NSG 552
EXAMS 1-3
Psychopharmacology
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
300 Exam Questions w/ Answers
Expert Rationales included.
Exam 1, 2 & 3 Comprehensive Study Guide
, Preview Pages Below
Get the Complete PDF After Purchase
NSG 552 EXAMS 1-3 - PSYCHOPHARMACOLOGY
If you require further clarification
or in need of any study resources,
feel free to Message me.
3 PAGES / EXAM NEW NOTO SANS FONT FULL PDF LINKED
,Table of Contents
NSG 552 Exam 1.................................................................................2
NSG 552 Exam 1 Study Guide..........................................................52
NSG 552 Exam 2...............................................................................73
NSG 552 Exam 2 Study Guide........................................................113
NSG 552 Exam 3.............................................................................134
NSG 552 Exam 3 Study Guide........................................................186
NSG 552 Exam 1
Question 1 (SINGLE BEST ANSWER)
A 24-year-old male with schizophrenia is prescribed haloperidol 10 mg IM for
acute agitation. Which medication should be co-administered to reduce the risk
of severe extrapyramidal symptoms (EPS)?
A. Propranolol
B. Benztropine
C. Amantadine
D. Clonazepam
Correct Answer: B. Benztropine
Rationale: IM haloperidol should be administered with an anticholinergic agent such as
benztropine or diphenhydramine to reduce the risk of severe EPS, particularly acute
dystonia.
,Rationale: IM haloperidol should be administered with an anticholinergic agent such
as benztropine or diphenhydramine to reduce the risk of severe EPS, particularly acute
dystonia.
───────────────────────────────────────────────────────
─────────────────────────
Question 2 (SINGLE BEST ANSWER)
A patient presents with involuntary movements of the facial muscles, tongue
protrusion, and lip smacking after 5 years of antipsychotic therapy. Which
condition is most likely?
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Correct Answer: C. Tardive dyskinesia
Rationale: Tardive dyskinesia (TD) is characterized by involuntary movements of the
facial muscles, tongue, and limbs. It is a neurotoxic side effect of long-term
antipsychotic use targeting dopamine receptors.
───────────────────────────────────────────────────────
─────────────────────────
Question 3 (SELECT ALL THAT APPLY)
A patient on clozapine presents with fever, sore throat, and malaise. The
PMHNP suspects agranulocytosis. Select all that apply regarding clozapine
monitoring:
A. Monitor WBC and ANC weekly for the first 6 months
,B. Discontinue clozapine if ANC falls below 1,500/mm³
C. Agranulocytosis occurs in approximately 1% of patients
D. Sialorrhea occurs in 30-80% of patients and is managed with glycopyrrolate
E. Clozapine is first-line for all patients with schizophrenia
Correct Answer: A, B, C, D
Rationale: Clozapine requires WBC/ANC monitoring due to agranulocytosis risk (1%). It
is discontinued if ANC <1,500. Sialorrhea is common (30-80%) and managed with
glycopyrrolate. Clozapine is reserved for treatment-resistant schizophrenia, not first-
line.
───────────────────────────────────────────────────────
─────────────────────────
Question 4 (SINGLE BEST ANSWER)
A 35-year-old female on risperidone reports galactorrhea and amenorrhea.
Which pathway is primarily responsible for this adverse effect?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Correct Answer: D. Tuberoinfundibular pathway
Rationale: D2 blockade in the tuberoinfundibular pathway results in
hyperprolactinemia, causing galactorrhea, amenorrhea, gynecomastia, and decreased
libido. Risperidone is particularly associated with this effect.
───────────────────────────────────────────────────────
─────────────────────────
Question 5 (SINGLE BEST ANSWER)
,A patient with bipolar disorder has a lithium level of 2.1 mEq/L. Which clinical
manifestation is most concerning?
A. Coarse tremor and ataxia
B. Seizures and coma
C. Nausea and diarrhea
D. Polyuria and polydipsia
Correct Answer: B. Seizures and coma
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L). Levels >2.0 mEq/L
are potentially lethal and manifest with seizures, coma, and death. Early signs include
nausea, vomiting, and coarse tremors.
───────────────────────────────────────────────────────
─────────────────────────
Question 6 (SELECT ALL THAT APPLY)
A 42-year-old male on haloperidol develops fever (40°C), lead-pipe rigidity,
altered mental status, and diaphoresis. Select all that apply regarding this
emergency:
A. This is Neuroleptic Malignant Syndrome (NMS)
B. Immediate discontinuation of the antipsychotic is required
C. Bromocriptine and dantrolene are treatment options
D. Mortality rate is approximately 20% if untreated
E. This condition is more common with atypical antipsychotics
Correct Answer: A, B, C, D
Rationale: NMS (FALTERED) is a life-threatening emergency more common with FGAs.
Management includes discontinuing the offending agent, supportive care, and
medications such as bromocriptine and dantrolene. Mortality is ~20% if untreated.
, NSG 552 Exam 2
Question 1 [Case-Based Scenario]
A 22-year-old female with Anorexia Nervosa is admitted to an inpatient
psychiatric unit. She reports severe anxiety before meals and refuses to eat
due to intense fear of weight gain. The psychiatrist considers pharmacologic
intervention. Which medication is most appropriate to administer as a pre-
meal anxiolytic to decrease anticipatory anxiety?
A. Fluoxetine 20 mg daily
B. Lorazepam 0.5 mg PRN before meals
C. Olanzapine 5 mg daily
D. Buspirone 10 mg BID
Correct Answer: B. Lorazepam 0.5 mg PRN before meals
Rationale: Lorazepam is a short-acting benzodiazepine commonly used as a pre-
meal anxiolytic in Anorexia Nervosa to reduce anticipatory anxiety. It has a rapid
onset and can be given PRN. SSRIs like fluoxetine take weeks to work and are not
appropriate for acute anxiety. Olanzapine is used for severe preoccupation with
weight and food, not acute anxiety. Buspirone has a slow onset and is not useful
for PRN anxiety relief.
Question 2 [Select All That Apply (SATA)]
A 19-year-old female with Anorexia Nervosa has been hospitalized for severe
malnutrition and obsessive preoccupation with food and body weight. Her
BMI is 14.2. The treatment team is considering pharmacologic options. Select
all that apply regarding appropriate medication management for this
patient.
A. Olanzapine may be prescribed to reduce severe preoccupation with weight and
food
,B. Fluoxetine is FDA-approved for Anorexia Nervosa
C. A pre-meal benzodiazepine such as lorazepam may reduce anticipatory anxiety
D. Bupropion is contraindicated due to seizure risk in malnourished patients
E. Mirtazapine is first-line for weight restoration in Anorexia Nervosa
Correct Answer: A, C, D
Rationale: Olanzapine (A) is used off-label for severe preoccupation with weight
and food in Anorexia Nervosa. A pre-meal benzodiazepine like lorazepam (C) can
help with anticipatory anxiety. Bupropion (D) is contraindicated in eating disorders
due to increased seizure risk, especially in malnourished patients. Fluoxetine (B) is
NOT FDA-approved for Anorexia Nervosa—it is approved for Bulimia Nervosa.
Mirtazapine (E) is not first-line for weight restoration, though it may be used
adjunctively.
Question 3 [Single Best Answer]
Which of the following medications is FDA-approved for the treatment of
Bulimia Nervosa?
A. Sertraline (Zoloft)
B. Fluoxetine (Prozac)
C. Venlafaxine (Effexor)
D. Bupropion (Wellbutrin)
Correct Answer: B. Fluoxetine (Prozac)
Rationale: Fluoxetine (Prozac) is the only FDA-approved medication for Bulimia
Nervosa. It is typically prescribed at higher doses (60 mg/day). Bupropion is
contraindicated in eating disorders due to seizure risk.
Question 4 [Case-Based Scenario]
A 28-year-old male presents with recurrent episodes of binge eating followed
by purging behaviors. He reports feelings of shame and guilt. His vital signs
are stable, and his BMI is within normal range. Which combination represents
the most evidence-based treatment approach?
,A. Fluoxetine monotherapy only
B. CBT-E plus fluoxetine
C. Olanzapine plus dietary counseling
D. Bupropion plus interpersonal therapy
Correct Answer: B. CBT-E plus fluoxetine
Rationale: The gold standard treatment for Bulimia Nervosa is Cognitive
Behavioral Therapy (CBT-E) combined with fluoxetine, the FDA-approved
medication. CBT addresses the behavioral and cognitive components, while
fluoxetine targets depressive and obsessive symptoms. Olanzapine is not indicated
for bulimia. Bupropion is contraindicated.
Question 5 [Single Best Answer]
What is the first-line treatment for Binge Eating Disorder (BED)?
A. Lisdexamfetamine (Vyvanse)
B. Cognitive Behavioral Therapy (CBT-E/CBT-BED)
C. Fluoxetine (Prozac)
D. Orlistat (Alli)
Correct Answer: B. Cognitive Behavioral Therapy (CBT-E/CBT-BED)
Rationale: CBT-E/CBT-BED is the first-line treatment for Binge Eating Disorder.
While lisdexamfetamine is FDA-approved for BED, psychotherapy remains the
initial treatment of choice. Medications are considered when psychotherapy alone
is insufficient.
Question 6 [Single Best Answer]
Which stimulant medication is FDA-approved for the treatment of Binge
Eating Disorder?
A. Methylphenidate (Ritalin)
B. Amphetamine salts (Adderall)
C. Lisdexamfetamine (Vyvanse)
, NSG 552 Exam 3
SECTION 1: SUBSTANCE USE DISORDERS
Question 1
A 34-year-old male is brought to the emergency department by EMS. His girlfriend
reports finding him unresponsive in the bathroom with a syringe nearby. On
examination, he has pinpoint pupils, respiratory rate of 6 breaths/minute, and
blood pressure of 88/52 mmHg. Which medication should be administered first?
A. Naloxone (Narcan)
B. Methadone
C. Buprenorphine (Suboxone)
D. Naltrexone
Correct Answer: A. Naloxone (Narcan)
Rationale: The patient presents with the classic triad of opioid intoxication: miosis
(pinpoint pupils), respiratory depression (RR 6), and hypotension (88/52). Naloxone is a
potent opioid antagonist and the treatment of choice for acute opioid overdose. It
rapidly reverses respiratory depression. Methadone and buprenorphine are
maintenance medications, not emergency treatments. Naltrexone is an antagonist used
after detoxification and would not be appropriate in an acute overdose.
───────────────────────────────────────────────────────
─────────────────────────
Question 2 [SELECT ALL THAT APPLY]
A nurse is assessing a patient suspected of opioid intoxication. Which findings are
consistent with this diagnosis? Select all that apply.
A. Miosis (pinpoint pupils)
B. Respiratory depression
C. Tachycardia
EXAMS 1-3
Psychopharmacology
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
300 Exam Questions w/ Answers
Expert Rationales included.
Exam 1, 2 & 3 Comprehensive Study Guide
, Preview Pages Below
Get the Complete PDF After Purchase
NSG 552 EXAMS 1-3 - PSYCHOPHARMACOLOGY
If you require further clarification
or in need of any study resources,
feel free to Message me.
3 PAGES / EXAM NEW NOTO SANS FONT FULL PDF LINKED
,Table of Contents
NSG 552 Exam 1.................................................................................2
NSG 552 Exam 1 Study Guide..........................................................52
NSG 552 Exam 2...............................................................................73
NSG 552 Exam 2 Study Guide........................................................113
NSG 552 Exam 3.............................................................................134
NSG 552 Exam 3 Study Guide........................................................186
NSG 552 Exam 1
Question 1 (SINGLE BEST ANSWER)
A 24-year-old male with schizophrenia is prescribed haloperidol 10 mg IM for
acute agitation. Which medication should be co-administered to reduce the risk
of severe extrapyramidal symptoms (EPS)?
A. Propranolol
B. Benztropine
C. Amantadine
D. Clonazepam
Correct Answer: B. Benztropine
Rationale: IM haloperidol should be administered with an anticholinergic agent such as
benztropine or diphenhydramine to reduce the risk of severe EPS, particularly acute
dystonia.
,Rationale: IM haloperidol should be administered with an anticholinergic agent such
as benztropine or diphenhydramine to reduce the risk of severe EPS, particularly acute
dystonia.
───────────────────────────────────────────────────────
─────────────────────────
Question 2 (SINGLE BEST ANSWER)
A patient presents with involuntary movements of the facial muscles, tongue
protrusion, and lip smacking after 5 years of antipsychotic therapy. Which
condition is most likely?
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Neuroleptic malignant syndrome
Correct Answer: C. Tardive dyskinesia
Rationale: Tardive dyskinesia (TD) is characterized by involuntary movements of the
facial muscles, tongue, and limbs. It is a neurotoxic side effect of long-term
antipsychotic use targeting dopamine receptors.
───────────────────────────────────────────────────────
─────────────────────────
Question 3 (SELECT ALL THAT APPLY)
A patient on clozapine presents with fever, sore throat, and malaise. The
PMHNP suspects agranulocytosis. Select all that apply regarding clozapine
monitoring:
A. Monitor WBC and ANC weekly for the first 6 months
,B. Discontinue clozapine if ANC falls below 1,500/mm³
C. Agranulocytosis occurs in approximately 1% of patients
D. Sialorrhea occurs in 30-80% of patients and is managed with glycopyrrolate
E. Clozapine is first-line for all patients with schizophrenia
Correct Answer: A, B, C, D
Rationale: Clozapine requires WBC/ANC monitoring due to agranulocytosis risk (1%). It
is discontinued if ANC <1,500. Sialorrhea is common (30-80%) and managed with
glycopyrrolate. Clozapine is reserved for treatment-resistant schizophrenia, not first-
line.
───────────────────────────────────────────────────────
─────────────────────────
Question 4 (SINGLE BEST ANSWER)
A 35-year-old female on risperidone reports galactorrhea and amenorrhea.
Which pathway is primarily responsible for this adverse effect?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Correct Answer: D. Tuberoinfundibular pathway
Rationale: D2 blockade in the tuberoinfundibular pathway results in
hyperprolactinemia, causing galactorrhea, amenorrhea, gynecomastia, and decreased
libido. Risperidone is particularly associated with this effect.
───────────────────────────────────────────────────────
─────────────────────────
Question 5 (SINGLE BEST ANSWER)
,A patient with bipolar disorder has a lithium level of 2.1 mEq/L. Which clinical
manifestation is most concerning?
A. Coarse tremor and ataxia
B. Seizures and coma
C. Nausea and diarrhea
D. Polyuria and polydipsia
Correct Answer: B. Seizures and coma
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L). Levels >2.0 mEq/L
are potentially lethal and manifest with seizures, coma, and death. Early signs include
nausea, vomiting, and coarse tremors.
───────────────────────────────────────────────────────
─────────────────────────
Question 6 (SELECT ALL THAT APPLY)
A 42-year-old male on haloperidol develops fever (40°C), lead-pipe rigidity,
altered mental status, and diaphoresis. Select all that apply regarding this
emergency:
A. This is Neuroleptic Malignant Syndrome (NMS)
B. Immediate discontinuation of the antipsychotic is required
C. Bromocriptine and dantrolene are treatment options
D. Mortality rate is approximately 20% if untreated
E. This condition is more common with atypical antipsychotics
Correct Answer: A, B, C, D
Rationale: NMS (FALTERED) is a life-threatening emergency more common with FGAs.
Management includes discontinuing the offending agent, supportive care, and
medications such as bromocriptine and dantrolene. Mortality is ~20% if untreated.
, NSG 552 Exam 2
Question 1 [Case-Based Scenario]
A 22-year-old female with Anorexia Nervosa is admitted to an inpatient
psychiatric unit. She reports severe anxiety before meals and refuses to eat
due to intense fear of weight gain. The psychiatrist considers pharmacologic
intervention. Which medication is most appropriate to administer as a pre-
meal anxiolytic to decrease anticipatory anxiety?
A. Fluoxetine 20 mg daily
B. Lorazepam 0.5 mg PRN before meals
C. Olanzapine 5 mg daily
D. Buspirone 10 mg BID
Correct Answer: B. Lorazepam 0.5 mg PRN before meals
Rationale: Lorazepam is a short-acting benzodiazepine commonly used as a pre-
meal anxiolytic in Anorexia Nervosa to reduce anticipatory anxiety. It has a rapid
onset and can be given PRN. SSRIs like fluoxetine take weeks to work and are not
appropriate for acute anxiety. Olanzapine is used for severe preoccupation with
weight and food, not acute anxiety. Buspirone has a slow onset and is not useful
for PRN anxiety relief.
Question 2 [Select All That Apply (SATA)]
A 19-year-old female with Anorexia Nervosa has been hospitalized for severe
malnutrition and obsessive preoccupation with food and body weight. Her
BMI is 14.2. The treatment team is considering pharmacologic options. Select
all that apply regarding appropriate medication management for this
patient.
A. Olanzapine may be prescribed to reduce severe preoccupation with weight and
food
,B. Fluoxetine is FDA-approved for Anorexia Nervosa
C. A pre-meal benzodiazepine such as lorazepam may reduce anticipatory anxiety
D. Bupropion is contraindicated due to seizure risk in malnourished patients
E. Mirtazapine is first-line for weight restoration in Anorexia Nervosa
Correct Answer: A, C, D
Rationale: Olanzapine (A) is used off-label for severe preoccupation with weight
and food in Anorexia Nervosa. A pre-meal benzodiazepine like lorazepam (C) can
help with anticipatory anxiety. Bupropion (D) is contraindicated in eating disorders
due to increased seizure risk, especially in malnourished patients. Fluoxetine (B) is
NOT FDA-approved for Anorexia Nervosa—it is approved for Bulimia Nervosa.
Mirtazapine (E) is not first-line for weight restoration, though it may be used
adjunctively.
Question 3 [Single Best Answer]
Which of the following medications is FDA-approved for the treatment of
Bulimia Nervosa?
A. Sertraline (Zoloft)
B. Fluoxetine (Prozac)
C. Venlafaxine (Effexor)
D. Bupropion (Wellbutrin)
Correct Answer: B. Fluoxetine (Prozac)
Rationale: Fluoxetine (Prozac) is the only FDA-approved medication for Bulimia
Nervosa. It is typically prescribed at higher doses (60 mg/day). Bupropion is
contraindicated in eating disorders due to seizure risk.
Question 4 [Case-Based Scenario]
A 28-year-old male presents with recurrent episodes of binge eating followed
by purging behaviors. He reports feelings of shame and guilt. His vital signs
are stable, and his BMI is within normal range. Which combination represents
the most evidence-based treatment approach?
,A. Fluoxetine monotherapy only
B. CBT-E plus fluoxetine
C. Olanzapine plus dietary counseling
D. Bupropion plus interpersonal therapy
Correct Answer: B. CBT-E plus fluoxetine
Rationale: The gold standard treatment for Bulimia Nervosa is Cognitive
Behavioral Therapy (CBT-E) combined with fluoxetine, the FDA-approved
medication. CBT addresses the behavioral and cognitive components, while
fluoxetine targets depressive and obsessive symptoms. Olanzapine is not indicated
for bulimia. Bupropion is contraindicated.
Question 5 [Single Best Answer]
What is the first-line treatment for Binge Eating Disorder (BED)?
A. Lisdexamfetamine (Vyvanse)
B. Cognitive Behavioral Therapy (CBT-E/CBT-BED)
C. Fluoxetine (Prozac)
D. Orlistat (Alli)
Correct Answer: B. Cognitive Behavioral Therapy (CBT-E/CBT-BED)
Rationale: CBT-E/CBT-BED is the first-line treatment for Binge Eating Disorder.
While lisdexamfetamine is FDA-approved for BED, psychotherapy remains the
initial treatment of choice. Medications are considered when psychotherapy alone
is insufficient.
Question 6 [Single Best Answer]
Which stimulant medication is FDA-approved for the treatment of Binge
Eating Disorder?
A. Methylphenidate (Ritalin)
B. Amphetamine salts (Adderall)
C. Lisdexamfetamine (Vyvanse)
, NSG 552 Exam 3
SECTION 1: SUBSTANCE USE DISORDERS
Question 1
A 34-year-old male is brought to the emergency department by EMS. His girlfriend
reports finding him unresponsive in the bathroom with a syringe nearby. On
examination, he has pinpoint pupils, respiratory rate of 6 breaths/minute, and
blood pressure of 88/52 mmHg. Which medication should be administered first?
A. Naloxone (Narcan)
B. Methadone
C. Buprenorphine (Suboxone)
D. Naltrexone
Correct Answer: A. Naloxone (Narcan)
Rationale: The patient presents with the classic triad of opioid intoxication: miosis
(pinpoint pupils), respiratory depression (RR 6), and hypotension (88/52). Naloxone is a
potent opioid antagonist and the treatment of choice for acute opioid overdose. It
rapidly reverses respiratory depression. Methadone and buprenorphine are
maintenance medications, not emergency treatments. Naltrexone is an antagonist used
after detoxification and would not be appropriate in an acute overdose.
───────────────────────────────────────────────────────
─────────────────────────
Question 2 [SELECT ALL THAT APPLY]
A nurse is assessing a patient suspected of opioid intoxication. Which findings are
consistent with this diagnosis? Select all that apply.
A. Miosis (pinpoint pupils)
B. Respiratory depression
C. Tachycardia
