NR 546 / NR546 MIDTERM EXAM (LATEST )
TESTED QUESTIONS WITH REVISED ANSWERS, (A+
GUARANTEE)
NR 546 – Advanced Pharmacology for PMHNP
Comprehensive Practice Exam
Part 1 (Questions 1–10)
Question 1
Which neurotransmitter is most strongly associated with the mechanism of action of selective
serotonin reuptake inhibitors (SSRIs)?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Histamine
Correct Answer: B. Serotonin
Rationale:
SSRIs work by selectively inhibiting the reuptake of serotonin (5-HT) into the presynaptic
neuron, increasing serotonin availability in the synaptic cleft. This mechanism improves
symptoms of depression and many anxiety disorders over several weeks.
Question 2
A patient taking phenelzine reports eating aged cheese at a party and now complains of a severe
headache and elevated blood pressure. What is the most likely explanation?
A. Serotonin syndrome
B. Hypertensive crisis
C. Neuroleptic malignant syndrome
D. Acute dystonia
Correct Answer: B. Hypertensive crisis
,Rationale:
Monoamine oxidase inhibitors (MAOIs) inhibit the breakdown of tyramine. Consuming
tyramine-rich foods (such as aged cheese, cured meats, and some fermented products) can
precipitate a hypertensive crisis, a medical emergency characterized by severe hypertension and
headache.
Question 3
Which laboratory test should be obtained before initiating clozapine therapy?
A. Serum potassium
B. Absolute neutrophil count (ANC)
C. Troponin I
D. D-dimer
Correct Answer: B. Absolute neutrophil count (ANC)
Rationale:
Clozapine can cause severe neutropenia and agranulocytosis. A baseline ANC is required before
starting treatment, followed by regular monitoring according to established safety protocols.
Question 4
Which atypical antipsychotic has the highest risk for significant weight gain and metabolic
syndrome?
A. Aripiprazole
B. Ziprasidone
C. Olanzapine
D. Lurasidone
Correct Answer: C. Olanzapine
Rationale:
Olanzapine is associated with substantial weight gain, dyslipidemia, and insulin resistance.
Patients taking olanzapine should receive routine monitoring of weight, blood glucose, blood
pressure, and lipid profile.
, Question 5
A patient receiving lithium develops coarse tremor, vomiting, confusion, and ataxia. What is the
priority nursing action?
A. Administer the next scheduled lithium dose.
B. Hold lithium and notify the healthcare provider immediately.
C. Encourage caffeine intake.
D. Increase oral sodium restriction.
Correct Answer: B. Hold lithium and notify the healthcare provider immediately.
Rationale:
These findings are consistent with possible lithium toxicity. Lithium should be withheld, and the
patient should be evaluated promptly. Serum lithium concentration, renal function, and hydration
status should be assessed.
Question 6
Which medication is commonly prescribed as first-line pharmacotherapy for generalized anxiety
disorder?
A. Haloperidol
B. Sertraline
C. Chlorpromazine
D. Benztropine
Correct Answer: B. Sertraline
Rationale:
SSRIs, including sertraline, are considered first-line pharmacologic therapy for generalized
anxiety disorder because they are effective and generally well tolerated for long-term
management.
Question 7
Which medication requires gradual dose titration to reduce the risk of Stevens–Johnson
syndrome?
A. Lamotrigine
TESTED QUESTIONS WITH REVISED ANSWERS, (A+
GUARANTEE)
NR 546 – Advanced Pharmacology for PMHNP
Comprehensive Practice Exam
Part 1 (Questions 1–10)
Question 1
Which neurotransmitter is most strongly associated with the mechanism of action of selective
serotonin reuptake inhibitors (SSRIs)?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Histamine
Correct Answer: B. Serotonin
Rationale:
SSRIs work by selectively inhibiting the reuptake of serotonin (5-HT) into the presynaptic
neuron, increasing serotonin availability in the synaptic cleft. This mechanism improves
symptoms of depression and many anxiety disorders over several weeks.
Question 2
A patient taking phenelzine reports eating aged cheese at a party and now complains of a severe
headache and elevated blood pressure. What is the most likely explanation?
A. Serotonin syndrome
B. Hypertensive crisis
C. Neuroleptic malignant syndrome
D. Acute dystonia
Correct Answer: B. Hypertensive crisis
,Rationale:
Monoamine oxidase inhibitors (MAOIs) inhibit the breakdown of tyramine. Consuming
tyramine-rich foods (such as aged cheese, cured meats, and some fermented products) can
precipitate a hypertensive crisis, a medical emergency characterized by severe hypertension and
headache.
Question 3
Which laboratory test should be obtained before initiating clozapine therapy?
A. Serum potassium
B. Absolute neutrophil count (ANC)
C. Troponin I
D. D-dimer
Correct Answer: B. Absolute neutrophil count (ANC)
Rationale:
Clozapine can cause severe neutropenia and agranulocytosis. A baseline ANC is required before
starting treatment, followed by regular monitoring according to established safety protocols.
Question 4
Which atypical antipsychotic has the highest risk for significant weight gain and metabolic
syndrome?
A. Aripiprazole
B. Ziprasidone
C. Olanzapine
D. Lurasidone
Correct Answer: C. Olanzapine
Rationale:
Olanzapine is associated with substantial weight gain, dyslipidemia, and insulin resistance.
Patients taking olanzapine should receive routine monitoring of weight, blood glucose, blood
pressure, and lipid profile.
, Question 5
A patient receiving lithium develops coarse tremor, vomiting, confusion, and ataxia. What is the
priority nursing action?
A. Administer the next scheduled lithium dose.
B. Hold lithium and notify the healthcare provider immediately.
C. Encourage caffeine intake.
D. Increase oral sodium restriction.
Correct Answer: B. Hold lithium and notify the healthcare provider immediately.
Rationale:
These findings are consistent with possible lithium toxicity. Lithium should be withheld, and the
patient should be evaluated promptly. Serum lithium concentration, renal function, and hydration
status should be assessed.
Question 6
Which medication is commonly prescribed as first-line pharmacotherapy for generalized anxiety
disorder?
A. Haloperidol
B. Sertraline
C. Chlorpromazine
D. Benztropine
Correct Answer: B. Sertraline
Rationale:
SSRIs, including sertraline, are considered first-line pharmacologic therapy for generalized
anxiety disorder because they are effective and generally well tolerated for long-term
management.
Question 7
Which medication requires gradual dose titration to reduce the risk of Stevens–Johnson
syndrome?
A. Lamotrigine
