NR 668 QUIZ 4 PSYCHOPHARMACOLOGY
LATEST STUDY GUIDE 2026 QUESTIONS
WITH CORRECT ANSWERS LATEST
EDITION
1. Which of the following would help the PMHNP differentiate
between NMS and serotonin syndrome?
Clonus
Temp of 101.7
Muscle Rigidity
Low Vitamin B12
A febrile patient with muscle rigidity may have either NMS or
serotonin syndrome. Clonus is associated with serotonin syndrome.
Low Vitamin B12 does not help narrow the differential diagnosis in
this clinical scenario.
2. Which of the following psychoactive medications is most
likely to be associated with fetal risk?
Valproate
Buspirone
Bupropion
Trazodone
Valproate may produce congenital malformations, lower IQ and greater
risk for autism spectrum disorder in children.
3. A patient was recently started on a dopamine antagonist, and
complains of breast tenderness and milky discharge. What is the
most likely explanation for the symptoms?
Dopamine transmission in the tuberoinfundibular
pathway
Dopamine transmission in the mesolimbic
pathway Dopamine transmission in the
nigrostriatal pathway Dopamine increases
throughout the basal ganglia
4. Pharmacogenetic testing shows that a 26 year old female with
MDD is a CYP450 2D6 slow metabolizer. This may require
, reduced dosing or awareness of drug-drug interactions to
minimize potential drug toxicity. Which of the following
medications is the theoretical safest choice for treating MDD in
this patient given the test results?
Citalopra
m
Vortioxetin
e
Venlafaxin
e
Paroxetine
Venlafaxine, Vortioxetine and Paroxetine are primarily substrates for
CYP2D6. Citalopram is metabolized by CYP3A4 and CYP2C19. A
CYP2D6 slow metabolizer phenotype would not affect the metabolism
of Citalopram.
5. Kerry is a 19-year-old female with Bipolar disorder about to start
on Lithium. Several lab values are recommended prior to the
initiation of Lithium. Which of the following listed below are part of
the lab panel the PMHNP would order?
Pregnancy test
LFT's
Lithium level
Full body skin exam to document pre-existing rashes.
Pregnancy test. Lithium is a known teratogen.
6. A patient is started on lamotrigine for bipolar depression. The
patient complained of a rash comprised of blistering skin and
mouth sores after a dose increase. The blood work reveals normal
renal and liver function. Which type of drug rash is most likely?
Stevens-Johnson syndrome
Atopic
dermatitis
, Psoriasis
DRESS syndrome
7. The PMHNP in the ED is evaluating a 68-year-old woman who was
recently diagnosed with mild cognitive impairment and cannot
remember the name of the medication that she has recently
started 1 week ago. The patient is complaining of increased heart
rate, sweating, and muscle spasms progressively worsening for the
last 3 days. Which neurotransmitter is associated with this adverse
effect?
Acetylcholine
Gamma-aminobenzoic acid (GABA)
Serotonin
Dopamine
8. Sunny is a 50-year -old female who presents to the clinic with a
recent ECG tracing. Her QTC is recorded at 327 ms. Mary is on
Citalopram 40 mg daily x 3 years secondary to generalized
anxiety disorder. Given this information, you decide to do what?
Do nothing
Repeat the ECG in 1 month to monitor for
prolonged QTC Decrease the citalopram to 20mg
daily
Switch to the bioequivalent of Escitalopram at 40mg daily
A QTC of 388 ms is considered normal. Persons over 60 are limited to a
daily dose of Citalopram 20mg given the potential risk of prolonged
QTC.
9. Jena is a 32-year-old female who presented to the emergency room
with severe weakness, lethargy and an AST/ALT of 660/776 U/L.
Which of the following could have contributed to this laboratory
result?
Kava
Vitamin C
Vitamin
B6
St. John's wart
Kava has the potential for severe liver injury.
LATEST STUDY GUIDE 2026 QUESTIONS
WITH CORRECT ANSWERS LATEST
EDITION
1. Which of the following would help the PMHNP differentiate
between NMS and serotonin syndrome?
Clonus
Temp of 101.7
Muscle Rigidity
Low Vitamin B12
A febrile patient with muscle rigidity may have either NMS or
serotonin syndrome. Clonus is associated with serotonin syndrome.
Low Vitamin B12 does not help narrow the differential diagnosis in
this clinical scenario.
2. Which of the following psychoactive medications is most
likely to be associated with fetal risk?
Valproate
Buspirone
Bupropion
Trazodone
Valproate may produce congenital malformations, lower IQ and greater
risk for autism spectrum disorder in children.
3. A patient was recently started on a dopamine antagonist, and
complains of breast tenderness and milky discharge. What is the
most likely explanation for the symptoms?
Dopamine transmission in the tuberoinfundibular
pathway
Dopamine transmission in the mesolimbic
pathway Dopamine transmission in the
nigrostriatal pathway Dopamine increases
throughout the basal ganglia
4. Pharmacogenetic testing shows that a 26 year old female with
MDD is a CYP450 2D6 slow metabolizer. This may require
, reduced dosing or awareness of drug-drug interactions to
minimize potential drug toxicity. Which of the following
medications is the theoretical safest choice for treating MDD in
this patient given the test results?
Citalopra
m
Vortioxetin
e
Venlafaxin
e
Paroxetine
Venlafaxine, Vortioxetine and Paroxetine are primarily substrates for
CYP2D6. Citalopram is metabolized by CYP3A4 and CYP2C19. A
CYP2D6 slow metabolizer phenotype would not affect the metabolism
of Citalopram.
5. Kerry is a 19-year-old female with Bipolar disorder about to start
on Lithium. Several lab values are recommended prior to the
initiation of Lithium. Which of the following listed below are part of
the lab panel the PMHNP would order?
Pregnancy test
LFT's
Lithium level
Full body skin exam to document pre-existing rashes.
Pregnancy test. Lithium is a known teratogen.
6. A patient is started on lamotrigine for bipolar depression. The
patient complained of a rash comprised of blistering skin and
mouth sores after a dose increase. The blood work reveals normal
renal and liver function. Which type of drug rash is most likely?
Stevens-Johnson syndrome
Atopic
dermatitis
, Psoriasis
DRESS syndrome
7. The PMHNP in the ED is evaluating a 68-year-old woman who was
recently diagnosed with mild cognitive impairment and cannot
remember the name of the medication that she has recently
started 1 week ago. The patient is complaining of increased heart
rate, sweating, and muscle spasms progressively worsening for the
last 3 days. Which neurotransmitter is associated with this adverse
effect?
Acetylcholine
Gamma-aminobenzoic acid (GABA)
Serotonin
Dopamine
8. Sunny is a 50-year -old female who presents to the clinic with a
recent ECG tracing. Her QTC is recorded at 327 ms. Mary is on
Citalopram 40 mg daily x 3 years secondary to generalized
anxiety disorder. Given this information, you decide to do what?
Do nothing
Repeat the ECG in 1 month to monitor for
prolonged QTC Decrease the citalopram to 20mg
daily
Switch to the bioequivalent of Escitalopram at 40mg daily
A QTC of 388 ms is considered normal. Persons over 60 are limited to a
daily dose of Citalopram 20mg given the potential risk of prolonged
QTC.
9. Jena is a 32-year-old female who presented to the emergency room
with severe weakness, lethargy and an AST/ALT of 660/776 U/L.
Which of the following could have contributed to this laboratory
result?
Kava
Vitamin C
Vitamin
B6
St. John's wart
Kava has the potential for severe liver injury.
