NR 546 Final Exam V1 | NR 546 Advanced
Psychopharmacology | Chamberlain | Q&A
with Rationale (Chamberlain NR546 Final
Exam)
1. Which neurotransmitter is primarily implicated in the reward system and is the target of
most drugs of abuse?
A. Serotonin
B. Dopamine
C. GABA
D. Glutamate
Answer: B
Rationale: Dopamine is the primary neurotransmitter involved in the brain’s reward
circuitry, particularly within the mesolimbic pathway. Most addictive substances increase
dopamine levels in the nucleus accumbens, reinforcing drug-seeking behavior.
Understanding this pathway is essential for treating substance use disorders and managing
dopamine-related side effects.
2. A patient taking Clozapine must have regular blood work to monitor for which life-
threatening side effect?
A. Nephrotoxicity
,B. Hepatotoxicity
C. Agranulocytosis
D. Aplastic Anemia
Answer: C
Rationale: Clozapine is associated with a risk of severe neutropenia, also known as
agranulocytosis, which can be fatal. Consequently, patients must be enrolled in a Risk
Evaluation and Mitigation Strategy (REMS) program to monitor Absolute Neutrophil Count
(ANC). This monitoring ensures that treatment is discontinued if the white blood cell count
drops below safe levels.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Fluoxetine
B. Sertraline
C. Bupropion
D. Venlafaxine
Answer: C
Rationale: Bupropion carries a dose-dependent risk of seizures and is strictly
contraindicated in individuals with seizure disorders. It is also contraindicated in patients
with bulimia or anorexia nervosa due to an increased risk of electrolyte imbalances that
, lower the seizure threshold. Clinicians must screen for these conditions before initiating
therapy with this Norepinephrine-Dopamine Reuptake Inhibitor (NDRI).
4. Which pathway is responsible for the development of extrapyramidal symptoms (EPS)
when D2 receptors are blocked?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: A
Rationale: The nigrostriatal pathway controls motor movement, and blockade of
dopamine receptors here leads to EPS. Side effects can include dystonia, akathisia, and
tardive dyskinesia. Second-generation antipsychotics are designed to have less affinity for
these receptors to reduce movement-related side effects.
5. What is the recommended therapeutic range for Lithium in the maintenance treatment of
Bipolar Disorder?
A. 0.1–0.5 mEq/L
B. 1.5–2.0 mEq/L
C. 0.6–1.2 mEq/L
D. 2.5–3.0 mEq/L
Psychopharmacology | Chamberlain | Q&A
with Rationale (Chamberlain NR546 Final
Exam)
1. Which neurotransmitter is primarily implicated in the reward system and is the target of
most drugs of abuse?
A. Serotonin
B. Dopamine
C. GABA
D. Glutamate
Answer: B
Rationale: Dopamine is the primary neurotransmitter involved in the brain’s reward
circuitry, particularly within the mesolimbic pathway. Most addictive substances increase
dopamine levels in the nucleus accumbens, reinforcing drug-seeking behavior.
Understanding this pathway is essential for treating substance use disorders and managing
dopamine-related side effects.
2. A patient taking Clozapine must have regular blood work to monitor for which life-
threatening side effect?
A. Nephrotoxicity
,B. Hepatotoxicity
C. Agranulocytosis
D. Aplastic Anemia
Answer: C
Rationale: Clozapine is associated with a risk of severe neutropenia, also known as
agranulocytosis, which can be fatal. Consequently, patients must be enrolled in a Risk
Evaluation and Mitigation Strategy (REMS) program to monitor Absolute Neutrophil Count
(ANC). This monitoring ensures that treatment is discontinued if the white blood cell count
drops below safe levels.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Fluoxetine
B. Sertraline
C. Bupropion
D. Venlafaxine
Answer: C
Rationale: Bupropion carries a dose-dependent risk of seizures and is strictly
contraindicated in individuals with seizure disorders. It is also contraindicated in patients
with bulimia or anorexia nervosa due to an increased risk of electrolyte imbalances that
, lower the seizure threshold. Clinicians must screen for these conditions before initiating
therapy with this Norepinephrine-Dopamine Reuptake Inhibitor (NDRI).
4. Which pathway is responsible for the development of extrapyramidal symptoms (EPS)
when D2 receptors are blocked?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: A
Rationale: The nigrostriatal pathway controls motor movement, and blockade of
dopamine receptors here leads to EPS. Side effects can include dystonia, akathisia, and
tardive dyskinesia. Second-generation antipsychotics are designed to have less affinity for
these receptors to reduce movement-related side effects.
5. What is the recommended therapeutic range for Lithium in the maintenance treatment of
Bipolar Disorder?
A. 0.1–0.5 mEq/L
B. 1.5–2.0 mEq/L
C. 0.6–1.2 mEq/L
D. 2.5–3.0 mEq/L
