Repeated USMLE Questions Step 1- 263

A 48-year old man presents to the emergency room with severe headache and blurred vision. His blood pressure is 230/140. Ophthalmologic examination reveals blurred optic discs with indistinct margins. An intravenous drip of nitroprusside is started.

What is the mechanism of action of this medication?

A- Alpha adrenergic antagonist

B- Beta adrenergic antagonist

C- Ganglion blocker

D- ACE inhibitor

E- Direct smooth muscle vasodilator


This is a case of hypertensive emergency and should be admitted to intensive care unit (ICU). Nitroprusside is the first line treatment in this condition. Nitroprusside is a direct smooth muscle vasodilator. It works directly on the large arteries to lower systolic blood pressure. This patient has to be continuously monitored to avoid sudden severe drop of blood pressure which can lead to ischemic injuries and death.

The correct answer is E

1 thought on “Repeated USMLE Questions Step 1- 263”

  1. I would be glad if I can get some the material from you to enable me prepare for the nclex.

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