NSG552 ADVANCED
PSYCHOPHARMACOLOGY FINAL
EXAM V3 QUESTIONS AND ANSWERS
1. Which laboratory value is the most critical to monitor for a patient prescribed Clozapine to
ensure safety regarding the risk of agranulocytosis?
A. Platelet count
B. Liver function tests
C. Serum Clozapine levels
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine requires strict monitoring of the Absolute Neutrophil
Count (ANC) due to the risk of life-threatening agranulocytosis. Patients must be registered
in the Clozapine REMS program.
2. A patient taking Lithium for Bipolar Disorder presents with coarse tremors, ataxia, and
confusion. What is the most likely serum Lithium level for this patient?
A. > 1.5 mEq/L
,B. 1.0 mEq/L
C. 0.6 mEq/L
D. 0.8 mEq/L
Answer: A
Conceptual Explanation: Serum lithium levels greater than 1.5 mEq/L are typically
associated with moderate to severe toxicity, manifesting as coarse tremors, ataxia,
confusion, and slurred speech.
3. When switching a patient from Fluoxetine to a Monoamine Oxidase Inhibitor (MAOI), how
long should the washout period be to avoid Serotonin Syndrome?
A. 2 weeks
B. 3 weeks
C. 7 days
D. 5 weeks
Answer: D
Conceptual Explanation: Due to the long half-life of Fluoxetine and its active metabolite
norfluoxetine, a 5-week washout period is required before starting an MAOI.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Sertraline
, B. Bupropion
C. Venlafaxine
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion is known to lower the seizure threshold and is
contraindicated in patients with seizure disorders and those with current or past diagnoses
of anorexia or bulimia due to increased seizure risk.
5. Smoking cigarettes can decrease the serum levels of which antipsychotic by inducing the
CYP1A2 enzyme?
A. Risperidone
B. Olanzapine
C. Quetiapine
D. Aripiprazole
Answer: B
Conceptual Explanation: Polycyclic aromatic hydrocarbons in cigarette smoke induce the
CYP1A2 enzyme, which metabolizes Olanzapine and Clozapine, leading to decreased drug
levels in smokers.
PSYCHOPHARMACOLOGY FINAL
EXAM V3 QUESTIONS AND ANSWERS
1. Which laboratory value is the most critical to monitor for a patient prescribed Clozapine to
ensure safety regarding the risk of agranulocytosis?
A. Platelet count
B. Liver function tests
C. Serum Clozapine levels
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine requires strict monitoring of the Absolute Neutrophil
Count (ANC) due to the risk of life-threatening agranulocytosis. Patients must be registered
in the Clozapine REMS program.
2. A patient taking Lithium for Bipolar Disorder presents with coarse tremors, ataxia, and
confusion. What is the most likely serum Lithium level for this patient?
A. > 1.5 mEq/L
,B. 1.0 mEq/L
C. 0.6 mEq/L
D. 0.8 mEq/L
Answer: A
Conceptual Explanation: Serum lithium levels greater than 1.5 mEq/L are typically
associated with moderate to severe toxicity, manifesting as coarse tremors, ataxia,
confusion, and slurred speech.
3. When switching a patient from Fluoxetine to a Monoamine Oxidase Inhibitor (MAOI), how
long should the washout period be to avoid Serotonin Syndrome?
A. 2 weeks
B. 3 weeks
C. 7 days
D. 5 weeks
Answer: D
Conceptual Explanation: Due to the long half-life of Fluoxetine and its active metabolite
norfluoxetine, a 5-week washout period is required before starting an MAOI.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Sertraline
, B. Bupropion
C. Venlafaxine
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion is known to lower the seizure threshold and is
contraindicated in patients with seizure disorders and those with current or past diagnoses
of anorexia or bulimia due to increased seizure risk.
5. Smoking cigarettes can decrease the serum levels of which antipsychotic by inducing the
CYP1A2 enzyme?
A. Risperidone
B. Olanzapine
C. Quetiapine
D. Aripiprazole
Answer: B
Conceptual Explanation: Polycyclic aromatic hydrocarbons in cigarette smoke induce the
CYP1A2 enzyme, which metabolizes Olanzapine and Clozapine, leading to decreased drug
levels in smokers.
