NR 606 ADVANCED
PSYCHOPHARMACOLOGY PRACTICE
QUESTIONS AND ANSWERS
1. A patient taking Lithium for Bipolar I Disorder presents with nausea, vomiting, and coarse
hand tremors. Which serum level is most likely indicative of acute toxicity?
A. 0.6 mEq/L
B. 2.2 mEq/L
C. 1.2 mEq/L
D. 0.9 mEq/L
Answer: B
Conceptual Explanation: Lithium toxicity usually occurs at levels above 1.5 mEq/L. Levels
above 2.0 mEq/L are associated with severe symptoms like coarse tremors, GI distress, and
CNS changes.
2. Which dopaminergic pathway is primarily associated with the development of
Extrapyramidal Symptoms (EPS) when blocked by first-generation antipsychotics?
A. Nigrostriatal
,B. Mesolimbic
C. Mesocortical
D. Tuberoinfundibular
Answer: A
Conceptual Explanation: The Nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway leads to EPS and tardive dyskinesia.
3. A client is prescribed an MAOI for treatment-resistant depression. The PMHNP instructs
the patient to avoid foods high in tyramine to prevent which complication?
A. Hypertensive crisis
B. Hypotensive crisis
C. Serotonin syndrome
D. Metabolic syndrome
Answer: A
Conceptual Explanation: Tyramine acts as a catecholamine releasing agent. When MAO is
inhibited, tyramine leads to excessive norepinephrine release, causing a hypertensive
crisis.
4. Clozapine treatment requires frequent monitoring of which lab parameter due to the risk
of agranulocytosis?
A. Blood Urea Nitrogen (BUN)
, B. Liver Function Tests (LFTs)
C. Thyroid Stimulating Hormone (TSH)
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine is associated with a risk of severe
neutropenia/agranulocytosis, necessitating strict ANC monitoring via the REMS program.
5. Which antidepressant is known for its dual mechanism of inhibiting the reuptake of both
Norepinephrine and Dopamine (NDRI)?
A. Fluoxetine
B. Bupropion
C. Venlafaxine
D. Duloxetine
Answer: B
Conceptual Explanation: Bupropion is an NDRI, distinguishing it from SSRIs and SNRIs. It
is often used to avoid sexual side effects or for smoking cessation.
6. Lamotrigine carries a black box warning for which life-threatening condition?
A. Hepatic Failure
B. Aplastic Anemia
PSYCHOPHARMACOLOGY PRACTICE
QUESTIONS AND ANSWERS
1. A patient taking Lithium for Bipolar I Disorder presents with nausea, vomiting, and coarse
hand tremors. Which serum level is most likely indicative of acute toxicity?
A. 0.6 mEq/L
B. 2.2 mEq/L
C. 1.2 mEq/L
D. 0.9 mEq/L
Answer: B
Conceptual Explanation: Lithium toxicity usually occurs at levels above 1.5 mEq/L. Levels
above 2.0 mEq/L are associated with severe symptoms like coarse tremors, GI distress, and
CNS changes.
2. Which dopaminergic pathway is primarily associated with the development of
Extrapyramidal Symptoms (EPS) when blocked by first-generation antipsychotics?
A. Nigrostriatal
,B. Mesolimbic
C. Mesocortical
D. Tuberoinfundibular
Answer: A
Conceptual Explanation: The Nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway leads to EPS and tardive dyskinesia.
3. A client is prescribed an MAOI for treatment-resistant depression. The PMHNP instructs
the patient to avoid foods high in tyramine to prevent which complication?
A. Hypertensive crisis
B. Hypotensive crisis
C. Serotonin syndrome
D. Metabolic syndrome
Answer: A
Conceptual Explanation: Tyramine acts as a catecholamine releasing agent. When MAO is
inhibited, tyramine leads to excessive norepinephrine release, causing a hypertensive
crisis.
4. Clozapine treatment requires frequent monitoring of which lab parameter due to the risk
of agranulocytosis?
A. Blood Urea Nitrogen (BUN)
, B. Liver Function Tests (LFTs)
C. Thyroid Stimulating Hormone (TSH)
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine is associated with a risk of severe
neutropenia/agranulocytosis, necessitating strict ANC monitoring via the REMS program.
5. Which antidepressant is known for its dual mechanism of inhibiting the reuptake of both
Norepinephrine and Dopamine (NDRI)?
A. Fluoxetine
B. Bupropion
C. Venlafaxine
D. Duloxetine
Answer: B
Conceptual Explanation: Bupropion is an NDRI, distinguishing it from SSRIs and SNRIs. It
is often used to avoid sexual side effects or for smoking cessation.
6. Lamotrigine carries a black box warning for which life-threatening condition?
A. Hepatic Failure
B. Aplastic Anemia
