INSTITUTE OF NURSING, WAH MEDICAL COLLEG

GENERIC BSCN PROF - II

SUBJECT: Pharmacology & Mathematics
Grand Test-II

Total Marks: 60 Time Allowed: 40 minutes

Student’s Name: _____________________ Date: 23/01/2018
Course Instructor: Mrs. Sumaira Naz & Mrs. Misbah Naureen
A. Encircle the correct answer
Multiple Choice Questions (MCQS)
1. A 45-year-old woman is distressed by the dissolution of her marriage. She has been
drinking heavily and overeating. She complains of persistent heartburn and an
unpleasant, acid-like taste in her mouth. The clinician suspects gastrointestinal reflux
disease and advises her to raise the head of her bed 6 to 8 inches, not to eat for several
hours before retiring, to avoid alcohol, and to eat smaller meals. Two weeks later, she
returns and says the symptoms have subsided slightly but still are a concern. The
clinician prescribes:
a. An antacid such as aluminum hydroxide.
b. Dicyclomine.
c. An antianxiety agent such as alprazolam.
d. Esomeprazole
e. Famotidine.
2. Which of the following agents interferes with most of the cytochrome p450 enzymes
and, thus, leads to many drug-drug interactions?
a. Famotidine.
b. Omeprazole.
c. Cimetidine.
d. Sucralfate.
e. Ondansetron
3. a couple celebrating their fortieth wedding anniversary is given a trip to peru to visit
machu picchu. Due to past experiences while traveling, they ask their doctor to
prescribe an agent for diarrhea. Which of the following would be effective?
a. Omeprazole.
b. Loperamide.
c. Famotidine.
d. Lorazepam
e. Ondansetron
4. A 68-year-old patient with cardiac failure is diagnosed with ovarian cancer. She is
started on cisplatin but becomes nauseous and suffers from severe vomiting. Which of
the following medications would be most effective to counteract the emesis in this
patient without exacerbating her cardiac problem?
a. Droperidol.
b. Dolasetron.
c. Prochlorperazine.
d. Dronabinol.
e. Ondansetron.
5. In which one of the following clinical situations is the prophylactic use of antibiotics not
warranted?
a. Prevention of meningitis among individuals in close contact with infected
patients.
b. Patient with a hip prosthesis who is having a tooth removed.
c. Presurgical treatment for implantation of a hip prosthesis.
d. Patient who complains of frequent respiratory illness.
e. Presurgical treatment in gastrointestinal procedures.
6. Which one of the following is the best route of administration/dosing schedule for treatment
with amino glycosides based on the drug's concentration-dependent killing property?
a. Oral every 8 hours.
b. Oral every 24 hours.
c. Parenterally by continuous intravenous infusion.
d. Parenterally every 8 hours.
e. Parenterally every 24 hours.
7. An elderly diabetic patient is admitted to the hospital with pneumonia. The sputum culture
stains for a gram-negative rod. The patient is started on iv ampicillin. Two days later, the patient
is not improving, and the microbiology laboratory reports the organism to be a î²-lactamase
producing h. Influenza. What course of treatment is indicated?
a. Continue with the iv ampicillin.
b. Switch to I/V cefotaxime.
c. Switch to oral vancomycin.
d. Add gentamicin to the ampicillin therapy
e. Add imipenem/cilastatin.
8. A patient with degenerative joint disease is to undergo insertion of a hip prosthesis. To avoid
complications due to postoperative infection, the surgeon will pretreat this patient with an
antibiotic. This hospital has a significant problem with mrsa. Which of the following antibiotics
should the surgeon select?
a. Ampicillin.
b. Imipenem/cilastatin.
c. Gentamicin/piperacillin.
d. Vancomycin.
e. Cefazolin
9. A 25-year-old male returns home from a holiday in the far east and complains of 3 days of
dysuria and a purulent urethral discharge. You diagnose this to be a case of gonorrhea. Which of
the following is appropriate treatment?
a. Ceftriaxone I/M.
b. Penicillin g im.
c. Gentamicin im.
d. Piperacillin/tazobactam iv.
e. Vancomycin iv.
10. A pregnant woman was hospitalized and catheterized with a foley catheter. She developed a
urinary tract infection caused by pseudomonas aeruginosa and was treated with gentamicin.
Which of the following adverse effects was a risk to the fetus when the woman was on
gentamicin?
a. Skeletal deformity.
b. Hearing loss.
c. Teratogenesis.
d. Blindness.
e. Mental retardation.
11. Children younger than 8 years of age should not receive tetracycline’s because these agents:
a. Cause rupture of tendons.
b. Do not cross into the cs.
c. Are not bactericidal.
d. Deposit in tissues undergoing calcification.
e. Can cause aplastic anemia
12. A 46-year-old woman is in the intensive care unit for treatment of a vancomycin-resistant
strain of enterococcus caused bacteremia. You want to limit the risk of drug interactions in this
woman, who is receiving five other medications. Which one of the following antibiotics would
you choose?
a. Azithromycin.
b. Clindamycin.
c. Doxycycline.
 d. Linezolid.
e. Quinupristin/dalfopristin.
13. A 26-year-old young man presents with the symptoms of gonorrhea. Because this condition
is often associated with an infection due to chlamydia trachomatis, which of the following
quinolones would be the best choice for treating him?
a. Ciprofloxacin.
b. Nalidixic acid.
c. Norfloxacin.
d. Levofloxacin
e. Cefazolin
14. Sulfonamides increase the risk of neonatal kernicterus, because they:
a. Diminish the production of plasma albumin.
b. Increase the turnover of red blood cells.
c. Inhibit the metabolism of bilirubin.
d. Compete for bilirubin-binding sites on plasma albumin.
e. Depress the bone marrow
15. A 31-year-old white intravenous drug user was admitted to the hospital with a 4-week history
of cough and fever. A chest radiograph showed left upper lobe cavitary infiltrate. Cultures of
sputum yielded m. Tuberculosis susceptible to all antimycobacterial drugs. The patient received
isoniazid, rifampin, and pyrazinamide. The patient's sputum remained culture-positive for the
subsequent 4 months. Which one of the following is the most likely cause of treatment failure?
a. False-positive cultures.
b. Maladsorption of the medications.
c. Concomitant infection with hiv.
d. Noncompliance by the patient.
e. Drug resistance.
16. A 40-year-old man has been on primary therapy for active pulmonary tuberculosis for the
past 2 months. At his regular clinic visit, he complains of a pins and needles sensation in his
feet. You suspect that he might be deficient in which one of the following vitamins?
a. Ascorbic acid.
b. Niacin.
c. Pyridoxine.
d. Calcitriol.
e. Folic acid
17. A 22-year-old male has been treating his athlete’s foot with an over-the-counter drug
without much success. Upon examination, it is found that the nail bed of both great toes is
infected. Which one of the following antifungal agents would be most appropriate for this
patient?
a. Caspofungin.
b. Fluconazole.
c. Griseofulvin.
d. Nystatin.
e. Terbinafine
18. A 36-year-old male of lebanese ancestry is being treated for plasmodium vivax malaria. He
experiences severe fatigue, back pain, and darkened urine. Which one of the following
antimalarial drugs is most likely to have caused his symptoms?
a. Pyrimethamine.
b. Artemisinin.
c. Chloroquine.
d. Quinine.
e. Primaquine
19. Chills, fever, and muscle aches are common reactions to which one of the following antiviral
drugs?
a. Acyclovir.
b. Ganciclovir.
 c. Oseltamivir.
d. Interferon.
e. Ribavirin
20. A 50-year-old migrant worker comes to the emergency department from the field he was
working in and complains of diarrhea, tearing, nausea and vomiting, and sweating. The clinician
notices that he looks generally anxious and has fine fasciculations in the muscles of the upper
chest as well as pinpoint pupils. Which antidote should he receive first?
a. N-acetylcysteine.
b. Sodium nitrite.
c. Edetate calcium disodium.
d. Atropine.
e. Charcoal
21. During treatment with ziduvadin, the nurse needs to monitor for which potential adverse
effect
a. Retinitis
b. Dvt
c. Kaposi sarcoma
d. Bone marrow suppression
e. Constipation
22. The nurse is teaching a patient who is starting antituberculor therapy with rifampin.which
adverse effects would the nurse expect to see
a. Headache and neck pain
b. Gynecomastia
c. Reddish brown urine
d. Numbness of extremities
e. Myalgia
23. All of the folowing are classifications of dietry deficiencies causing nutritional
anemia except one
a. Vitamin b12 cynocobalmine
b. Folic acid
c. Vitamin d
d. Iron
e. Sickel cell anemia
24. Which of the following iron suppliments contains the highest percentage of elemental iron?
a. Ferrous sulfate
b. Carbonyl iron
c. Ferrous gluconate
d. Ferric amonium citrate
e. Poly saccharide iron complex
25. A 56 year old female is discovered to have megaloblastic anemia .her past medical history is
significant for alcoholism .which of the following would be the best treatment
a. Oral vitamin b12
b. Parenteral vitamin b12
c. Oral folate
d. Oral vitamin b12 with oral folate
e. Oral vitamin b12
26. Which of the following might be beneficial to reduce the frequency of painfull crises in a
patient with sickle cell disease?
a. Epotein alpha
b. Filgrastim
c. Hydroxyurea
d. Sargramostim
e. Parenteral vitamin b12
27. A patient with colonic cancer is being treated with 5-fu as well as leucovorin (n5,n10-
methylene tetrahydrofolate). The rationale for administering the coenzyme depends on it being
essential for:
a. Conversion of 5-fu to fluorodeoxyuridylic acid (fdump).
b. protection against the anemia caused by 5-fu treatment.
c. the inhibition of thymidylate synthase by fdump.
d. prolongation of the antitumor effect of 5-fu.

28. Neutropenia develops in a patient undergoing cancer chemotherapy. Administration of which

one of the following agents would accelerate recovery of neutrophil counts?
a. Leucovorin.
b. Filgrastim.
c. Prednisone.
d. Vitamin b12.
e.
29. Hydration and/or diuresis can prevent the renal toxicity associated with:
a. Cisplatin.
b. Chlorambucil.
c. Tamoxifen.
d. Gemcitabine.
e. Mtx.
30. A patient is being treated with allopurinol to control hyperuricemia resulting from
chemotherapy. Which of the following would have to have its dose reduced to prevent toxicity?
a. A. 5-fu.
b. 6-mp.
c. 6-tg.
d. Fludarabine.
e. cytarabine.
f.
31. All of the following drugs are derivatives of nitrosoureas, EXCEPT:
a) Carmustine
b) Vincristine
c) Lomustine
d) Semustine

32. Fluorouracil belongs to:

a) Antibiotics
b) Antimetabolites
c) Plant alkaloids
d) Bone marrow growth factor

33. Action mechanism of alkylating agents is:

a) Producing carbonium ions altering protein structure
b) Producing carbonium ions altering DNA structure
c) Structural antagonism against purine and pyrimidine
d) Inhibition of DNA-dependent RNA synthesis
34. All of the following antiviral drugs are anti-influenza agents, EXCEPT:
a) Acyclovir
b) Amantadine
c) Interferons
d) Rimantadine
35. All of the following antiviral drugs are the analogs of nucleosides, EXCEPT:
a) Acyclovir
b) Zidovudine
c) Saquinavir
 d) Didanozine

36. The drug for the treatment of a hepatic form of amebiasis:

a) Diloxanide or iodoquinol
b) Tetracycline or doxycycline
c) Metronidazole or emetine
d) Erythromycin or azitromycin
37. The group of antibiotics having an antimalarial effect:
a) Aminoglycosides
b) Tetracyclins
c) Carbapenems
d) Penicillins
38. The drug used for malaria chemoprophylaxis and treatment:
a) Chloroquine
b) Quinidine
c) Quinine
d) Sulfonamides

39. Rational combination of anticancer drugs is used to:

a) Provide synergism resulting from the use of anticancer drugs with different mechanisms
combination
b) Provide synergism resulting from the use of anticancer drugs with the same mechanisms
combination
c) Provide stimulation of immune system
d) Provide stimulation of cell proliferation

40. All of the following effects are disadvantages of anticancer drugs, EXCEPT:
a) Low selectivity to cancer cells
b) Depression of bone marrow
c) Depression of angiogenesis
d) Depression of immune system

41. The group of hormonal drugs used for cancer treatment:

a) Mineralocorticoids and glucocorticoids
b) Glucocorticoids and gonadal hormones
c) Gonadal hormones and somatotropin
d) Insulin

42. Niclosamide mechanism of action:

a) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement and
death of helminthes
b) Blocking acetylcholine transmission at the myoneural junction and paralysis of helminthes
c) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose uptake
d) Inhibiting oxidative phosphorylation in some species of helminthes

43. The unwanted effects of fluoroquinolones:

a) Hallucinations
b) Headache, dizziness, insomnia
c) Hypertension
d) Immunetoxicity

44. The indications for fluoroquinolones:

a) Infections of the urinary tract
b) Bacterial diarrhea
c) Infections of the urinary and respiratory tract, bacterial diarrhea
d) Respiratory tract infections

45. The drug of choice for syphilis treatment is:

a) Gentamycin
b) Penicillin
c) Chloramphenicol
d) Doxycycline

46. Combination of sulfonamides with trimethoprim:

a) Decreases the unwanted effects of sulfonamides
b) Increases the antimicrobial activity
c) Decreases the antimicrobial activity
d) Increases the elimination of sulfonamides

47. Sulfonamide potency is decreased in case of co-administration with:

a) Oral hypoglycemic agents
b) Local anesthetics – derivatives of paraaminobenzoic acid
c) Local anesthetics – derivatives of benzoic acid
d) Non-narcotic analgesics

48. Amfotericin B has the following unwanted effects:

a) Psychosis
b) Renal impairment, anemia
c) Hypertension, cardiac arrhythmia
d) Bone marrow toxicity

49. Mechanism of Izoniazid action is:

a) Inhibition of protein synthesis
b) Inhibition of mycolic acids synthesis
c) Inhibition of RNA synthesis
d) Inhibition of ADP synthesis

50. Vancomicin has the following unwanted effects:

a) Pseudomembranous colitis
b) Hepatotoxicity
c) “Red neck” syndrome, phlebitis
d) All of the above

51. Chloramphenicol has the following unwanted effects:

a) Nephrotoxicity
b) Pancytopenia
c) Hepatotoxicity
d) Ototoxicity

52. Pick out the beta-lactamase inhibitor for co-administration with penicillins:
a) Clavulanic acid
b) Sulbactam
c) Tazobactam
d) All of the above
53. Calculating doses based on body weight, the order of medication & size of patient must be:

a) Divide
b) Multiply
c) Added
d) Subtracted
54. If 20mg of a drug is ordered b.i.d, how many mg will the patient receive per day?
a) 20
b) 80
c) 40
d) 120
55. A hollow cylinder that holds the medication, is?
a) Plunger
b) Barrel
c) Tip
d) Needle
56. The part of needle, attach with syringe is?
a) Bevel
b) Hub
c) Guage
d) Shaft
57. 0.5ml per minute=…….. ounces per hour?
a) 2.5
b) 2
c) 1
d) 0.5
58. BSA is measured in?
a) m
b) m2
c) cm
d) mL
59. The BSA of an adult who is 183cm tall & weights 92kg is?
a) 1.62
b) 3600
c) 2.16
d) 3131
60. 2pt=……oz?
a) 16
b) 32
c) 8
d) 24
 INSTITUTE OF NURSING, WAH MEDICAL COLLEG
GENERIC BSCN PROF - II
SUBJECT: Pharmacology & Mathematics
Grand Test-II

Total Marks: 40 Time Allowed: 80 minutes

Student’s Name: _____________________ Date: 23/01/2018
Course Instructor: Mrs. Sumaira Naz & Mrs. Misbah Naureen
PART-B

Give Short Answers:

1. Enlist drugs included in class of H-2 receptor antagonists and describe mechanism of
action for these drugs.
2. Enlist indications and contraindications of proton pump inhibitors.
3. Enlist adverse effects and monitoring parameters of vitamin B12.
4. How you will classify anti-cancer drugs?
5. Enlist indications of Methotrexate?
6. Discuss super infections.
7. Enlist indications and classification of Cephalosporins.
8. Enlist adverse effects of tetracycline’s.
9. Enlist first line drugs which are used to treat tuberculosis and what is meant by DOT
therapy.
10. A drug is ordered 200mg/m2.po b.i.d. how many ml will the patient receive if her BSA is
1.34m2, and concentration of solution is 5mg/ml?
11. A patient is schedule to receive 0.015g of a drug by mouth every morning. The drug is
available as 7.5mg tablets. How many tablets would you administer?