ADVANCED PHARM NR 567 COMPREHENSIVE EXAM
Weeks 1-7 | 100+ Questions with ANSWER & Rationales
2026
WEEK 1: NEUROLOGY & PSYCHIATRIC PHARMACOLOGY
1. Which medication should be given to patients presenting to the ED with altered level of
consciousness, seizures, or both, if concern of Wernicke-Korsakoff syndrome exists?
A) Folate (Folic acid)
B) Chlordiazepoxide (Librium)
C) Thiamine (Vitamin B1)
D) Lorazepam (Ativan)
ANSWER: C) Thiamine (Vitamin B1)
Rationale: Wernicke-Korsakoff syndrome results from thiamine deficiency, commonly seen in chronic
alcohol use. Thiamine must be administered before or concurrently with glucose to prevent
precipitation or worsening of encephalopathy. It is critical in patients with altered mental status,
seizures, or ophthalmoplegia.
2. Which pharmaceutical agent is NOT recommended for treating methanol poisoning?
A) Ethanol intravenously
B) Fomepizole (Antizole)
C) Sodium Bicarbonate
D) Disulfiram (Antabuse)
,ANSWER: D) Disulfiram (Antabuse)
Rationale: Disulfiram is used for alcohol aversion therapy, not methanol poisoning. Methanol poisoning
treatment includes fomepizole or ethanol to compete for alcohol dehydrogenase, and sodium
bicarbonate to correct metabolic acidosis.
3. Which antiseizure medication is preferred for a generalized seizure disorder in a 25-year-old pregnant
female?
A) Phenobarbital (Solfoton)
B) Valproate (Valproic acid)
C) Levetiracetam (Keppra)
D) Topiramate (Topamax)
ANSWER: C) Levetiracetam (Keppra)
Rationale: Levetiracetam is preferred in pregnancy due to a more favorable teratogenicity profile.
Valproate is a known human teratogen associated with neural tube defects (spina bifida) and increased
risk of autism spectrum disorder. Phenobarbital and topiramate also carry higher risks during pregnancy.
4. Which is the LEAST preferable initial treatment for status epilepticus?
A) Lorazepam (Ativan)
B) Diazepam (Valium)
C) Propofol (Diprivan)
D) Fosphenytoin (Cerebyx)
ANSWER: C) Propofol (Diprivan)
,Rationale: Propofol is a second-line or anesthetic agent for refractory status epilepticus, not first-line.
First-line treatment is benzodiazepines (lorazepam or diazepam), followed by fosphenytoin or other
antiseizure medications.
5. Which statement is NOT true regarding sedative-hypnotics?
A) In hypovolemic states or heart failure, normal doses may cause cardiovascular depression
B) In pulmonary disease, therapeutic doses can produce significant respiratory depression
C) Sedative-hypnotics can be used as anticonvulsants; zolpidem (Ambien) and lorazepam (Ativan) are
excellent options for managing seizures
D) Benzodiazepines exert dose-dependent anterograde amnestic effects
ANSWER: C) Sedative-hypnotics can be used as anticonvulsants; zolpidem (Ambien) and lorazepam
(Ativan) are excellent options for managing seizures
Rationale: Zolpidem is a non-benzodiazepine hypnotic that is NOT indicated for seizure management.
While lorazepam (a benzodiazepine) has anticonvulsant properties, zolpidem does not. This statement is
false. All other statements are true.
6. A patient taking risperidone (Risperdal) develops hyperprolactinemia. Which medication may help
manage this?
A) Alprazolam (Xanax)
B) Bromocriptine (Parlodel)
C) Eszopiclone (Lunesta)
D) Zolpidem (Ambien)
ANSWER: B) Bromocriptine (Parlodel)
Rationale: Bromocriptine is a dopamine agonist that can help manage antipsychotic-induced
hyperprolactinemia by suppressing prolactin secretion. Risperidone (a second-generation antipsychotic)
commonly causes hyperprolactinemia due to D2 receptor blockade.
, 7. Acute dystonia can develop after early initiation of which medication?
A) Clozapine (Clozaril)
B) Haloperidol (Haldol)
C) Aripiprazole (Abilify)
D) Olanzapine (Zyprexa)
ANSWER: B) Haloperidol (Haldol)
Rationale: Haloperidol is a first-generation (typical) antipsychotic with a high risk of acute
extrapyramidal symptoms including acute dystonia. This reaction is most likely to occur within the first
few days of treatment, particularly in young males. Atypical antipsychotics like clozapine, aripiprazole,
and olanzapine have lower EPS risk.
8. What medication is used to treat akathisia?
A) Haloperidol
B) Bromocriptine
C) Beta-blockers (specifically propranolol)
D) Diphenhydramine
ANSWER: C) Beta-blockers (specifically propranolol)
Rationale: Propranolol and other beta-blockers are effective treatments for antipsychotic-induced
akathisia. Other options include benzodiazepines and anticholinergics, but beta-blockers are specifically
indicated.
9. What is Tardive Dyskinesia (TD) and its treatment options?
Weeks 1-7 | 100+ Questions with ANSWER & Rationales
2026
WEEK 1: NEUROLOGY & PSYCHIATRIC PHARMACOLOGY
1. Which medication should be given to patients presenting to the ED with altered level of
consciousness, seizures, or both, if concern of Wernicke-Korsakoff syndrome exists?
A) Folate (Folic acid)
B) Chlordiazepoxide (Librium)
C) Thiamine (Vitamin B1)
D) Lorazepam (Ativan)
ANSWER: C) Thiamine (Vitamin B1)
Rationale: Wernicke-Korsakoff syndrome results from thiamine deficiency, commonly seen in chronic
alcohol use. Thiamine must be administered before or concurrently with glucose to prevent
precipitation or worsening of encephalopathy. It is critical in patients with altered mental status,
seizures, or ophthalmoplegia.
2. Which pharmaceutical agent is NOT recommended for treating methanol poisoning?
A) Ethanol intravenously
B) Fomepizole (Antizole)
C) Sodium Bicarbonate
D) Disulfiram (Antabuse)
,ANSWER: D) Disulfiram (Antabuse)
Rationale: Disulfiram is used for alcohol aversion therapy, not methanol poisoning. Methanol poisoning
treatment includes fomepizole or ethanol to compete for alcohol dehydrogenase, and sodium
bicarbonate to correct metabolic acidosis.
3. Which antiseizure medication is preferred for a generalized seizure disorder in a 25-year-old pregnant
female?
A) Phenobarbital (Solfoton)
B) Valproate (Valproic acid)
C) Levetiracetam (Keppra)
D) Topiramate (Topamax)
ANSWER: C) Levetiracetam (Keppra)
Rationale: Levetiracetam is preferred in pregnancy due to a more favorable teratogenicity profile.
Valproate is a known human teratogen associated with neural tube defects (spina bifida) and increased
risk of autism spectrum disorder. Phenobarbital and topiramate also carry higher risks during pregnancy.
4. Which is the LEAST preferable initial treatment for status epilepticus?
A) Lorazepam (Ativan)
B) Diazepam (Valium)
C) Propofol (Diprivan)
D) Fosphenytoin (Cerebyx)
ANSWER: C) Propofol (Diprivan)
,Rationale: Propofol is a second-line or anesthetic agent for refractory status epilepticus, not first-line.
First-line treatment is benzodiazepines (lorazepam or diazepam), followed by fosphenytoin or other
antiseizure medications.
5. Which statement is NOT true regarding sedative-hypnotics?
A) In hypovolemic states or heart failure, normal doses may cause cardiovascular depression
B) In pulmonary disease, therapeutic doses can produce significant respiratory depression
C) Sedative-hypnotics can be used as anticonvulsants; zolpidem (Ambien) and lorazepam (Ativan) are
excellent options for managing seizures
D) Benzodiazepines exert dose-dependent anterograde amnestic effects
ANSWER: C) Sedative-hypnotics can be used as anticonvulsants; zolpidem (Ambien) and lorazepam
(Ativan) are excellent options for managing seizures
Rationale: Zolpidem is a non-benzodiazepine hypnotic that is NOT indicated for seizure management.
While lorazepam (a benzodiazepine) has anticonvulsant properties, zolpidem does not. This statement is
false. All other statements are true.
6. A patient taking risperidone (Risperdal) develops hyperprolactinemia. Which medication may help
manage this?
A) Alprazolam (Xanax)
B) Bromocriptine (Parlodel)
C) Eszopiclone (Lunesta)
D) Zolpidem (Ambien)
ANSWER: B) Bromocriptine (Parlodel)
Rationale: Bromocriptine is a dopamine agonist that can help manage antipsychotic-induced
hyperprolactinemia by suppressing prolactin secretion. Risperidone (a second-generation antipsychotic)
commonly causes hyperprolactinemia due to D2 receptor blockade.
, 7. Acute dystonia can develop after early initiation of which medication?
A) Clozapine (Clozaril)
B) Haloperidol (Haldol)
C) Aripiprazole (Abilify)
D) Olanzapine (Zyprexa)
ANSWER: B) Haloperidol (Haldol)
Rationale: Haloperidol is a first-generation (typical) antipsychotic with a high risk of acute
extrapyramidal symptoms including acute dystonia. This reaction is most likely to occur within the first
few days of treatment, particularly in young males. Atypical antipsychotics like clozapine, aripiprazole,
and olanzapine have lower EPS risk.
8. What medication is used to treat akathisia?
A) Haloperidol
B) Bromocriptine
C) Beta-blockers (specifically propranolol)
D) Diphenhydramine
ANSWER: C) Beta-blockers (specifically propranolol)
Rationale: Propranolol and other beta-blockers are effective treatments for antipsychotic-induced
akathisia. Other options include benzodiazepines and anticholinergics, but beta-blockers are specifically
indicated.
9. What is Tardive Dyskinesia (TD) and its treatment options?
