Introduction: Pre-anesthetics MCQs With Answer is an essential study resource for B.Pharm students preparing for pharmacology and clinical rotations. This concise, keyword-rich guide covers pre-anesthetic assessment, preoperative medication, anxiolytics, analgesics, anticholinergics, antiemetics, H2 blockers, prokinetics, alpha-2 agonists, ASA classification, airway evaluation, drug interactions, reversal agents and perioperative safety. Emphasis on mechanism of action, indications, contraindications, side effects and monitoring helps build strong clinical reasoning. Designed to deepen understanding beyond basics, these questions reinforce evidence-based choices in preoperative pharmacotherapy, patient optimization and complication prevention. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which agent is commonly used as a preoperative benzodiazepine for anxiolysis and short-term amnesia?
- Diazepam
- Lorazepam
- Midazolam
- Flumazenil
Correct Answer: Midazolam
Q2. Which drug is an anticholinergic premedication that does NOT cross the blood–brain barrier and reduces oral secretions?
- Atropine
- Glycopyrrolate
- Scopolamine
- Pilocarpine
Correct Answer: Glycopyrrolate
Q3. Which pre-anesthetic agent is a 5-HT3 antagonist used to prevent postoperative nausea and vomiting?
- Dexamethasone
- Ondansetron
- Metoclopramide
- Promethazine
Correct Answer: Ondansetron
Q4. Which medication increases gastric emptying and is used as an aspiration prophylactic premedication?
- Omeprazole
- Ranitidine
- Metoclopramide
- Sodium citrate
Correct Answer: Metoclopramide
Q5. Which class of drugs is recommended to be continued in patients already on therapy to reduce perioperative cardiac risk?
- ACE inhibitors
- Beta blockers
- NSAIDs
- Thiazide diuretics
Correct Answer: Beta blockers
Q6. Which pre-anesthetic drug should be avoided in Parkinson’s disease due to risk of worsening extrapyramidal symptoms?
- Ondansetron
- Metoclopramide
- Dexamethasone
- Glycopyrrolate
Correct Answer: Metoclopramide
Q7. Which agent is a prokinetic and also has antiemetic action via dopamine D2 receptor antagonism?
- Domperidone
- Ondansetron
- Dexmedetomidine
- Ranitidine
Correct Answer: Domperidone
Q8. Which H2-receptor antagonist is commonly used preoperatively to reduce gastric acidity?
- Famotidine
- Omeprazole
- Metoclopramide
- Sodium citrate
Correct Answer: Famotidine
Q9. What is the primary clinical benefit of preoperative administration of alpha-2 agonists like clonidine?
- Increase gastric acidity
- Provide anxiolysis and reduce sympathetic responses
- Reverse neuromuscular blockade
- Induce profound amnesia
Correct Answer: Provide anxiolysis and reduce sympathetic responses
Q10. Which reversal agent is specific for benzodiazepine overdose or excessive benzodiazepine effect?
- Naloxone
- Flumazenil
- Neostigmine
- Sugammadex
Correct Answer: Flumazenil
Q11. Which drug is the specific reversal agent for rocuronium-induced neuromuscular blockade?
- Neostigmine
- Atropine
- Sugammadex
- Physostigmine
Correct Answer: Sugammadex
Q12. Which pre-anesthetic medication is an opioid commonly used for analgesic premedication and can cause respiratory depression?
- Fentanyl
- Ketamine
- Midazolam
- Ondansetron
Correct Answer: Fentanyl
Q13. Which preoperative intervention directly reduces gastric acidity and volume to lower aspiration risk?
- Administration of sodium citrate
- Giving IV fluids
- Applying oxygen mask
- Administering neostigmine
Correct Answer: Administration of sodium citrate
Q14. Which classification system is used to assess preoperative physical status and operative risk?
- APGAR score
- Mallampati score
- ASA physical status classification
- Glasgow Coma Scale
Correct Answer: ASA physical status classification
Q15. A high Mallampati score primarily predicts difficulty in which aspect of anesthesia care?
- Monitoring blood pressure
- Endotracheal intubation and airway management
- Intravenous access
- Postoperative pain control
Correct Answer: Endotracheal intubation and airway management
Q16. Which pre-anesthetic medication is contraindicated in patients with known prolonged QT interval due to risk of further QT prolongation?
- Dexamethasone
- Ondansetron
- Metoclopramide
- Ranitidine
Correct Answer: Ondansetron
Q17. Which agent is used to treat opioid-induced respiratory depression in the perioperative period?
- Flumazenil
- Naloxone
- Neostigmine
- Sugammadex
Correct Answer: Naloxone
Q18. Which pre-anesthetic practice is most important to minimize risk of pulmonary aspiration?
- Administering preoperative antibiotics
- Appropriate fasting according to guidelines
- Using high-dose sedatives for all patients
- Routine placement of nasogastric tube
Correct Answer: Appropriate fasting according to guidelines
Q19. Which drug used as a premedication can cause bradycardia and hypotension due to central sympatholytic effects?
- Atropine
- Clonidine
- Glycopyrrolate
- Ondansetron
Correct Answer: Clonidine
Q20. Which anticholinergic is preferred when central sedation or delirium must be avoided in elderly patients?
- Atropine
- Scopolamine
- Glycopyrrolate
- Physostigmine
Correct Answer: Glycopyrrolate
Q21. Which preoperative medication class can blunt the stress response and is often used in hypertensive patients?
- Benzodiazepines
- Alpha-2 agonists
- 5-HT3 antagonists
- Proton pump inhibitors
Correct Answer: Alpha-2 agonists
Q22. Which anesthetic trigger plus succinylcholine is classically associated with malignant hyperthermia?
- Propofol
- Local anesthetics
- Inhalational volatile anesthetics (e.g., halothane)
- Benzodiazepines
Correct Answer: Inhalational volatile anesthetics (e.g., halothane)
Q23. Which medication is commonly given preoperatively to reduce gastric acidity by inhibiting the proton pump?
- Ranitidine
- Omeprazole
- Metoclopramide
- Sodium citrate
Correct Answer: Omeprazole
Q24. In severe organophosphate poisoning risk during anesthesia, which premedicant can be used to block muscarinic effects?
- Neostigmine
- Atropine
- Physostigmine
- Glycopyrrolate
Correct Answer: Atropine
Q25. Which antiemetic used as premedication has glucocorticoid activity and synergizes with 5-HT3 antagonists?
- Dexamethasone
- Ondansetron
- Metoclopramide
- Promethazine
Correct Answer: Dexamethasone
Q26. Which neuromuscular blocker is contraindicated in patients with severe burns or hyperkalemia due to risk of life-threatening hyperkalemia?
- Rocuronium
- Vecuronium
- Succinylcholine
- Pancuronium
Correct Answer: Succinylcholine
Q27. For antibiotic prophylaxis in surgery, when should the first dose typically be administered relative to incision?
- After skin closure
- Within 60 minutes before incision
- 24 hours before surgery
- Only if infection develops
Correct Answer: Within 60 minutes before incision
Q28. Which cholinesterase inhibitor is used to reverse non-depolarizing neuromuscular blockade but requires concomitant anticholinergic to prevent bradycardia?
- Neostigmine
- Neostigmine combined with glycopyrrolate
- Atropine alone
- Flumazenil
Correct Answer: Neostigmine combined with glycopyrrolate
Q29. Which pre-anesthetic consideration is especially important in obstetric patients to reduce aspiration risk?
- Administering prokinetics and antacids (e.g., sodium citrate)
- Routine high-dose benzodiazepines
- Stopping all antihypertensives
- Using succinylcholine in all cases
Correct Answer: Administering prokinetics and antacids (e.g., sodium citrate)
Q30. Which statement about pre-anesthetic medication in elderly patients is most appropriate?
- Use higher doses due to tolerance
- Avoid individualized dosing; standard doses are fine
- Start low and go slow because of altered pharmacokinetics and sensitivity
- Always avoid anticholinergics regardless of indication
Correct Answer: Start low and go slow because of altered pharmacokinetics and sensitivity
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