🏥 NCLEX Pharmacology MCQs (151–200) – Part 4
Are you preparing for the NCLEX exam or other nursing and medical board exams? This guide covers Pharmacology MCQs (Part 4: 151–200) with correct answers and simple explanations. From antidotes and side effects to life-saving drugs in emergencies, each question is designed to strengthen your knowledge. Whether you’re in the USA, UK, Canada, Australia, or worldwide, these practice questions will help you master drug classifications, nursing responsibilities, and clinical applications. Practice daily and boost your chances of exam success!
151. A patient prescribed digoxin should be closely monitored for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hyponatremia
Answer: B) Hypokalemia
Explanation: Hypokalemia increases the risk of digoxin toxicity, leading to arrhythmias, nausea, and vision changes (yellow halos). Nurses must monitor potassium levels and assess ECG changes.
152. Which antibiotic class is associated with ototoxicity and nephrotoxicity?
A) Macrolides
B) Aminoglycosides
C) Tetracyclines
D) Cephalosporins
Answer: B) Aminoglycosides
Explanation: Aminoglycosides (e.g., gentamicin) can cause hearing loss (ototoxicity) and kidney injury (nephrotoxicity). Nurses must check renal function tests and monitor for hearing changes.
153. A nurse should instruct a patient on warfarin (Coumadin) to avoid excessive intake of which food?
A) Bananas
B) Leafy green vegetables
C) Dairy products
D) Citrus fruits
Answer: B) Leafy green vegetables
Explanation: Warfarin’s effectiveness is reduced by vitamin K-rich foods (spinach, kale, broccoli). Patients don’t need to avoid them completely, but intake must remain consistent.
154. What is the antidote for opioid overdose?
A) Protamine sulfate
B) Atropine
C) Naloxone
D) Flumazenil
Answer: C) Naloxone
Explanation: Naloxone is an opioid antagonist that rapidly reverses respiratory depression caused by opioids (e.g., morphine, heroin). It acts quickly but may require repeated doses due to short half-life.
155. Which drug is contraindicated in asthma patients because it may cause bronchospasm?
A) Beta-blockers
B) Corticosteroids
C) Antihistamines
D) Calcium channel blockers
Answer: A) Beta-blockers
Explanation: Non-selective beta-blockers (e.g., propranolol) can block beta-2 receptors, leading to bronchoconstriction. Nurses should assess respiratory history before administration.
156. A patient on furosemide (Lasix) should be monitored for which complication?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hyperglycemia
Answer: B) Hypokalemia
Explanation: Furosemide is a loop diuretic that promotes excretion of potassium, sodium, and water. Potassium supplements or high-potassium foods may be required to prevent arrhythmias.
157. Which insulin has the fastest onset of action?
A) Regular insulin
B) NPH insulin
C) Insulin lispro
D) Insulin glargine
Answer: C) Insulin lispro
Explanation: Insulin lispro (rapid-acting) begins working within 15 minutes and is given just before meals. Regular insulin is short-acting, NPH is intermediate, and glargine is long-acting.
158. What is the primary nursing concern when administering morphine?
A) Hypertension
B) Respiratory depression
C) Hypoglycemia
D) Bradycardia
Answer: B) Respiratory depression
Explanation: Morphine can depress the respiratory center, especially at high doses. Nurses must monitor respiratory rate, oxygen saturation, and sedation level. Naloxone is the antidote.
159. Which drug is classified as a proton pump inhibitor (PPI)?
A) Ranitidine
B) Omeprazole
C) Sucralfate
D) Misoprostol
Answer: B) Omeprazole
Explanation: PPIs (omeprazole, pantoprazole) inhibit gastric acid secretion and are used for GERD, peptic ulcers, and esophagitis. Long-term use may cause vitamin B12 deficiency.
160. A nurse administering heparin should monitor which laboratory test?
A) PT/INR
B) aPTT
C) Hemoglobin
D) Creatinine
Answer: B) aPTT
Explanation: Activated partial thromboplastin time (aPTT) monitors heparin therapy effectiveness. Normal range is 30–40 seconds; therapeutic is 1.5–2.5 times normal. Protamine sulfate is the antidote.
161. A nurse should withhold digoxin if the patient’s apical pulse is:
A) Below 100 bpm
B) Below 90 bpm
C) Below 70 bpm
D) Below 60 bpm
Answer: D) Below 60 bpm
Explanation: Digoxin can slow the heart rate. Nurses must check the apical pulse for one full minute before giving. If HR < 60 bpm, the drug should be withheld, and the provider notified.
162. Which drug is used as the antidote for benzodiazepine overdose?
A) Naloxone
B) Protamine sulfate
C) Flumazenil
D) Vitamin K
Answer: C) Flumazenil
Explanation: Flumazenil reverses the sedative effects of benzodiazepines (e.g., diazepam, lorazepam). However, it must be given cautiously because it may trigger seizures in dependent patients.
163. Which side effect is most common with statins (cholesterol-lowering drugs)?
A) Muscle pain
B) Hypoglycemia
C) Hypertension
D) Constipation
Answer: A) Muscle pain
Explanation: Statins (e.g., atorvastatin, simvastatin) can cause myopathy and rhabdomyolysis. Nurses should assess for muscle weakness and monitor liver function tests.
164. Which medication is used in the treatment of anaphylaxis?
A) Epinephrine
B) Atropine
C) Hydralazine
D) Furosemide
Answer: A) Epinephrine
Explanation: Epinephrine (adrenaline) is the first-line treatment for anaphylaxis. It causes bronchodilation and vasoconstriction, reversing airway obstruction and hypotension.
165. Which drug is contraindicated during pregnancy because it may cause birth defects?
A) Acetaminophen
B) Tetracyclines
C) Penicillin
D) Amoxicillin
Answer: B) Tetracyclines
Explanation: Tetracyclines cross the placenta and can cause tooth discoloration and impaired bone growth in the fetus. Safer options include penicillin and cephalosporins.
166. Which drug is used to treat Parkinson’s disease?
A) Levodopa-carbidopa
B) Diazepam
C) Amoxicillin
D) Phenytoin
Answer: A) Levodopa-carbidopa
Explanation: Levodopa converts to dopamine in the brain, while carbidopa prevents peripheral breakdown. It helps reduce tremors and rigidity in Parkinson’s disease.
167. Which adverse effect is linked to ACE inhibitors (like lisinopril)?
A) Hypotension
B) Dry cough
C) Constipation
D) Hypoglycemia
Answer: B) Dry cough
Explanation: ACE inhibitors may cause a persistent dry cough due to accumulation of bradykinin. Angioedema and hyperkalemia are other possible complications.
168. Which medication is used for acute asthma attacks?
A) Salmeterol
B) Albuterol
C) Montelukast
D) Ipratropium
Answer: B) Albuterol
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides quick relief during acute asthma attacks. Salmeterol is long-acting and not for emergencies.
169. Which drug is prescribed for tuberculosis (TB) treatment?
A) Rifampin
B) Ceftriaxone
C) Azithromycin
D) Vancomycin
Answer: A) Rifampin
Explanation: Rifampin is part of the standard TB treatment regimen (RIPE: Rifampin, Isoniazid, Pyrazinamide, Ethambutol). It may cause red-orange urine and interacts with many drugs.
170. What is the antidote for heparin overdose?
A) Vitamin K
B) Protamine sulfate
C) Flumazenil
D) Naloxone
Answer: B) Protamine sulfate
Explanation: Protamine sulfate binds with heparin to neutralize its anticoagulant effect. It is given in emergencies when bleeding risk is high.
171. Which class of drugs is used as first-line therapy for anaphylaxis?
A) Antihistamines
B) Corticosteroids
C) Epinephrine ✅
D) Beta-blockers
👉 Explanation: Epinephrine IM is the first-line lifesaving treatment in anaphylaxis due to its vasoconstrictor and bronchodilator effects.
172. What is the antidote for opioid overdose?
A) Naloxone ✅
B) Flumazenil
C) Atropine
D) Protamine sulfate
👉 Explanation: Naloxone rapidly reverses opioid-induced respiratory depression by blocking opioid receptors.
173. Which diuretic is considered potassium-sparing?
A) Furosemide
B) Hydrochlorothiazide
C) Spironolactone ✅
D) Mannitol
👉 Explanation: Spironolactone conserves potassium while promoting sodium and water excretion.
174. Which drug is used in status epilepticus as first-line treatment?
A) Phenytoin
B) Diazepam ✅
C) Carbamazepine
D) Lamotrigine
👉 Explanation: Diazepam (IV) or lorazepam is first-line due to rapid onset for seizure control.
175. Which medication is given to prevent mother-to-child transmission of HIV during pregnancy?
A) Zidovudine ✅
B) Tenofovir
C) Efavirenz
D) Ritonavir
👉 Explanation: Zidovudine (AZT) reduces vertical HIV transmission when given in pregnancy and delivery.
176. Which drug is commonly used to treat motion sickness?
A) Metoclopramide
B) Scopolamine ✅
C) Ondansetron
D) Domperidone
👉 Explanation: Scopolamine (anticholinergic patch) is effective in preventing nausea and vomiting due to motion sickness.
177. Which antipsychotic drug is associated with agranulocytosis?
A) Haloperidol
B) Clozapine ✅
C) Risperidone
D) Olanzapine
👉 Explanation: Clozapine requires regular WBC monitoring due to risk of agranulocytosis (severe neutropenia).
178. Which antiplatelet drug irreversibly inhibits COX enzymes?
A) Clopidogrel
B) Aspirin ✅
C) Ticagrelor
D) Prasugrel
👉 Explanation: Aspirin irreversibly inhibits cyclooxygenase, reducing thromboxane A2 and platelet aggregation.
179. Which anti-TB drug causes red-orange discoloration of body fluids?
A) Isoniazid
B) Rifampin ✅
C) Ethambutol
D) Pyrazinamide
👉 Explanation: Rifampin commonly causes red-orange urine, sweat, and tears — harmless but alarming for patients.
180. Which antibiotic can cause permanent tooth discoloration in children?
A) Amoxicillin
B) Tetracycline ✅
C) Azithromycin
D) Ciprofloxacin
👉 Explanation: Tetracyclines bind to calcium in teeth, leading to enamel discoloration in children <8 years.
181. Which drug is used to treat malignant hyperthermia?
A) Dantrolene ✅
B) Diazepam
C) Succinylcholine
D) Halothane
👉 Explanation: Dantrolene blocks calcium release from sarcoplasmic reticulum, reversing muscle rigidity and hyperthermia.
182. Which drug is commonly used for prevention of organ transplant rejection?
A) Methotrexate
B) Cyclosporine ✅
C) Azathioprine
D) Leflunomide
👉 Explanation: Cyclosporine is an immunosuppressant that inhibits calcineurin and T-cell activation.
183. Which chemotherapy drug can cause hemorrhagic cystitis?
A) Methotrexate
B) Cyclophosphamide ✅
C) Doxorubicin
D) Cisplatin
👉 Explanation: Cyclophosphamide produces toxic metabolites in the bladder → hemorrhagic cystitis (prevented by Mesna).
184. Which antidiabetic drug increases insulin secretion from pancreatic beta cells?
A) Metformin
B) Sulfonylureas ✅
C) Acarbose
D) Sitagliptin
👉 Explanation: Sulfonylureas (e.g., glipizide) act by stimulating insulin release from pancreatic beta cells.
185. Which medication is contraindicated in asthmatic patients?
A) Beta-blockers ✅
B) Calcium channel blockers
C) ACE inhibitors
D) Nitrates
👉 Explanation: Non-selective beta-blockers may trigger bronchospasm in asthmatic patients.
186. Which antiarrhythmic drug can cause pulmonary fibrosis?
A) Amiodarone ✅
B) Lidocaine
C) Digoxin
D) Verapamil
👉 Explanation: Long-term amiodarone use is associated with pulmonary fibrosis, thyroid dysfunction, and corneal deposits.
187. Which vitamin prevents neural tube defects in pregnancy?
A) Vitamin A
B) Vitamin B9 (Folic Acid) ✅
C) Vitamin C
D) Vitamin D
👉 Explanation: Adequate folic acid supplementation before conception prevents neural tube defects like spina bifida.
188. Which diuretic is used in acute pulmonary edema?
A) Furosemide ✅
B) Spironolactone
C) Hydrochlorothiazide
D) Mannitol
👉 Explanation: Furosemide (loop diuretic) provides rapid relief by reducing fluid overload in acute pulmonary edema.
189. Which drug is contraindicated in children due to risk of Reye’s syndrome?
A) Ibuprofen
B) Paracetamol
C) Aspirin ✅
D) Naproxen
👉 Explanation: Aspirin in children with viral infections can trigger Reye’s syndrome, a fatal hepatic encephalopathy.
190. Which antihypertensive is safe in pregnancy?
A) Lisinopril
B) Losartan
C) Methyldopa ✅
D) Enalapril
👉 Explanation: Methyldopa is a centrally acting antihypertensive considered safe in pregnancy.
191. Which drug is a serotonin-selective reuptake inhibitor (SSRI)?
A) Amitriptyline
B) Fluoxetine ✅
C) Venlafaxine
D) Lithium
👉 Explanation: Fluoxetine is an SSRI, first-line for depression and anxiety disorders.
192. Which antifungal is used for systemic infections?
A) Nystatin
B) Amphotericin B ✅
C) Clotrimazole
D) Griseofulvin
👉 Explanation: Amphotericin B is the drug of choice for severe systemic fungal infections, but nephrotoxic.
193. Which drug is used in bipolar disorder for mood stabilization?
A) Fluoxetine
B) Lithium ✅
C) Diazepam
D) Imipramine
👉 Explanation: Lithium is a classic mood stabilizer effective in bipolar disorder management.
194. Which drug is used in alcohol withdrawal to prevent seizures?
A) Phenytoin
B) Diazepam ✅
C) Carbamazepine
D) Valproic acid
👉 Explanation: Benzodiazepines (diazepam, lorazepam) are first-line in preventing seizures and delirium tremens in alcohol withdrawal.
195. Which anti-TB drug causes optic neuritis (red-green color blindness)?
A) Isoniazid
B) Rifampin
C) Ethambutol ✅
D) Pyrazinamide
👉 Explanation: Ethambutol can cause dose-dependent optic neuritis — patients need regular eye exams.
196. Which drug is used to treat gout by inhibiting xanthine oxidase?
A) Allopurinol ✅
B) Colchicine
C) Probenecid
D) Indomethacin
👉 Explanation: Allopurinol reduces uric acid formation by inhibiting xanthine oxidase.
197. Which anti-cancer drug is cardiotoxic?
A) Doxorubicin ✅
B) Cyclophosphamide
C) Cisplatin
D) Methotrexate
👉 Explanation: Doxorubicin (anthracycline) causes dose-dependent cardiomyopathy and requires monitoring.
198. Which drug is used for benign prostatic hyperplasia (BPH)?
A) Finasteride ✅
B) Sildenafil
C) Diazepam
D) Omeprazole
👉 Explanation: Finasteride (5-alpha-reductase inhibitor) reduces prostate size and improves urine flow.
199. Which antihyperlipidemic drug can cause flushing?
A) Niacin (Vitamin B3) ✅
B) Atorvastatin
C) Gemfibrozil
D) Ezetimibe
👉 Explanation: Niacin causes prostaglandin-mediated flushing, which can be reduced with aspirin.
200. Which drug is used as an anticoagulant during pregnancy?
A) Warfarin
B) Heparin ✅
C) Dabigatran
D) Rivaroxaban
👉 Explanation: Heparin is safe in pregnancy as it does not cross the placenta, unlike warfarin which is teratogenic.
That wraps up NCLEX Pharmacology MCQs Part 4 (151–200). 🎉 By now, you’ve revised antidotes, antibiotics, psychiatric medications, cardiovascular drugs, and more. Keep practicing to build confidence for your NCLEX, NCLEX-PN, and nursing pharmacology exams.
👉 Don’t miss the other sets:
- NCLEX Pharmacology MCQs Part 1 (1–50)
- NCLEX Pharmacology MCQs Part 2 (51–100)
- NCLEX Pharmacology MCQs Part 3 (101–150)
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