NU 643 Exam 2 V1 | NU 643 Advanced
Psychopharmacology | Actual Q&A with
Rationale (NU643 Exam 2) | Regis
University
1. Which neurotransmitter system is primarily targeted by Selective Serotonin Reuptake
Inhibitors (SSRIs) to treat Major Depressive Disorder?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Answer: A
Rationale: SSRIs function by inhibiting the reuptake of serotonin at the presynaptic
terminal, thereby increasing its availability in the synaptic cleft. This increased
concentration is thought to lead to downstream neuroplastic changes that alleviate
depressive symptoms. According to the monoamine hypothesis, a deficiency in serotonin is
a primary driver of mood disorders.
2. A patient taking Lithium for Bipolar I Disorder presents with coarse hand tremors, ataxia,
and a serum lithium level of 1.8 mEq/L. What is the most appropriate clinical interpretation?
A. The patient is experiencing significant lithium toxicity.
,B. The patient is experiencing mild lithium toxicity.
C. The level is within the therapeutic range.
D. The patient is having a normal allergic reaction.
Answer: A
Rationale: The standard therapeutic range for lithium maintenance is generally 0.6 to 1.2
mEq/L. Levels above 1.5 mEq/L are considered toxic and require immediate intervention
to prevent permanent neurological damage or renal failure. Clinical signs such as coarse
tremors and ataxia are hallmark indicators that the serum concentration has reached a
dangerous threshold.
3. Which of the following antidepressants is strictly contraindicated in patients with a history
of seizure disorders or bulimia nervosa?
A. Fluoxetine
B. Bupropion
C. Sertraline
D. Venlafaxine
Answer: B
Rationale: Bupropion is known to lower the seizure threshold, especially at higher doses
or in patients with electrolyte imbalances. Patients with eating disorders like bulimia or
anorexia are at a significantly higher risk for these electrolyte shifts, making the drug
,unsafe for them. Guidelines emphasize that this medication must be avoided in these
specific populations to prevent life-threatening seizures.
4. When initiating Lamotrigine, what is the most critical safety instruction to provide to the
patient?
A. Take the medication only on an empty stomach.
B. Avoid foods high in tyramine.
C. Report any new rashes immediately.
D. Expect significant weight gain within the first month.
Answer: C
Rationale: Lamotrigine carries a black box warning for Stevens-Johnson Syndrome (SJS), a
life-threatening dermatological emergency. The risk of SJS is minimized by a slow titration
schedule, but any new rash must be evaluated immediately by a clinician. Educating the
patient on this specific side effect is the most vital component of the informed consent
process for this medication.
5. A patient on Clozapine therapy must have regular blood draws to monitor for which life-
threatening condition?
A. Agranulocytosis
B. Hepatotoxicity
C. Thrombocytopenia
, D. Hyperthyroidism
Answer: A
Rationale: Clozapine is associated with a risk of severe neutropenia, also known as
agranulocytosis, which compromises the immune system. Because of this, the FDA
mandates a Risk Evaluation and Mitigation Strategy (REMS) program involving regular
Absolute Neutrophil Count (ANC) monitoring. If the ANC falls below a certain threshold, the
medication must be discontinued immediately to prevent fatal infections.
6. Which antipsychotic is most likely to cause significant weight gain and metabolic
syndrome?
A. Olanzapine
B. Aripiprazole
C. Ziprasidone
D. Lurasidone
Answer: A
Rationale: Olanzapine and Clozapine are the two antipsychotics with the highest risk for
weight gain, dyslipidemia, and insulin resistance. This metabolic profile requires clinicians
to monitor BMI, fasting glucose, and lipid levels regularly. In contrast, agents like
Ziprasidone and Aripiprazole are generally considered to be metabolic-neutral.
Psychopharmacology | Actual Q&A with
Rationale (NU643 Exam 2) | Regis
University
1. Which neurotransmitter system is primarily targeted by Selective Serotonin Reuptake
Inhibitors (SSRIs) to treat Major Depressive Disorder?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Answer: A
Rationale: SSRIs function by inhibiting the reuptake of serotonin at the presynaptic
terminal, thereby increasing its availability in the synaptic cleft. This increased
concentration is thought to lead to downstream neuroplastic changes that alleviate
depressive symptoms. According to the monoamine hypothesis, a deficiency in serotonin is
a primary driver of mood disorders.
2. A patient taking Lithium for Bipolar I Disorder presents with coarse hand tremors, ataxia,
and a serum lithium level of 1.8 mEq/L. What is the most appropriate clinical interpretation?
A. The patient is experiencing significant lithium toxicity.
,B. The patient is experiencing mild lithium toxicity.
C. The level is within the therapeutic range.
D. The patient is having a normal allergic reaction.
Answer: A
Rationale: The standard therapeutic range for lithium maintenance is generally 0.6 to 1.2
mEq/L. Levels above 1.5 mEq/L are considered toxic and require immediate intervention
to prevent permanent neurological damage or renal failure. Clinical signs such as coarse
tremors and ataxia are hallmark indicators that the serum concentration has reached a
dangerous threshold.
3. Which of the following antidepressants is strictly contraindicated in patients with a history
of seizure disorders or bulimia nervosa?
A. Fluoxetine
B. Bupropion
C. Sertraline
D. Venlafaxine
Answer: B
Rationale: Bupropion is known to lower the seizure threshold, especially at higher doses
or in patients with electrolyte imbalances. Patients with eating disorders like bulimia or
anorexia are at a significantly higher risk for these electrolyte shifts, making the drug
,unsafe for them. Guidelines emphasize that this medication must be avoided in these
specific populations to prevent life-threatening seizures.
4. When initiating Lamotrigine, what is the most critical safety instruction to provide to the
patient?
A. Take the medication only on an empty stomach.
B. Avoid foods high in tyramine.
C. Report any new rashes immediately.
D. Expect significant weight gain within the first month.
Answer: C
Rationale: Lamotrigine carries a black box warning for Stevens-Johnson Syndrome (SJS), a
life-threatening dermatological emergency. The risk of SJS is minimized by a slow titration
schedule, but any new rash must be evaluated immediately by a clinician. Educating the
patient on this specific side effect is the most vital component of the informed consent
process for this medication.
5. A patient on Clozapine therapy must have regular blood draws to monitor for which life-
threatening condition?
A. Agranulocytosis
B. Hepatotoxicity
C. Thrombocytopenia
, D. Hyperthyroidism
Answer: A
Rationale: Clozapine is associated with a risk of severe neutropenia, also known as
agranulocytosis, which compromises the immune system. Because of this, the FDA
mandates a Risk Evaluation and Mitigation Strategy (REMS) program involving regular
Absolute Neutrophil Count (ANC) monitoring. If the ANC falls below a certain threshold, the
medication must be discontinued immediately to prevent fatal infections.
6. Which antipsychotic is most likely to cause significant weight gain and metabolic
syndrome?
A. Olanzapine
B. Aripiprazole
C. Ziprasidone
D. Lurasidone
Answer: A
Rationale: Olanzapine and Clozapine are the two antipsychotics with the highest risk for
weight gain, dyslipidemia, and insulin resistance. This metabolic profile requires clinicians
to monitor BMI, fasting glucose, and lipid levels regularly. In contrast, agents like
Ziprasidone and Aripiprazole are generally considered to be metabolic-neutral.
