NSG 552 FINAL EXAM: ADVANCED
PSYCHOPHARMACOLOGY 2026/2027
QUESTIONS AND ANSWERS
1. A patient on Clozapine presents with a sudden onset of high fever, muscle rigidity, and
tachycardia. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome
B. Serotonin Syndrome
C. Agranulocytosis
D. Anticholinergic Toxicity
Answer: A
Conceptual Explanation: Neuroleptic Malignant Syndrome (NMS) is a life-threatening
reaction to antipsychotics characterized by lead-pipe rigidity, hyperpyrexia, and autonomic
instability.
2. Which cytochrome P450 enzyme is most significantly inhibited by the antidepressant
Fluoxetine, leading to potential drug interactions with Beta-blockers?
A. CYP1A2
,B. CYP2D6
C. CYP3A4
D. CYP2C19
Answer: B
Conceptual Explanation: Fluoxetine is a potent inhibitor of CYP2D6, which metabolizes
many beta-blockers, opioids, and other psychotropic medications.
3. What is the black box warning associated with all SSRIs and SNRIs when prescribed to
children, adolescents, and young adults?
A. Increased risk of seizure activity
B. Risk of sudden cardiac death
C. Increased risk of suicidal ideation and behavior
D. Severe hepatotoxicity
Answer: C
Conceptual Explanation: The FDA requires a black box warning on all antidepressants
regarding the increased risk of suicidal thoughts and behaviors in patients aged 24 and
younger.
4. Lithium is known to have a narrow therapeutic index. Which of the following lab values
represents the standard maintenance therapeutic range?
A. 0.2 - 0.5 mEq/L
, B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.0 - 3.0 mEq/L
Answer: B
Conceptual Explanation: The standard maintenance therapeutic range for Lithium is 0.6
to 1.2 mEq/L; levels above 1.5 are considered toxic.
5. A patient experiencing acute dystonia after a dose of Haloperidol should be treated with
which of the following?
A. Benztropine
B. Lorazepam
C. Propranolol
D. Bromocriptine
Answer: A
Conceptual Explanation: Anticholinergic medications like Benztropine or
Diphenhydramine are the first-line treatment for acute dystonic reactions.
6. Which antidepressant is unique for its mechanism of antagonizing alpha-2 adrenergic
receptors, thereby increasing both serotonin and norepinephrine?
A. Mirtazapine
B. Venlafaxine
PSYCHOPHARMACOLOGY 2026/2027
QUESTIONS AND ANSWERS
1. A patient on Clozapine presents with a sudden onset of high fever, muscle rigidity, and
tachycardia. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome
B. Serotonin Syndrome
C. Agranulocytosis
D. Anticholinergic Toxicity
Answer: A
Conceptual Explanation: Neuroleptic Malignant Syndrome (NMS) is a life-threatening
reaction to antipsychotics characterized by lead-pipe rigidity, hyperpyrexia, and autonomic
instability.
2. Which cytochrome P450 enzyme is most significantly inhibited by the antidepressant
Fluoxetine, leading to potential drug interactions with Beta-blockers?
A. CYP1A2
,B. CYP2D6
C. CYP3A4
D. CYP2C19
Answer: B
Conceptual Explanation: Fluoxetine is a potent inhibitor of CYP2D6, which metabolizes
many beta-blockers, opioids, and other psychotropic medications.
3. What is the black box warning associated with all SSRIs and SNRIs when prescribed to
children, adolescents, and young adults?
A. Increased risk of seizure activity
B. Risk of sudden cardiac death
C. Increased risk of suicidal ideation and behavior
D. Severe hepatotoxicity
Answer: C
Conceptual Explanation: The FDA requires a black box warning on all antidepressants
regarding the increased risk of suicidal thoughts and behaviors in patients aged 24 and
younger.
4. Lithium is known to have a narrow therapeutic index. Which of the following lab values
represents the standard maintenance therapeutic range?
A. 0.2 - 0.5 mEq/L
, B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.0 - 3.0 mEq/L
Answer: B
Conceptual Explanation: The standard maintenance therapeutic range for Lithium is 0.6
to 1.2 mEq/L; levels above 1.5 are considered toxic.
5. A patient experiencing acute dystonia after a dose of Haloperidol should be treated with
which of the following?
A. Benztropine
B. Lorazepam
C. Propranolol
D. Bromocriptine
Answer: A
Conceptual Explanation: Anticholinergic medications like Benztropine or
Diphenhydramine are the first-line treatment for acute dystonic reactions.
6. Which antidepressant is unique for its mechanism of antagonizing alpha-2 adrenergic
receptors, thereby increasing both serotonin and norepinephrine?
A. Mirtazapine
B. Venlafaxine
