NSG552 FINAL EXAM 3 -
PSYCHOPHARMACOLOGY WILKES
QUESTIONS AND ANSWERS
1. A patient taking Clozapine presents with a sudden onset of high fever, pharyngitis, and
mouth sores. Which laboratory value is most critical to check immediately?
A. Thyroid Stimulating Hormone
B. Liver Function Tests
C. Serum Creatinine
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
sudden drop in ANC can lead to severe infection, presenting as fever and sore throat.
2. Which mechanism of action differentiates Vilazodone (Viibryd) from standard Selective
Serotonin Reuptake Inhibitors (SSRIs)?
A. Norepinephrine reuptake inhibition
B. D2 receptor antagonism
,C. Alpha-2 adrenergic antagonism
D. 5-HT1A receptor partial agonism
Answer: D
Conceptual Explanation: Vilazodone is a SPARI (Serotonin Partial Agonist and Reuptake
Inhibitor), combining SSRI activity with 5-HT1A partial agonism.
3. Lithium is known to have a narrow therapeutic index. Which serum level range is generally
considered therapeutic for acute mania?
A. 0.4 to 0.8 mEq/L
B. 1.2 to 2.0 mEq/L
C. 0.8 to 1.2 mEq/L
D. 2.5 to 3.0 mEq/L
Answer: C
Conceptual Explanation: For acute mania, lithium levels are typically targeted between
0.8 and 1.2 mEq/L, while maintenance levels are slightly lower (0.6 to 1.0 mEq/L).
4. A patient is diagnosed with Bipolar I disorder and is HLA-B*1502 positive. Which
medication should be avoided to prevent Stevens-Johnson Syndrome?
A. Lithium Carbonate
B. Carbamazepine
C. Quetiapine
, D. Valproic Acid
Answer: B
Conceptual Explanation: Carbamazepine is strongly associated with SJS/TEN in
individuals of Asian descent who carry the HLA-B*1502 allele.
5. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders like anorexia/bulimia?
A. Sertraline
B. Bupropion
C. Mirtazapine
D. Duloxetine
Answer: B
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances associated with purging behaviors.
6. A patient with schizophrenia is experiencing acute dystonia after their first dose of
Haloperidol. What is the preferred immediate treatment?
A. Benztropine IM
B. Propranolol PO
C. Lorazepam IV
D. Olanzapine SL
PSYCHOPHARMACOLOGY WILKES
QUESTIONS AND ANSWERS
1. A patient taking Clozapine presents with a sudden onset of high fever, pharyngitis, and
mouth sores. Which laboratory value is most critical to check immediately?
A. Thyroid Stimulating Hormone
B. Liver Function Tests
C. Serum Creatinine
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
sudden drop in ANC can lead to severe infection, presenting as fever and sore throat.
2. Which mechanism of action differentiates Vilazodone (Viibryd) from standard Selective
Serotonin Reuptake Inhibitors (SSRIs)?
A. Norepinephrine reuptake inhibition
B. D2 receptor antagonism
,C. Alpha-2 adrenergic antagonism
D. 5-HT1A receptor partial agonism
Answer: D
Conceptual Explanation: Vilazodone is a SPARI (Serotonin Partial Agonist and Reuptake
Inhibitor), combining SSRI activity with 5-HT1A partial agonism.
3. Lithium is known to have a narrow therapeutic index. Which serum level range is generally
considered therapeutic for acute mania?
A. 0.4 to 0.8 mEq/L
B. 1.2 to 2.0 mEq/L
C. 0.8 to 1.2 mEq/L
D. 2.5 to 3.0 mEq/L
Answer: C
Conceptual Explanation: For acute mania, lithium levels are typically targeted between
0.8 and 1.2 mEq/L, while maintenance levels are slightly lower (0.6 to 1.0 mEq/L).
4. A patient is diagnosed with Bipolar I disorder and is HLA-B*1502 positive. Which
medication should be avoided to prevent Stevens-Johnson Syndrome?
A. Lithium Carbonate
B. Carbamazepine
C. Quetiapine
, D. Valproic Acid
Answer: B
Conceptual Explanation: Carbamazepine is strongly associated with SJS/TEN in
individuals of Asian descent who carry the HLA-B*1502 allele.
5. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders like anorexia/bulimia?
A. Sertraline
B. Bupropion
C. Mirtazapine
D. Duloxetine
Answer: B
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances associated with purging behaviors.
6. A patient with schizophrenia is experiencing acute dystonia after their first dose of
Haloperidol. What is the preferred immediate treatment?
A. Benztropine IM
B. Propranolol PO
C. Lorazepam IV
D. Olanzapine SL
