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NSG 552 Exam 2 Psychopharmacology Newest Exam
Preparation With Complete Questions And Correct
Answers With Rationales Already Graded A+Brand
New Version!!
1. A patient asks how their antidepressant medication works at the
neuronal level. The nurse correctly explains that selective serotonin
reuptake inhibitors (SSRIs) primarily exert their therapeutic effect by:
A) Blocking the presynaptic autoreceptors, leading to increased
serotonin synthesis.
B) Inhibiting the enzyme monoamine oxidase, thereby preventing the
breakdown of serotonin.
C) Blocking the reuptake of serotonin from the synaptic cleft, increasing
its availability at the postsynaptic receptor.
D) Acting as a direct agonist at the postsynaptic serotonin receptor site.
Answer: C
Explanation: SSRIs such as fluoxetine and sertraline specifically block the
serotonin transporter (SERT) on the presynaptic neuron. This prevents
the reuptake of serotonin from the synaptic cleft, leading to an
increased concentration of serotonin available to bind to postsynaptic
receptors. This is the fundamental mechanism of action for this class of
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drugs. Options A, B, and D describe mechanisms of other drug classes or
theoretical actions.
2. A patient with schizophrenia has been on a typical antipsychotic for
years and now presents with involuntary, repetitive movements of the
tongue and lips. The nurse recognizes this as:
A) Acute dystonia
B) Parkinsonism
C) Tardive dyskinesia
D) Akathisia
Answer: C
Explanation: Tardive dyskinesia is a late-onset, potentially irreversible
movement disorder characterized by involuntary, repetitive, and
purposeless movements, most commonly involving the orofacial region.
It is a severe side effect associated with long-term use of typical (first-
generation) antipsychotics, likely due to dopamine receptor
supersensitivity. Acute dystonia, Parkinsonism, and akathisia are all
early-onset extrapyramidal symptoms (EPS).
3. The nurse is teaching a patient prescribed a monoamine oxidase
inhibitor (MAOI) about dietary restrictions. Which of the following
foods should the patient be instructed to strictly avoid?
A) Fresh fruits and vegetables
B) Aged cheeses and cured meats
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C) Low-fat dairy products
D) Plain grilled chicken
Answer: B
Explanation: MAOIs inhibit the breakdown of tyramine, an amino acid
found in high quantities in aged, fermented, or cured foods. Concurrent
consumption of these foods can lead to a rapid and dangerous increase
in blood pressure known as a hypertensive crisis. Aged cheeses, cured
meats, and fermented soy products are classic culprits. Fresh foods are
generally safe.
4. A patient who is stabilized on lithium carbonate for bipolar disorder
has a serum lithium level of 1.8 mEq/L. The nurse would expect to
observe which of the following clinical manifestations?
A) Polyuria, polydipsia, and fine tremor
B) Severe nausea, vomiting, and coarse tremor
C) Hyperactivity and pressured speech
D) No observable side effects at this level
Answer: B
Explanation: The therapeutic range for lithium is generally 0.6 to 1.2
mEq/L. A level of 1.8 mEq/L is in the toxic range. Early signs of lithium
toxicity often include severe gastrointestinal distress (nausea, vomiting,
diarrhea) and neurological symptoms such as a coarse tremor,
confusion, and ataxia. Option A describes mild, manageable side effects
that can occur within the therapeutic range. Options C and D are
incorrect.
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5. The nurse is preparing to administer an antipsychotic medication.
Which assessment is most critical to perform before giving the first
dose of a typical antipsychotic like haloperidol?
A) A full set of vital signs, including orthostatic blood pressure
B) A baseline electrocardiogram (ECG)
C) An assessment for the presence of abnormal involuntary movements
D) A review of the patient's dietary intake for the past 24 hours
Answer: B
Explanation: Typical antipsychotics, particularly haloperidol, can
prolong the QTc interval, increasing the risk for potentially fatal cardiac
arrhythmias like torsades de pointes. Therefore, obtaining a baseline
ECG and monitoring for electrolyte imbalances that could exacerbate
this effect is a critical safety measure. While vital signs are important,
the ECG is the most specific and critical assessment in this context.
6. A patient presents to the emergency department in an agitated state
after ingesting a large dose of an unknown medication. They are
displaying muscle rigidity, hyperthermia, and autonomic instability. The
nurse suspects neuroleptic malignant syndrome (NMS). Which class of
medication is most likely responsible?
A) Selective serotonin reuptake inhibitors
B) Tricyclic antidepressants
C) Antipsychotics
NSG 552 Exam 2 Psychopharmacology Newest Exam
Preparation With Complete Questions And Correct
Answers With Rationales Already Graded A+Brand
New Version!!
1. A patient asks how their antidepressant medication works at the
neuronal level. The nurse correctly explains that selective serotonin
reuptake inhibitors (SSRIs) primarily exert their therapeutic effect by:
A) Blocking the presynaptic autoreceptors, leading to increased
serotonin synthesis.
B) Inhibiting the enzyme monoamine oxidase, thereby preventing the
breakdown of serotonin.
C) Blocking the reuptake of serotonin from the synaptic cleft, increasing
its availability at the postsynaptic receptor.
D) Acting as a direct agonist at the postsynaptic serotonin receptor site.
Answer: C
Explanation: SSRIs such as fluoxetine and sertraline specifically block the
serotonin transporter (SERT) on the presynaptic neuron. This prevents
the reuptake of serotonin from the synaptic cleft, leading to an
increased concentration of serotonin available to bind to postsynaptic
receptors. This is the fundamental mechanism of action for this class of
,2|Page
drugs. Options A, B, and D describe mechanisms of other drug classes or
theoretical actions.
2. A patient with schizophrenia has been on a typical antipsychotic for
years and now presents with involuntary, repetitive movements of the
tongue and lips. The nurse recognizes this as:
A) Acute dystonia
B) Parkinsonism
C) Tardive dyskinesia
D) Akathisia
Answer: C
Explanation: Tardive dyskinesia is a late-onset, potentially irreversible
movement disorder characterized by involuntary, repetitive, and
purposeless movements, most commonly involving the orofacial region.
It is a severe side effect associated with long-term use of typical (first-
generation) antipsychotics, likely due to dopamine receptor
supersensitivity. Acute dystonia, Parkinsonism, and akathisia are all
early-onset extrapyramidal symptoms (EPS).
3. The nurse is teaching a patient prescribed a monoamine oxidase
inhibitor (MAOI) about dietary restrictions. Which of the following
foods should the patient be instructed to strictly avoid?
A) Fresh fruits and vegetables
B) Aged cheeses and cured meats
,3|Page
C) Low-fat dairy products
D) Plain grilled chicken
Answer: B
Explanation: MAOIs inhibit the breakdown of tyramine, an amino acid
found in high quantities in aged, fermented, or cured foods. Concurrent
consumption of these foods can lead to a rapid and dangerous increase
in blood pressure known as a hypertensive crisis. Aged cheeses, cured
meats, and fermented soy products are classic culprits. Fresh foods are
generally safe.
4. A patient who is stabilized on lithium carbonate for bipolar disorder
has a serum lithium level of 1.8 mEq/L. The nurse would expect to
observe which of the following clinical manifestations?
A) Polyuria, polydipsia, and fine tremor
B) Severe nausea, vomiting, and coarse tremor
C) Hyperactivity and pressured speech
D) No observable side effects at this level
Answer: B
Explanation: The therapeutic range for lithium is generally 0.6 to 1.2
mEq/L. A level of 1.8 mEq/L is in the toxic range. Early signs of lithium
toxicity often include severe gastrointestinal distress (nausea, vomiting,
diarrhea) and neurological symptoms such as a coarse tremor,
confusion, and ataxia. Option A describes mild, manageable side effects
that can occur within the therapeutic range. Options C and D are
incorrect.
, 4|Page
5. The nurse is preparing to administer an antipsychotic medication.
Which assessment is most critical to perform before giving the first
dose of a typical antipsychotic like haloperidol?
A) A full set of vital signs, including orthostatic blood pressure
B) A baseline electrocardiogram (ECG)
C) An assessment for the presence of abnormal involuntary movements
D) A review of the patient's dietary intake for the past 24 hours
Answer: B
Explanation: Typical antipsychotics, particularly haloperidol, can
prolong the QTc interval, increasing the risk for potentially fatal cardiac
arrhythmias like torsades de pointes. Therefore, obtaining a baseline
ECG and monitoring for electrolyte imbalances that could exacerbate
this effect is a critical safety measure. While vital signs are important,
the ECG is the most specific and critical assessment in this context.
6. A patient presents to the emergency department in an agitated state
after ingesting a large dose of an unknown medication. They are
displaying muscle rigidity, hyperthermia, and autonomic instability. The
nurse suspects neuroleptic malignant syndrome (NMS). Which class of
medication is most likely responsible?
A) Selective serotonin reuptake inhibitors
B) Tricyclic antidepressants
C) Antipsychotics
