NU 643 Exam 3 V3 | NU 643 Advanced
Psychopharmacology | Actual Q&A with
Rationale (NU643 Exam 3) | Regis
University
1. A patient with Bipolar I Disorder is prescribed Lithium. Which lab value is the most
essential to monitor baseline and periodically to prevent renal impairment?
A. AST and ALT
B. Complete Blood Count (CBC)
C. Amylase and Lipase
D. Serum Creatinine and GFR
Answer: D
Rationale: Lithium is almost exclusively cleared by the kidneys and does not undergo
hepatic metabolism. Chronic lithium use can lead to nephrogenic diabetes insipidus or
interstitial nephritis, necessitating regular monitoring of renal function. Clinicians must
track serum creatinine and glomerular filtration rate (GFR) to adjust dosages and prevent
long-term kidney damage.
2. A 22-year-old female starting Valproate (Depakote) for mood stabilization should be
counselled about which significant risk?
A. Aplastic Anemia
,B. Hyponatremia
C. Polycystic Ovary Syndrome (PCOS)
D. Nephrolithiasis
Answer: C
Rationale: Valproate therapy in young women has been significantly associated with an
increased risk of developing Polycystic Ovary Syndrome (PCOS). This condition often
presents with symptoms such as weight gain, hirsutism, and irregular menses.
Furthermore, it is a known teratogen and can cause neural tube defects, making baseline
pregnancy testing and counseling on contraception mandatory.
3. When initiating Lamotrigine (Lamictal), why is a slow titration schedule strictly followed?
A. To minimize the risk of serotonin syndrome
B. To avoid immediate hepatotoxicity
C. To reduce the risk of hypertensive crisis
D. To prevent the onset of Stevens-Johnson Syndrome (SJS)
Answer: D
Rationale: Lamotrigine carries a black box warning for serious dermatologic reactions,
including Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). The risk
of these life-threatening rashes is significantly increased if the dose is escalated too quickly
or started at a high level. Following the standardized titration schedule allows the body to
acclimate and reduces the incidence of severe cutaneous adverse reactions.
, 4. Which Second-Generation Antipsychotic (SGA) is associated with the highest risk of weight
gain and metabolic syndrome?
A. Olanzapine (Zyprexa)
B. Ziprasidone (Geodon)
C. Aripiprazole (Abilify)
D. Lurasidone (Latuda)
Answer: A
Rationale: Olanzapine is known for its high affinity for H1 and 5-HT2C receptors, which
contributes to significant weight gain and increased appetite. Patients on Olanzapine often
experience metabolic changes including dyslipidemia and insulin resistance. Monitoring of
waist circumference, blood glucose, and lipid profiles is required for all patients on this
medication.
5. Before starting a patient on Carbamazepine (Tegretol), particularly those of Asian descent,
which genetic test is recommended?
A. HLA-B*1502 allele
B. CYP2D6 genotyping
C. MTHFR gene mutation
D. ApoE4 allele
Answer: A
Psychopharmacology | Actual Q&A with
Rationale (NU643 Exam 3) | Regis
University
1. A patient with Bipolar I Disorder is prescribed Lithium. Which lab value is the most
essential to monitor baseline and periodically to prevent renal impairment?
A. AST and ALT
B. Complete Blood Count (CBC)
C. Amylase and Lipase
D. Serum Creatinine and GFR
Answer: D
Rationale: Lithium is almost exclusively cleared by the kidneys and does not undergo
hepatic metabolism. Chronic lithium use can lead to nephrogenic diabetes insipidus or
interstitial nephritis, necessitating regular monitoring of renal function. Clinicians must
track serum creatinine and glomerular filtration rate (GFR) to adjust dosages and prevent
long-term kidney damage.
2. A 22-year-old female starting Valproate (Depakote) for mood stabilization should be
counselled about which significant risk?
A. Aplastic Anemia
,B. Hyponatremia
C. Polycystic Ovary Syndrome (PCOS)
D. Nephrolithiasis
Answer: C
Rationale: Valproate therapy in young women has been significantly associated with an
increased risk of developing Polycystic Ovary Syndrome (PCOS). This condition often
presents with symptoms such as weight gain, hirsutism, and irregular menses.
Furthermore, it is a known teratogen and can cause neural tube defects, making baseline
pregnancy testing and counseling on contraception mandatory.
3. When initiating Lamotrigine (Lamictal), why is a slow titration schedule strictly followed?
A. To minimize the risk of serotonin syndrome
B. To avoid immediate hepatotoxicity
C. To reduce the risk of hypertensive crisis
D. To prevent the onset of Stevens-Johnson Syndrome (SJS)
Answer: D
Rationale: Lamotrigine carries a black box warning for serious dermatologic reactions,
including Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). The risk
of these life-threatening rashes is significantly increased if the dose is escalated too quickly
or started at a high level. Following the standardized titration schedule allows the body to
acclimate and reduces the incidence of severe cutaneous adverse reactions.
, 4. Which Second-Generation Antipsychotic (SGA) is associated with the highest risk of weight
gain and metabolic syndrome?
A. Olanzapine (Zyprexa)
B. Ziprasidone (Geodon)
C. Aripiprazole (Abilify)
D. Lurasidone (Latuda)
Answer: A
Rationale: Olanzapine is known for its high affinity for H1 and 5-HT2C receptors, which
contributes to significant weight gain and increased appetite. Patients on Olanzapine often
experience metabolic changes including dyslipidemia and insulin resistance. Monitoring of
waist circumference, blood glucose, and lipid profiles is required for all patients on this
medication.
5. Before starting a patient on Carbamazepine (Tegretol), particularly those of Asian descent,
which genetic test is recommended?
A. HLA-B*1502 allele
B. CYP2D6 genotyping
C. MTHFR gene mutation
D. ApoE4 allele
Answer: A
