NU 643 Final Exam V2 | NU 643 Advanced
Psychopharmacology | Actual Q&A with
Rationale (NU643 Final Exam) | Regis
University
1. Which neurotransmitter pathway is primarily associated with the development of
extrapyramidal symptoms (EPS) when dopamine is blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Rationale: The nigrostriatal pathway controls motor function and movement. Blockade of
D2 receptors in this pathway by antipsychotics leads to EPS, including dystonia and
parkinsonism. This is distinct from the mesolimbic pathway, which is associated with
reward and positive symptoms of schizophrenia.
2. A patient on Clozapine reports a sudden fever and sore throat. What is the most critical
laboratory test to order immediately?
A. Liver function tests
B. Fast glucose and lipid panel
,C. Serum Clozapine level
D. Complete blood count with differential
Answer: D
Rationale: Clozapine carries a black box warning for agranulocytosis, which is a severe
drop in the absolute neutrophil count (ANC). Fever and sore throat are classic signs of an
underlying infection due to neutropenia. Prompt monitoring of the CBC with differential is
mandatory to assess the ANC and ensure patient safety.
3. What is the mechanism of action for the antidepressant Vilazodone?
A. SSRI and 5-HT1A partial agonist
B. SNRI and 5-HT2A antagonist
C. NDRI and 5-HT3 antagonist
D. MAOI and Alpha-2 antagonist
Answer: A
Rationale: Vilazodone acts as a selective serotonin reuptake inhibitor (SSRI) and also as a
5-HT1A receptor partial agonist. This dual mechanism is intended to provide a faster
antidepressant response and potentially fewer sexual side effects compared to traditional
SSRIs. It is often referred to as a Serotonin Partial Agonist and Reuptake Inhibitor (SPARI).
, 4. Which mood stabilizer is most strongly associated with a risk for neural tube defects when
taken during the first trimester of pregnancy?
A. Lithium
B. Lamotrigine
C. Carbamazepine
D. Valproate
Answer: D
Rationale: Valproate (Depakote) is highly teratogenic and is specifically linked to an
increased risk of neural tube defects like spina bifida. Women of childbearing age should be
counselled on these risks and prescribed folic acid if the medication is necessary. Lithium is
more associated with Ebstein’s anomaly, a cardiac defect, rather than neural tube issues.
5. A patient is prescribed Lurasidone for bipolar depression. What dietary instruction is
essential for this medication’s efficacy?
A. Take on an empty stomach to avoid malabsorption.
B. Avoid foods high in tyramine.
C. Take with at least 350 calories of food.
D. Limit caffeine intake to avoid toxicity.
Answer: C
Psychopharmacology | Actual Q&A with
Rationale (NU643 Final Exam) | Regis
University
1. Which neurotransmitter pathway is primarily associated with the development of
extrapyramidal symptoms (EPS) when dopamine is blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Rationale: The nigrostriatal pathway controls motor function and movement. Blockade of
D2 receptors in this pathway by antipsychotics leads to EPS, including dystonia and
parkinsonism. This is distinct from the mesolimbic pathway, which is associated with
reward and positive symptoms of schizophrenia.
2. A patient on Clozapine reports a sudden fever and sore throat. What is the most critical
laboratory test to order immediately?
A. Liver function tests
B. Fast glucose and lipid panel
,C. Serum Clozapine level
D. Complete blood count with differential
Answer: D
Rationale: Clozapine carries a black box warning for agranulocytosis, which is a severe
drop in the absolute neutrophil count (ANC). Fever and sore throat are classic signs of an
underlying infection due to neutropenia. Prompt monitoring of the CBC with differential is
mandatory to assess the ANC and ensure patient safety.
3. What is the mechanism of action for the antidepressant Vilazodone?
A. SSRI and 5-HT1A partial agonist
B. SNRI and 5-HT2A antagonist
C. NDRI and 5-HT3 antagonist
D. MAOI and Alpha-2 antagonist
Answer: A
Rationale: Vilazodone acts as a selective serotonin reuptake inhibitor (SSRI) and also as a
5-HT1A receptor partial agonist. This dual mechanism is intended to provide a faster
antidepressant response and potentially fewer sexual side effects compared to traditional
SSRIs. It is often referred to as a Serotonin Partial Agonist and Reuptake Inhibitor (SPARI).
, 4. Which mood stabilizer is most strongly associated with a risk for neural tube defects when
taken during the first trimester of pregnancy?
A. Lithium
B. Lamotrigine
C. Carbamazepine
D. Valproate
Answer: D
Rationale: Valproate (Depakote) is highly teratogenic and is specifically linked to an
increased risk of neural tube defects like spina bifida. Women of childbearing age should be
counselled on these risks and prescribed folic acid if the medication is necessary. Lithium is
more associated with Ebstein’s anomaly, a cardiac defect, rather than neural tube issues.
5. A patient is prescribed Lurasidone for bipolar depression. What dietary instruction is
essential for this medication’s efficacy?
A. Take on an empty stomach to avoid malabsorption.
B. Avoid foods high in tyramine.
C. Take with at least 350 calories of food.
D. Limit caffeine intake to avoid toxicity.
Answer: C
