The National List of Essential Medicines (NLEM) MCQs With Answer is a focused practice resource for B.Pharm students aiming to master essential-medicine policy, pharmacology, selection criteria and rational prescribing. This NLEM guide covers key topics: WHO Model List alignment, therapeutic categories, generic names, fixed-dose combinations, procurement, storage, quality control, and cost-effectiveness. Through targeted multiple-choice questions you will reinforce learning about national policy, standard treatment guidelines, drug pricing, safety monitoring and evidence-based selection. Questions emphasize practical application, regulatory concepts, and clinical relevance for community and hospital pharmacy practice. Ideal for exam revision and competitive preparation. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which of the following best describes the primary purpose of the National List of Essential Medicines (NLEM)?
- To list all patented medicines available in the market
- To guide selection of essential, cost-effective medicines for public health
- To provide a commercial formulary for private hospitals
- To rank pharmaceutical companies by sales
Correct Answer: To guide selection of essential, cost-effective medicines for public health
Q2. Which organization publishes the Model List of Essential Medicines that many countries use as a reference for their NLEM?
- World Bank
- World Health Organization
- International Pharmaceutical Federation
- United Nations Development Programme
Correct Answer: World Health Organization
Q3. Which criterion is most important when selecting a drug for inclusion in NLEM?
- Brand popularity
- Cost-effectiveness and public health need
- Manufacturer profit margin
- Advertising frequency
Correct Answer: Cost-effectiveness and public health need
Q4. In the context of NLEM, what does “essential medicine” primarily imply?
- A medicine prescribed only in tertiary hospitals
- A medicine that satisfies the priority health care needs of the population
- A medicine used exclusively for clinical trials
- A medicine that is always patented
Correct Answer: A medicine that satisfies the priority health care needs of the population
Q5. How often is the NLEM typically reviewed and updated to reflect changing health needs?
- Every 50 years
- Never
- Periodically, based on evidence and expert review
- Only when requested by pharmaceutical companies
Correct Answer: Periodically, based on evidence and expert review
Q6. Which of the following is a typical therapeutic category included in the NLEM?
- Antimicrobials
- Luxury cosmetic agents
- Experimental herbal remedies with no evidence
- Exclusive lifestyle supplements
Correct Answer: Antimicrobials
Q7. The NLEM emphasizes use of which type of names for medicines to promote rational use?
- Brand names
- Manufacturer codes
- Generic (International Nonproprietary) names
- Trademarked local names
Correct Answer: Generic (International Nonproprietary) names
Q8. Which concept related to antibiotics appears in essential-medicine policies to promote stewardship?
- AWaRe classification
- Celebrity endorsement
- Unlimited empirical use
- Price inflation
Correct Answer: AWaRe classification
Q9. For B.Pharm students, why is knowledge of NLEM important in hospital pharmacy practice?
- To increase the sale of branded drugs
- To ensure availability, rational prescribing and cost-containment
- To bypass procurement rules
- To promote use of expired medicines
Correct Answer: To ensure availability, rational prescribing and cost-containment
Q10. Which of the following is a common reason to remove a drug from the NLEM?
- New evidence shows lack of efficacy or safety concerns
- The drug becomes cheaper
- The drug gains more brand competitors
- It is featured in a movie
Correct Answer: New evidence shows lack of efficacy or safety concerns
Q11. Which type of fixed-dose combinations (FDCs) are generally discouraged in NLEM selection?
- Evidence-based, WHO-recommended FDCs
- Rational FDCs with synergistic action
- Unnecessary or irrational FDCs lacking evidence
- FDCs for tuberculosis supported by guidelines
Correct Answer: Unnecessary or irrational FDCs lacking evidence
Q12. Which aspect of supply chain management is directly relevant to NLEM implementation?
- Celebrity endorsements
- Cold chain, storage conditions and inventory control
- Label design trends
- Advertising in social media
Correct Answer: Cold chain, storage conditions and inventory control
Q13. Which indicator is commonly used to evaluate access to essential medicines?
- Number of TV ads for drugs
- Availability and affordability at public health facilities
- Amount of packaging used
- Number of private pharmacies per mall
Correct Answer: Availability and affordability at public health facilities
Q14. When preparing an exam question on NLEM, a B.Pharm student should focus on:
- Trade secrets of manufacturers
- Selection criteria, therapeutic use, generic names and dosing
- Only cosmetic formulations
- Irrelevant advertising data
Correct Answer: Selection criteria, therapeutic use, generic names and dosing
Q15. Which of the following drugs would you expect to find on a national essential medicines list for managing acute pain?
- Morphine (parenteral) for severe pain
- Expensive designer analgesic with no advantage
- Topical perfume oil
- Unapproved herbal elixir
Correct Answer: Morphine (parenteral) for severe pain
Q16. Which regulatory concept ensures that medicines on the NLEM meet quality standards?
- GMP (Good Manufacturing Practice)
- Celebrity endorsement
- Zero manufacturing oversight
- Ad hoc local blending
Correct Answer: GMP (Good Manufacturing Practice)
Q17. Which component of pharmacoeconomics is most relevant when adding a drug to the NLEM?
- Cost-effectiveness analysis
- Logo design cost
- Number of advertisements
- Color of the pill
Correct Answer: Cost-effectiveness analysis
Q18. In NLEM context, what is the role of standard treatment guidelines (STGs)?
- To provide evidence-based recommendations for medicine use
- To promote only branded therapies
- To reduce pharmacist responsibilities
- To replace clinical judgment entirely
Correct Answer: To provide evidence-based recommendations for medicine use
Q19. Which of the following pediatric considerations is important for inclusion in the NLEM?
- Availability of age-appropriate formulations and dosing
- Adult-only packaging for all medicines
- Only injectable forms for children
- High-dose adult tablets for infants
Correct Answer: Availability of age-appropriate formulations and dosing
Q20. Which statement about generic substitution in the context of NLEM is correct?
- Generic substitution promotes affordable access when quality is assured
- Generic drugs are always inferior
- Substitution is illegal under all circumstances
- Only brand-name drugs should be used in public hospitals
Correct Answer: Generic substitution promotes affordable access when quality is assured
Q21. Which of the following is an example of a medicine class commonly prioritized in NLEM for chronic disease management?
- Antihypertensives (e.g., ACE inhibitors)
- Rare investigative oncology agents with no public program
- Ornamental fragrances
- Exclusive cosmetic injectables
Correct Answer: Antihypertensives (e.g., ACE inhibitors)
Q22. What is the significance of listing dosage forms in NLEM?
- To ensure appropriate, effective and safe formulations are available
- To limit prescriptions to only one brand
- To increase marketing costs
- To encourage use of expired medicines
Correct Answer: To ensure appropriate, effective and safe formulations are available
Q23. Which of the following surveillance activities supports the NLEM’s safe use of medicines?
- Pharmacovigilance and adverse drug reaction monitoring
- Counting pills as a social activity
- Advertising adverse events
- Ignoring safety reports to save costs
Correct Answer: Pharmacovigilance and adverse drug reaction monitoring
Q24. Which factor is least likely to influence inclusion of a medicine in the NLEM?
- Public health relevance
- Availability of clinical evidence
- High-quality safety data
- Recent celebrity promotion
Correct Answer: Recent celebrity promotion
Q25. How does NLEM contribute to rational prescribing by physicians?
- By offering a prioritized list of effective, safe and affordable drugs
- By recommending maximum use of brand names
- By encouraging polypharmacy
- By eliminating clinical guidelines
Correct Answer: By offering a prioritized list of effective, safe and affordable drugs
Q26. Which of the following anti-tuberculosis medicines is commonly included in national essential medicines lists?
- Isoniazid
- Unapproved herbal cough syrup
- Expired antibiotic mixtures
- Topical skin whitening cream
Correct Answer: Isoniazid
Q27. What is a likely outcome when public facilities implement the NLEM effectively?
- Improved access to essential medicines and reduced out-of-pocket expenditure
- Decreased availability of standard treatments
- Increased irrational polypharmacy
- Higher incidence of counterfeit sales
Correct Answer: Improved access to essential medicines and reduced out-of-pocket expenditure
Q28. Which of the following best describes the role of evidence in updating the NLEM?
- Decisions are primarily evidence-driven, considering clinical trials and cost-effectiveness
- Updates are made randomly without review
- Only marketing data are used
- Decisions depend solely on social media trends
Correct Answer: Decisions are primarily evidence-driven, considering clinical trials and cost-effectiveness
Q29. Which stakeholder group is typically consulted during NLEM revision?
- Clinical experts, public health specialists, pharmacists and patient representatives
- Only advertising agencies
- Telephone marketers
- Unregulated street vendors
Correct Answer: Clinical experts, public health specialists, pharmacists and patient representatives
Q30. For a B.Pharm student, mastering NLEM content helps primarily with which professional competency?
- Rational drug selection, procurement and patient-centered dispensing
- Designing pill colors for branding
- Maximizing personal retail sales outside regulations
- Creating catchy pharmaceutical jingles
Correct Answer: Rational drug selection, procurement and patient-centered dispensing
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
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