,NSG 552 Exam 3 | Psychopharmacology (2026)
Actual Q&A PDF | Wilkes
1. The mechanism of action of naloxone is best described as:
A) A pure opioid antagonist that competes and displaces opioids at receptor
sites
B) A partial mu receptor agonist
C) An NMDA receptor antagonist
D) A dopamine reuptake inhibitor
Correct Answer: A pure opioid antagonist that competes and displaces opioids
at receptor sites
Rationale: Naloxone is a competitive antagonist at mu, kappa, and delta opioid
receptors with no intrinsic activity. It rapidly reverses respiratory depression by
displacing opioids.
2. Buprenorphine is classified as a:
A) Full opioid agonist
B) Partial mu receptor agonist
C) Pure opioid antagonist
D) NMDA receptor antagonist
Correct Answer: Partial mu receptor agonist
,Rationale: Buprenorphine binds with high affinity to mu receptors but activates
them only partially, producing a ceiling effect that reduces overdose risk and
helps with withdrawal management.
3. Which medication for opioid use disorder is available as an implant?
A) Buprenorphine
B) Methadone
C) Naltrexone
D) Buprenorphine/naloxone
Correct Answer: Naltrexone
Rationale: Naltrexone is available as a tablet, an injectable suspension, and an
implant (restricted to inpatient use). Buprenorphine and methadone are not
available as implants.
4. When buprenorphine is taken too soon after the last opioid use, the most
significant risk is:
A) Severe respiratory depression
B) Euphoria and drug‑seeking behavior
C) Intense precipitated withdrawal
D) Hypertensive crisis
Correct Answer: Intense precipitated withdrawal
, Rationale: Buprenorphine has higher mu affinity than full agonists. When a full
agonist is still bound, buprenorphine displaces it, causing rapid‑onset, severe
withdrawal. Patients must be in moderate withdrawal before induction.
5. The clinical triad of Wernicke encephalopathy consists of:
A) Confusion, ataxia, and nystagmus
B) Hallucinations, seizures, and coma
C) Hyperthermia, rigidity, and autonomic instability
D) Disorientation, tremor, and tachycardia
Correct Answer: Confusion, ataxia, and nystagmus
Rationale: Wernicke encephalopathy is a medical emergency caused by
thiamine deficiency, presenting with the classic triad. Parenteral thiamine must
be given before glucose to prevent permanent damage.
6. For a patient with alcohol use disorder who develops confusion, ataxia, and
ophthalmoplegia, the priority intervention is to:
A) Administer IV lorazepam
B) Start oral naltrexone
C) Administer parenteral thiamine before glucose
D) Begin acamprosate therapy
Correct Answer: Administer parenteral thiamine before glucose
Actual Q&A PDF | Wilkes
1. The mechanism of action of naloxone is best described as:
A) A pure opioid antagonist that competes and displaces opioids at receptor
sites
B) A partial mu receptor agonist
C) An NMDA receptor antagonist
D) A dopamine reuptake inhibitor
Correct Answer: A pure opioid antagonist that competes and displaces opioids
at receptor sites
Rationale: Naloxone is a competitive antagonist at mu, kappa, and delta opioid
receptors with no intrinsic activity. It rapidly reverses respiratory depression by
displacing opioids.
2. Buprenorphine is classified as a:
A) Full opioid agonist
B) Partial mu receptor agonist
C) Pure opioid antagonist
D) NMDA receptor antagonist
Correct Answer: Partial mu receptor agonist
,Rationale: Buprenorphine binds with high affinity to mu receptors but activates
them only partially, producing a ceiling effect that reduces overdose risk and
helps with withdrawal management.
3. Which medication for opioid use disorder is available as an implant?
A) Buprenorphine
B) Methadone
C) Naltrexone
D) Buprenorphine/naloxone
Correct Answer: Naltrexone
Rationale: Naltrexone is available as a tablet, an injectable suspension, and an
implant (restricted to inpatient use). Buprenorphine and methadone are not
available as implants.
4. When buprenorphine is taken too soon after the last opioid use, the most
significant risk is:
A) Severe respiratory depression
B) Euphoria and drug‑seeking behavior
C) Intense precipitated withdrawal
D) Hypertensive crisis
Correct Answer: Intense precipitated withdrawal
, Rationale: Buprenorphine has higher mu affinity than full agonists. When a full
agonist is still bound, buprenorphine displaces it, causing rapid‑onset, severe
withdrawal. Patients must be in moderate withdrawal before induction.
5. The clinical triad of Wernicke encephalopathy consists of:
A) Confusion, ataxia, and nystagmus
B) Hallucinations, seizures, and coma
C) Hyperthermia, rigidity, and autonomic instability
D) Disorientation, tremor, and tachycardia
Correct Answer: Confusion, ataxia, and nystagmus
Rationale: Wernicke encephalopathy is a medical emergency caused by
thiamine deficiency, presenting with the classic triad. Parenteral thiamine must
be given before glucose to prevent permanent damage.
6. For a patient with alcohol use disorder who develops confusion, ataxia, and
ophthalmoplegia, the priority intervention is to:
A) Administer IV lorazepam
B) Start oral naltrexone
C) Administer parenteral thiamine before glucose
D) Begin acamprosate therapy
Correct Answer: Administer parenteral thiamine before glucose
