2)
A. antihistamines decrease nausea and heartburn through the H2-
A. can be blocked only by histamine
receptors
B. cannot be prophylactically treated
B. mastocytosis is a condition of excess histamine release and
C. is characterized by itching, sneezing, and edema
stimulation
D. is only characterized by wheals and urticaria
C. only a few antihistamines can be administered orally @
E. is the same as a type IV delayed allergic response
D. levocetirizine is usually administered once a day
E. antihistamines can reduce ocular hyperemia
4. Antihistamines like chlorpheniramine (LO 31.3) 11. Levocetirizine (Xyzal) (LO 31.3)
A. are the newest, third-generation drugs A. is only found in OTC products
B. are effective and cause sedation and drowsiness B. stimulates eosinophil chemotaxis
C. are not found in OTC products C. is the newest antihistamine
D. do not have anticholinergic properties D. is not related to cetirizine
E. are less effective than diphenhydramine @ E. only binds with H2- and H4-receptors
5. Fexofenadine and cetirizine (LO 31.3) 12. Mast cell stabilizers work by blocking (LO 31.2)
A. are more selective for peripheral H1-receptors A. histamine after it is released
B. bind the H1-receptors in the brain to produce fewer side effects B. H1-receptors from binding histamine
C. are more sedating and drying than diphenhydramine C. the release of histamine and other active substances from cells
D. are mast cell stabilizers D. the effect of histamine after it binds
E. shorten the cardiac QTc interval E. only histamine in the treatment of eczematoid dermatitis
6. Cromolyn and pemirolast (LO 31.4) 13. Which of the following drug actions of antihistamines are due
A. are effective oral antihistamines to their action on the CNS? (LO 31.3)
B. work best after the mast cells have degranulated A. sedation @
C. are effective in reducing the symptoms of conjunctivitis B. relief of motion sickness
D. are applied intranasally C. reduction of nausea and vomiting
 D. relief of local pain
E. increase ocular hyperemia
E. drowsiness @
7. Adverse effects associated with antihistamine use DO NOT 14. Which of the following is a side effect of antihistaminic drugs? 
include (LO 31.3) (LO 31.4)
A. eczematoid dermatitis A. increased appetite
B. increased intraocular pressure B. nausea @
C. urinary retention C. hypertension
D. heparin reaction on blood clotting D. xerostomia @
E. rapid heartbeat E. increased mucous production
15. Select the first-generation antihistaminic drug. (LO 31.3)
A. promethazine
B. cetirizine
C. loratadine
D. levocetirizine
E. bep

Chapter 32: Respiratory Pharmacology, Treatment of Asthma and COPD

1. The bronchodilator drug that would provide the longest
2. The drug used in the treatment of asthma that blocks the
duration of action is (LO 32.4)
leukotriene receptor is (LO 32.5)
A. epinephrine (Adrenaline)
A. fluticasone (Flovent)
B. ipratropium (Atrovent)
B. cromolyn (Intal)
C. salmeterol (Serevent)
C. albuterol (Proventil)
D. theophylline (Elixophylline)
D. montelukast (Singulair)
E. terbutaline (Brethine)
E. tiotropium (Spiriva)
3. The only drug class that provides immediate relief of an acute 4. The mechanism of action of cromolyn sodium (Intal) is to (LO
asthmatic attack is (LO 32.4) 32.6)

A. anticholinergics A. produce bronchodilation

B. beta adrenergics B. increase expectoration of mucus
C. methylxanthines C. inhibit release of mast cell mediators
D. corticosteroids D. liquefy bronchial secretions
E. leukotriene inhibitors E. block leukotrienes
5. The pharmacologic actions of theophylline (Elixophylline) in the
6. The drug used in asthma to block IgE antibodies is (LO 32.5)
treatment of COPD include (LO 32.4)
A. cromolyn
A. bronchodilation
B. omalizumab
B. increased contractility of respiratory muscles
C. ipratropium
C. increased mucociliary activity
D. guaifenesin
D. only bronchodilation and increased mucociliary activity
E. nedocromil
E. all of these
8. Parasympathetic activation of the respiratory tract causes which
7. The chemical mediators involved in asthma include (LO 32.2)
of the following? (LO 32.3)
A. prostaglandins
A. bronchodilation
B. ECF-A
B. increased cyclic AMP
C. leukotrienes
C. increased mucous secretion
D. only prostaglandins and leukotrienes
D. stimulation of the beta-2 receptors
E. all of these
E. increased mucociliary action
10. Corticosteroids are used in the treatment of asthma in which of
9. Select the mechanisms of action for terbutaline. (LO 32.4)
the following ways? (LO 32.5)
A. inhibit release of mediators from mast cells
A. decrease activation of arachidonic acid
B. block beta-2 receptors
B. increase the release of inflammatory mediators
C. relax smooth muscle
C. decrease the production of allergic antibodies
D. only inhibit release of mediators from mast cells and relax
D. only decrease activation of arachidonic acid and decrease the
smooth muscle @
production of allergic antibodies @
E. all of these
E. all of these
Chapter 33: Therapy of GI Disorders: Peptic Ulcers, GERD, and Vomiting
1. Which of the three phases of gastric acid secretion is stimulated
6. Which of the following is NOT an antiemetic drug?
by the distention of the stomach?
A. cisplatin
A. cephalic
B. granisetron
B. colonic
C. aprepitant (Emend)
C. gastric
D. promethazine
D. intestinal
E. dolasetron (Anzemet)
E. activation of the CTZ
2. What is the most common etiology of peptic ulcer disease? 7. The causes of peptic ulcers include
A. alcohol A. not enough mucosal lining in the stomach
B. GERD (gastroesophageal reflux disease) B. suppressed acid production
C. NSAIDs (nonsteroidal antiinflammatory drugs) C. regurgitation of bile acids into the esophagus
D. Helicobacter pylori D. being genetically predisposed
E. hypersecretory conditions E. hypersecretion of mucus in the stomach
3. Which of the following drugs blocks the release of HCl from the 8. The primary therapeutic goal in treatment of GERD and peptic
parietal gland? ulcer is to
A. antacids A. increase mucosal production
B. H2-receptor antagonists B. suppress acid production and relieve symptoms
C. proton pump inhibitors C. prevent erosion of ileum
D. sucralfate D. maintain levels of magnesium and calcium with antacids
E. misoprostil E. get patient on prostaglandins
4. A patient is newly diagnosed with mild GERD. Which of the
9. Select the mechanism of action for 5HT3 antagonists.
following medications might be prescribed first?
A. prevent labyrinthine stimulation of emesis
A. barbiturates
B. prevent serotonin from stimulating the CTZ
B. H2-receptor antagonists
C. block stimulation of dopamine receptors
C. metoclopramide
D. increase secretions from ECL cells
D. dronabinol (Marinol)
E. coat the stomach lining
E. OTC Emetrol
5. A patient presents with severe nausea and vomiting after his
10. Metoclopramide (Reglan) is used to treat which ailments of the
cisplatin chemotherapy this morning. Which of the following drugs
GI tract?
would you prescribe to reduce nausea and vomiting?
A. GI hypermotility
A. a prokinetic drug like bismuth subsalicylate
B. irritable bowel syndrome
B. serotonin (5-HT3) antagonists
C. newly diagnosed peptic ulcers
C. proton pump inhibitors
D. neurogenic colon
D. antisecretory drugs
E. GERD and chemotherapy induced vomiting @
E. diphenhydramine

Chapter 34: Agents That Affect Intestinal Motility

6. Which of the following is NOT a primary cause of diarrhea? (LO
1. The defecation reflex (LO 34.1)
34.2)
A. is a voluntary process
A. increased intestinal motility
B. contracts the external anal sphincter
B. inflammation
C. is initiated by distension of the colon
C. osmotic imbalance
D. propels feces into the small intestine
D. drug therapy
E. is controlled by the sympathetic nervous system
E. hydration from daily water intake
2. A patient presents with severe diarrhea. Upon questioning, the
patient mentions that he returned from Thailand a week ago. The 7. Choose the mechanism of action of adsorbents antidiarrheal
patient is diagnosed with “traveler’s diarrhea.” The drug of choice drugs. (LO 34.4)
for this patient would include (LO 34.3) A. kill bacteria
A. rifaximin B. decrease serotonin release
B. bulk laxatives C. form a complex with irritating substance
C. lubiprostone D. absorbed into blood circulation to work on the system
D. methylnaltrexone E. complex with glucose in the intestinal lumen
E. polyethylene glycol-electrolyte solution (PEG-ES)
3. Whic h of the following treatments for simple diarrhea works by 8. Which of the following drugs are used to stimulate defecation? 
forming a complex with the irritant? (LO 34.3) (LO 34.3, 34.5)
A. antibiotics A. 5HT3 antagonists
B. opioid derivatives B. adsorbents
C. anticholinergics C. antimotility drugs
D. adsorbents D. cathartics @
E. lactulose E. cholestyramine resin
4. Which of the following drugs has been approved for treatment
9. Select the mechanisms by which swelling agents increase
of patients with constipation caused by opioid analgesics? (LO
defecation. (LO 34.6)
34.5)
A. soak up water and distend the rectum
A. emollients
B. irritate the mucosal lining of the intestine
B. lubiprostone
C. inhibit stool formation in the large intestine
C. stimulants
D. coat the fecal matter
D. methylnaltrexone
E. complex with bile salts to produce diarrhea
E. magnesium citrate
5. Which of the following laxatives would be ordered before a
10. What is NOT an adverse effect of osmotic laxatives? (LO 34.5)
colonoscopy? (LO 34.5, 34.6)
A. depressed CNS
A. docusate sodium @
B. decreased muscle function
B. polyethylene glycol
C. dehydration
C. psyllium hydrophilic
D. respiratory depression @
D. mineral oil
E. flatulence and cramps
E. bismuth subsalicylate

Chapter 35: Introduction to the Endocrine System

1. A hormone (LO 35.1) 7. Which is not a function of hormones? (LO 35.1)
A. rapidly responds to a stimulus A. conduct electrical impulses
B. is a neurotransmitter B. regulate growth
C. binds to specific receptors to produce its effects C. control metabolism
D. produces nerve impulses D. help in reproduction
E. is secreted into a specialized duct system E. milk letdown
2. Releasing hormones (LO 35.2) 8. Which of the following is true of the hypothalamus? (LO 35.2)
A. travel along axons to the posterior pituitary A. it controls the master gland
B. affect the secretion of hormones in the anterior pituitary B. it is composed of two main lobes C. it is connected by a portal
C. are released by the target organ to regulate hypothalamus system to the posterior pituitary gland
D. produce nerve impulses D. it releases luteinizing hormone
E. stimulate the release of oxytocin E. it is the target organ for growth hormone
3. All hormones released by the anterior pituitary are regulated by 9. Choose the hormones whose target organs are the gonads of
(LO 35.2) males and females. (LO 35.2)
A. the hypothalamus A. TSH
B. the posterior pituitary B. ACTH
C. the fat-soluble releasing hormones C. LH, FSH
D. TSH D. GH
E. a positive feedback response E. somatostatin
4. Dwarfism is caused by (LO 35.4) 10. Water-soluble hormones work by (LO 35.1)
A. elevated thyroid hormone production A. binding receptors on the cell membranes
B. decreased adrenocorticotropic hormone (ACTH) B. crossing the plasma membrane
C. decreased growth hormone C. being second messengers
D. high plasma glucose concentration D. stimulating gene transcription
E. an overactive negative feedback response E. binding to receptors inside the cell nucleus
5. A patient newly diagnosed with hyperthyroidism has blood
11. Which of the following is true of the negative feedback
drawn for labs. The physician tells the patient that his TRH
system? (LO 35.3)
function is normal as is the TSH level. Using negative feedback,
A. levels of circulating hormone always change suddenly and
which location is most likely secreting excess hormone? (LO 35.3)
severely
A. CNS
B. the target organ turns off pituitary secretion
B. anterior pituitary
C. a baby suckling is an example of negative feedback
C. hypothalamus
D. hormones are NOT controlled by this process
D. target organ (thyroid gland)
E. oxytocin causes the reduction in thyroid hormone secretion
E. adrenal cortex
6. Which of the following hormone disorders causes mental
retardation in infancy? (LO 35.4)
A. cretinism: thyroid hormone
B. gigantism: growth hormone
C. dwarfism: adrenal medulla
D. diabetes mellitus: insulin-like factor
E. acromegaly: growth hormone
Chapter 36: Adrenal Steroids
2. A patient presents with dehydration. Following ACTH
1. Which of the following is correct about mineralocorticoids? administration, plasma cortisol levels cannot be detected. The
A. they are secreted by the adrenal medulla most likely diagnosis for this patient is:
B. the target organ is the pancreas A. Addison’s disease
C. they cause excess excretion of sodium ions B. Cushing’s disease
D. their principle action is to reduce inflammation C. thyroid disease
E. aldosterone is the primary hormone D. rheumatoid arthritis
E. excessive cortisol excretion
4. A patient diagnosed with rheumatoid arthritis is in remission,
and the physician tells the patient to discontinue her prednisone.
3. The advantage of a repository preparation of a glucocorticoid is: Which important advice would the physician give to his patient?
A. rapid response A. discontinuing the prednisone will lower your potassium
B. slow release from the muscle B. taper the medication dosage down over the next few months
C. oral administration C. your immune function will decrease after discontinuing the
D. prevention of edema in the joint medication
E. to reduce itching from poison ivy D. your skin may bruise more easily
E. discontinue the dosage over the next 48 hours to none taken on
the third day
5. A patient taking prednisone long term (chronically) might 6. Select the true statement about dexamethasone:
develop which of the following adverse effects? A. it is a naturally occurring steroid
A. dehydration B. it is transported to the target cell and stimulates protein
B. hypotension production in the nucleus
C. bronchial asthma C. it is a short-acting, low-potency steroid
D. weight loss D. it has high potency for sodium retention
E. moon face or buffalo hump E. it is used only to diagnose adrenal insufficiency
7. The regulation of cortisol secretions involves which of the 8. Which of the following is not a function of secreted
following? glucocorticoids?
A. diurnal rhythm A. regulate the metabolism of carbohydrates
B. negative feedback triggered by elevated circulating cortisol levels B. make new protein
C. stress C. gluconeogenesis
D. circadian rhythm D. retention of sodium @
E. all of these E. transcription of nucleus DNA
9. Which of the following is not true of mineralocorticoids like 10. Which of these effects is not associated with long-term steroid
fludrocortisone? therapy?
A. cause an increase in reabsorption of sodium A. obesity
B. cause K+ ion transport to urine B. thinning of skin
C. regulate fluid balance C. glaucoma
D. decrease inflammation D. increased muscle strength
E. are administered with a glucocorticoid in Addison’s disease E. steroid addiction

Chapter 37: Gonadal Hormones, Oral Contraceptives, and Erectile Dysfunction

Drugs
1. In both males and females the hypothalamus secretes this
6. Which of the following is NOT part of the ovarian cycle?
hormone to stimulate the release of LH and FSH.
A. ovulation
A. testosterone
B. luteal
B. estrogen
C. developing corpus luteum
C. GnRH
D. follicular
D. DHEA
E. endometrial @
E. TRH
2. In the menstrual cycle, which of the following hormones is
7. Which of the following are true about oral contraceptives?
responsible for ovulation?
A. the hormone is delivered via a vaginal ring
A. progesterone
B. they can be monophasic, biphasic, or triphasic
B. FSH
C. they can be administered as a spray
C. hCG
D. the doses of estrogen are at the highest effective coverage dose
D. LH
E. they are used for hormone replacement therapy (HRT)
E. oxymetholone
3. A mechanism by which oral contraceptives prevent ovulation 8. Which is not correct about how clomiphene works?
includes A. stimulates the release of FSH and LH
A. inhibiting the corpus luteum’s production of progesterone
B. can cause more than one egg to be released
B. facilitating implantation to occur
C. acts as a follicular development stimulant
C. increasing the levels of estrogen and progesterone
D. increases estrogen receptors
D. stimulating the release of LH and FSH
E. binds to estrogen receptors as a receptor antagonist @
E. stimulating the release of follitropin
9. Which of the following is true of monophasic oral
4. Clomiphene produces its effects by contraceptives?
A. inhibiting the release of LH A. pill color varies over the cycle
B. inhibiting estrogen’s negative feedback B. estrogen to progestin ratio changes over the cycle
C. combining estrogen and progesterone C. the first 10 pills of the cycle may be iron supplements
D. increasing bone mineral density D. there is a fixed ratio of hormones for days 0 to 21
E. stimulating dysfunctional ovarian tissue directly @ E. Ortho-Novum 7/7/7 and Ortho tri-cyclen are included in this
group
5. The mechanism of drug action by which erectile dysfunction is
10. Which is not an action of androgens?
treated is
A. stimulation of protein synthesis
A. inhibition of phosphodiesterases
B. increase in appetite
B. inhibition of GnRH
C. erythropoiesis
C. vasoconstriction of the blood vessels in the penis
D. weight gain
D. stimulation of the release of testosterone
E. dyspareunia
E. stimulation of estrogen secretion

Chapter 38: Drugs Affecting the Thyroid and Parathyroid Glands and Bone
Degeneration
1. A patient has just been diagnosed with hyperthyroidism. You
review her labs and find that T3-T4 level is elevated; however, TSH 7. Thyroid hormone replacement therapy
level is low, along with TRH. You suspect the problem is occurring A. is indicated in the management of euthyroid patients
at the (LO 38.1) B. increases bone density with long-term use
A. hypothalamus C. increases blood glucose levels
B. anterior pituitary D. is recommended in the management of patients with a history of
C. thyroid gland @ myocardial infarction
D. parathyroid gland E. includes potassium iodide combination therapy
E. posterior pituitary
2. If calcium levels decrease below normal, which hormone would 8. Which of the following is true regarding bisphosphonates?
be released to compensate? (LO 38.6) A. they include ibandronate and calcitrol
A. calcitonin B. they can only be administered orally once or twice a year
B. PTH @ C. they reverse hypocalcemia
C. TRH D. they promote osteoporosis
D. TSH E. they should be combined with calcium supplements and vitamin
E. FSH D for optimal effect
3. Which of the following could be used for treatment in an infant 9. Which of the following is NOT associated with thyroid hormone
diagnosed with cretinism? (LO 38.2) actions on the body? (LO 38.1)
A. T3 and T4 A. increase in blood glucose
B. calcitonin B. stimulation of protein synthesis
C. propylthiouracil C. decrease in serum cholesterol
D. bisphosphonates D. increase in circulating fatty acids
E. thyroglobulin E. calcitonin stimulation of osteoclasts @
4. Therapy for a patient with hypercalcemia would include (LO 10. Which of the following is a hormone secreted from the thyroid
38.6) gland to help regulate tissue growth? (LO 38.1)
A. estrogen A. TRH
B. irradiation B. TSH
C. vitamin D C. T3, triiodothyronine @
D. calcitonin D. calciothyroxin
E. antibody replacement E. osteoprozin
11. Which of the following is NOT a symptom of hypothyroidism? 
5. Bisphosphonates (LO 38.8)
(LO 38.2)
A. inhibit bone resorption
A. cretinism
B. increase T3 and T4 synthesis
B. tachycardia
C. inhibit propylthiouracil
C. myxedema
D. stimulate PTH
D. goiter
E. stimulate TRAb (thyrotropin receptor antibody) production
E. agranulocytosis @
6. Irradiation and antithyroid drug administration 12. The adverse effects of thioamide drugs include (LO 38.5)
A. increases T3 and T4 secretion A. psychotic behavior
B. increases blood flow to the thyroid gland B. increased blood pressure
C. inactivates overactive thyroid tissue C. weight loss
D. has no effect on thyroid tumors D. insomnia
E. increases heat production in the body E. rash and myalgia

Chapter 39: Pancreatic Hormones and Antidiabetic Drugs

2. Which of the following insulins would provide a patient
1. Which of the following parameters would help to differentiate
diagnosed with type 1 diabetes mellitus a constant release of
between type 1 and type 2 diabetes?
insulin over a 24'-hour period?
A. blood glucose level
A. regular insulin
B. hemoglobin A1c level
B. insulin aspart
C. ketoacidosis @
C. insulin glargine
D. cholesterol level
D. insulin lispro
E. glucagon levels
E. aerosolized insulin powder
3. Which of the following oral antidiabetic agents increases the 4. Which of the following oral agents is categorized as a
incretin’s duration of action? secretagogue?
A. sitagliptin A. metformin
B. acarbose B. glipizide
C. nateglinide C. sitagliptin
D. tolbutamide D. miglitol
E. exenatide E. dapagliflozin
5. Which of the following hormones would be elevated during a 6. Which of the following is an indicator of glycemic control in type
fast? 2 DM patients?
A. insulin A. hourly blood glucose values
B. glucagon B. HbA1c level
C. humulin C. RBC hematocrit
D. GnRH D. blood insulin of 50 IU/dl
E. pioglitazone E. miglitol secretion
7. Which is NOT a mechanism of action of an oral antidiabetic 8. Which of the following is correct about type 2 DM?
drug? A. insulin is secreted by the beta cells and insulin resistance is
A. increased insulin sensitivity in target tissues present
B. inhibit or delay the breakdown of carbohydrates in the intestine B. insulin cannot be used in type 2 DM
C. direct action on the beta cell membrane-bound receptors C. patients are only prone to persistent infections in type 1 DM
D. direct stimulation of insulin receptors in skeletal muscle D. oral antidiabetic drugs cannot be combined to achieve glycemic
E. inhibit renal glucose transport proteins control E. oral antidiabetic drugs are ineffective
9. Which of the following is correct about polyuria in types 1 and 2
DM?
10. Which of the following when used together have
A. excess glucose spills into the urine and osmotically attracts water
complementary actions that increase insulin secretion?
into the renal tubule
A. regular human insulin and insulin glargine
B. antidiuretic hormone is no longer secreted in DM
B. DPP-4 inhibitor sitagliptin and metformin
C. GLUT2 receptors move glucose from the blood into the renal
C. amylin and glucagon
tubule
D. glyburide and incretin mimetics
D. sulfonylurea drugs interact with their receptors in the kidney to
E. SGLT2 in hibitor canagliflozin and metformin
increase urine flow
E. glucose transport proteins in the renal tubules are blocked
12. Choose the true statement about oral antidiabetic drugs.
11. Beta cells secrete the following substances: A. incretins increase glucagon secretion
A. insulin and amylin B. biguanides have receptors on skeletal muscle
B. glucagon C. elderly patients are usually resistant so doses have to be
C. incretins increased
D. acetate D. insulin sensitizers (thiazolidinediones) do not stimulate insulin
E. GLP1 and GIP secretion
E. they cannot be used with insulins
13. Which of the following is correct? 14. Choose the true statement about oral antidiabetic drugs.
A. lipodystrophy is exacerbated by alpha-glucosidase inhibitors A. incretins increase glucagon secretion
miglitol and acarbose B. biguanides have receptors on skeletal muscle
B. insulin is the preferred treatment in type 2 DM because there are C. elderly patients are usually resistant so doses have to be
no drug interactions increased
C. oral antidiabetic drugs include pramlintide D. insulin sensitizers (thiazolidinediones) do not stimulate insulin
D. hypoglycemia is the most common adverse effect of many secretion
antidiabetic drugs E. they cannot be used with insulins
E. metformin is the drug of choice in patients with metabolic
acidosis
15. Select the causes of type 1 diabetes
A. autoantibody destruction of beta cells
B. malformed beta cells
C. failure of target tissue to respond to insulin
D. hyperinsulinemia
E. increase in the secretion of incretins

Chapter 40: Posterior Pituitary Hormones: Antidiuretic Hormone and Oxytocin

1. Which hormone is synthesized in the hypothalamus and 6. Choose the correct action of antidiuretic hormone on the body. 
released from the posterior pituitary? (LO 40.1) (LO 40.2)
A. insulin A. it increases urine output
B. thyroxine B. it regulates water balance
C. cortisol C. the adrenal glands are its target organ
D. oxytocin D. its secretion is controlled by ADH-releasing factor
E. mefipristone E. all of these
2. Which of these symptoms would lead the physician to diagnose
7. Which of the following is true? (LO 40.1)
diabetes insipidus? (LO 40.3)
A. oxytocin and ADH are both polypeptides
A. edema
B. ADH is the only hormone secreted from the posterior pituitary
B. low blood pressure
C. the release of ADH and oxytocin is caused by another hormone
C. large volume of dilute urine @
D. ADH and oxytocin are secreted by the anterior pituitary gland
D. glucose in the urine
E. vasopressin is the trade name for oxytocin
E. darkening fingernails
8. Which of the following are causes of diabetes insipidus? (LO
3. During parturition, oxytocin (LO 40.4)
40.3)
A. stimulates uterine muscle contraction
A. increased ADH
B. increases urine output
B. damage to the pancreas
C. inhibits preterm labor
C. tumors of the thyroid gland
D. decreases urine output
D. positive feedback response on the posterior pituitary
E. relaxes uterine muscle
E. renal disease and head trauma
4. The route by which desmopressin acetate is administered is (LO
9. Select the possible side effects of vasopressin. (LO 40.3)
40.3)
A. nausea
A. intravenous
B. diarrhea
B. subcutaneous
C. increase in blood pressure
C. orally
D. sweating
D. intranasally
E. all of these
E. all of these
5. Control of bleeding after delivery is achieved with (LO 40.4) 10. The uses of oxytocics include (LO 40.4)
A. ADH A. control of postpartum bleeding @
B. DDAVP B. decreasing contractions
C. dinoprost C. inducing therapeutic abortions @
D. methylergonovine D. uterine tetany
E. vasopressin E. lowering blood pressure

Chapter 42: Antifungal and Antiviral Drugs

2. Which of the following is NOT correct about antifungal drugs or
fungal infection?
1. Griseofulvin is useful in dermatophytic infections because it
A. systemic infection may occur in patients who are receiving drugs
A. binds to keratin
to suppress their immune system
B. is fungicidal
B. warts are an example of a dermatophytic fungal infection
C. forms ergosterol in hair and nails
C. the majority of antifungal drugs interfere with fungal cell-wall
D. incorporates itself into fungal RNA
integrity
E. inhibits fungal reverse transcriptase
D. amphotericin B is associated with serious renal toxicity
E. topical antifungal drugs are available OTC
3. Which of the following describes a systemic fungal infection? 4. Which of the following pairs are antifungal drugs? (LO 42.3)
(LO 42.1) A. fluconazole and micafungin
A. candidemia B. ritonavir and ketoprofen
 B. vaginal candidiasis
C. dehydroepiandrosterone and inositol
C. influenza
D. mebendazole and gentian violet
D. Staphylococcus
E. nelfinavir and zidovudine
E. syncytial respiratory fungus (SRF)
5. Which antifungal drug is matched with its correct mechanism of 6. Which of the following is NOT correct about these antifungal
action? (LO 42.3) drugs? (LO 42.3, 42.4)
A. echinocandins inhibit polysaccharide (glucan) synthesis in the cell A. caspofungin and micafungin are administered by slow IV infusion
wall B. voriconazole and posaconazole are man-made drugs (synthetic)
B. flucytosine binds to the cell membrane C. anidulafungin undergoes degradation in the bloodstream to
C. tioconazole is an antimetabolite for fungal RNA peptide fragments
D. amphotericin B binds to a cytochrome P450-dependent enzyme D. vaginal yeast infection (candidiasis) can only be treated with
E. ketoconazole inhibits proteases in the host cell nuclei prescription drugs
8. Which of the following is correct about viruses? (LO 42.5)
7. Which is the correct fungal infection site of action and common
A. active infection is the only way to develop immunity to the
name? (LO 42.1)
microorganism
A. warm moist areas on the feet: onychomycosis
B. viruses attach to the keratin protein and remain dormant for
B. Candida in the mouth: thrush
years
C. toe- and fingernails: aspergillosis
C. viruses can quickly develop resistance to drugs
D. hair protein: candidiasis
D. viruses die as soon as they land on hard surfaces
E. respiratory tract: cytomegalo fungus
E. respiratory viral infections are treated with acyclovir
9. Which drug is effective against systemic viral infections? (LO 10. The mechanisms of action for antiviral medications include (LO
42.6) 42.7)
A. griseofulvin A. changing cell-wall synthesis
B. butenafine B. binding to ergosterol
C. gentian violet C. inhibiting cell mitosis
D. clotrimazole D. inhibiting neuraminidase
E. enfuvirtide E. facilitating viral fusion to the host cell
11. Which of the following is NOT true of the treatment for viral
12. Which is NOT a potential side effect of antiviral drugs? (LO
infections? (LO 42.5)
42.8)
A. they are difficult to treat due to host cell invasion
A. blurred vision and tinnitus
B. immunity can be gained through the attenuated live virus
B. dysgeusia
C. treatment can be given via an intranasal spray
C. nephrotoxicity
D. the vaccines are contraindicated in people allergic to eggs
D. neutropenia
E. effective treatment occurs only with respiratory drug
E. hyperphagia
administration
13. Choose the true statement about oral antidiabetic drugs.
A. incretins increase glucagon secretion @
B. biguanides have receptors on skeletal muscle
C. elderly patients are usually resistant so doses have to be increased
D. insulin sensitizers (thiazolidinediones) do not stimulate insulin secretion
E. they cannot be used with insulins

Chapter 43: Parasitic Infections: Antiprotozoal and Anthelmintic Drugs

7. Which of the following is NOT transmitted through
1. Which of the following drugs kills pinworms? (LO 43.5)
contaminated food or water? (LO 43.4)
A. voriconizole
A. Trichomonas and Toxoplasma
B. mebendazole and pyrantel pamoate
B. Giardia lamblia
C. ritonovir
C. Entamoeba histolytica
D. flucytocine
D. amebiasis
E. quinine
E. Pneumocystis jirovecii
8. Which of the following is the correct statement? (LO 43.4)
2. Protozoal infections include all of the following except: (LO
A. cinchonism is a side effect of paromomycin from tree bark
43.1, 43.4)
B. malaria is symptomatic when it invades the liver
A. Tinea pedis
C. tetracyclines/doxycycline have no place in the treatment of
B. Trichomonas
malaria
C. Giardia lamblia
D. metronidazole should not be given in the first trimester of
D. Toxoplasma gondii
pregnancy
E. Plasmodia
E. metronidazole causes methemoglobinemia
3. Amebiasis (LO 43.3) 9. Which of the following ways can protozoa infect humans? (LO
A. causes diarrhea and intense intestinal pain 43.1)
 A. via sexual intercourse
B. stops electrolyte loss from the gut
B. via contaminated food
C. is not caused by contaminated streams and water supply
C. via mosquitos
D. only affects the lumen of the intestine
D. via contaminated ice cubes
E. is the name for hepatic malaria
E. all of these
10. Select the ways antimalarial drugs work to eradicate protozoan
4. In the malaria life cycle (LO 43.1)
infections. (LO 43.2)
A. there is no life or stage outside of human
A. interfere with metabolism of protozoans
B. organisms rapidly multiply in the liver
B. eliminate intestinal bacteria
C. eggs are shed in human feces
C. inhibit the formation of hemozoin
D. chills and fever coincide with bursting red blood cells
D. inhibit the conversion of folic acid to folinic acid
E. gametes must enter WBC to reproduce
E. all of these
5. Which combination is the correct drug and organism? (LO 43.2,
11. The symptoms of dysentery do NOT include (LO 43.3)
43.4)
A. tenesmus
A. metronidazole: Plasmodium vivax
B. abdominal pain
B. primaquine radical cure: Plasmodium
C. jaundice
C. paromomycin: Trichomonas vaginalis
D. dehydration
D. tinidazole: hepatic malaria
E. fatigue
E. quinine: Giardia lamblia
12. Choose the medications effective in treating parasitic worms. 
6. Paromomycin (LO 43.5)
(LO 43.5)
A. paralyzes parasitic worms in the intestine
A. pyrimethamine
B. eliminates intestinal bacteria as an antibiotic
B. doxycycline
C. is in the chloroquine family of drugs
C. mefloquine
D. is the drug of choice for Giardia
D. praziquantel
E. must achieve a minimum blood level to be effective
E. tinidazole
13. Which of the following is an adverse reaction of mefloquine? (LO 43.4)
A. disulfiram-like reaction
B. cinchonism @
C. Stevens-Johnson syndrome
D. tenesmus
E. decrease in the PR to QT interval on ECG

Chapter 44: Antiseptics and Disinfectants

9. Narrow-spectrum disinfection?
1. Which of the following is correct about antiseptics? A. means the chemical has to be left on the surface for more than 1
A. only bacteria are affected hour
B. antiseptics are antimicrobial only in very high concentrations B. cannot be used to sterilize a local surface
C. they can be bacteriostatic and bactericidal C. does not harm human tissue
D. viruses are not affected by them D. means fewer types of microorganisms are affected compared to
E. they have little effect on pathogens broad-spectrum agents
E. is cold sterilization
10. Which of the following explains what an active vehicle is?
2. The principal difference between disinfectants and antiseptics
A. the solution used to dilute or dissolve an antiseptic that is also
is:
antimicrobial itself
A. a broader spectrum of microorganisms are killed with antiseptics
B. bacterial spores that carry the microorganism into the hospital
B. antiseptics cause skin rashes
C. a chemical that inhibits bacterial growth but does not eradicate
C. disinfectants cannot penetrate cell membranes
the organism
D. disinfectants by definition are used on nonliving surfaces
D. the term for chlorhexidine’s mechanism of action
E. antiseptics cannot be used to irrigate wounds
E. formaldehyde diluted in distilled water
3. Which of the following is correct about aldehyde disinfectants? 11. Select the way antiseptics and disinfectants can reduce
A. they are not used as an antiseptic at diluted concentrations bacterial function.
B. special handling procedures must be followed because of their A. increase surface tension of bacterial cell walls
inherent toxicity to humans B. damage nucleic acid
C. they are broad-spectrum microbicidal agents C. interfere with cell metabolism
D. they are used for cold sterilization of instruments D. inhibit cell enzyme systems
E. all of these E. all of these
4. Which of the following is correct? 12. Select the statement that is correct.
A. antiseptics are used to reduce contamination only in homes A. antiseptics eradicate microbial growth on living tissue
B. disinfectants are microbiostatic surgical hand scrubs B. disinfectants destroy pathogenic microbes on nonliving surfaces
C. iodophors are compounds that have mercury as the active
antimicrobial element
C. antibiotics are used to eliminate systemic microbes
D. antiseptics that contain iodine and silver stimulate cell enzyme
D. sterilization is the complete eradication of all microorganisms
(respiration) systems
E. all of these @
E. triclosan is an antibacterial widely found in consumer products
(soaps, skin cleansers)
5. Which of the following is correct?
A. hydrogen peroxide releases iodine as part of its action
13. Choose the true statements.
B. chlorhexidine is antiseptic because it disrupts oxygen in the cell
A. antibiotics should not be administered to the skin
membrane
B. antiseptics are used to eliminate multiple microorganisms
C. alcohol can be added to many other antiseptics to increase
C. antibiotics only target viruses and not bacteria
penetrability and antimicrobial effectiveness
D. disinfectants are intended for internal use
D. sterilization reduces the number of microorganisms but does not
E. isopropyl alcohol can be taken internally
kill them
E. chlorhexidine mouthwash causes aphthous ulcers
6. How do general antibiotics differ from antiseptics and
14. Choose the possible adverse effects of topical disinfectants.
disinfectants?
A. dryness
A. antibiotics are usually expected to achieve a certain blood level
B. rash
B. antiseptics cover a different spectrum of microorganisms
C. irritation
C. antibiotics do not lyse cell walls or inhibit protein synthesis in
D. hypersensitivity
microbes
E. All of these @
D. disinfectants must reach the same blood level
7. Which of the following is correct?
A. surfaces must be thoroughly cleaned prior to using antiseptics
15. Select the term that means to kill a particular microorganism.
B. organic matter and pus increase the activity of antiseptics
A. bacteriostatic
C. benzalkonium chloride is a mouthwash that causes “hairy
B. fungistatic
tongue”
C. pathogenic
D. argyria is a permanent black stain from prolonged use of
D. virucidal
hydrogen peroxide
E. antimicrobial @
E. antibiotics and antiseptics are interchangeable terms (mean the
same thing)
8. Which is true concerning nosocomial infections?
A. they are caused only by viruses
B. the patient is responsible for a nosocomial infection
C. they are acquired in the hospital
D. the infections are usually easy to eradicate
E. they respond well to topical antibiotics

Chapter 45: Antineoplastic Agents and Oncology Immunotherapy

1. Carmustine functions as an (LO 45.2) 6. Which of the following is true of chemotherapy? (LO 45.1)
A. antimetabolite A. one of the early goals of chemotherapy is remission
B. alkylator B. antineoplastic drugs only attack cancerous cells
C. hormone antagonist C. drug resistance is increased with combination therapy
D. mitotic inhibitor D. it is the primary form of treatment for solid tumors
E. monoclonal antibody E. it is usually effective after one treatment
2. The antimetabolite that blocks DNA synthesis by interfering
7. Select the correct statements for alkylating drugs. (LO 45.2)
with folic acid is (LO 45.3)
A. bind irreversibly with nucleic acids
A. mercaptopurine
B. decrease cells’ ability to synthesize proteins
B. fluorouracil
C. are cell-cycle nonspecific
C. methotrexate
D. bind irreversibly with nucleic acids and are cell-cycle nonspecific
D. cytarabine
E. all statements are true @
E. tamoxifen
3. The drug that binds to mitotic tubules to cause metaphase 8. The mechanisms of actions for the antimetabolites include (LO
arrest is (LO 45.4) 45.3)
A. doxorubicin A. preventing DNA replication
B. asparaginase B. blocking DNA synthesis
C. etoposide C. forming abnormal nucleotides
D. vincristine D. preventing DNA replication and forming abnormal nucleotides
E. mercaptopurine E. all of these
4. Enzyme inhibition of aromatase is the mechanism of action of 9. Select the correct statements about the plant extract
(LO 45.5) treatments for cancer. (LO 45.4)
A. tamoxifen A. they can bind to microtubules
 B. they induce enzymes
B. anastrozole
C. they increase DNA strand breakage
C. leuprolide
D. they can bind to microtubules, and they increase DNA strand
D. goserelin
breakage @
E. asparaginase
E. all statements are true
10. Which of the following are correct about hormone
5. The monoclonal antibody that inhibits vascular endothelial
antagonists? (LO 45.5)
growth factor and new blood vessel formation is (LO 45.6)
A. their function is to block hormones
A. imatinib
B. they are cytotoxic and cause cell death
B. trastuzumab
C. they are primarily indicated after surgery and radiation
C. bevacizumab
D. their function is to block hormones, and they are primarily
D. gefitinib
indicated after surgery and radiation
E. cetuximab
E. all statements are true @