Page 1 of 35
NSG 552 EXAM 3 – 2026 WILKES
PSYCHOPHARMACOLOGY COMPLETE (110) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NSG
Prepare for the NSG 552 Exam 3 – Wilkes Psychopharmacology with this
comprehensive practice resource designed to strengthen your psychiatric medication
knowledge and exam readiness. It features exam-style questions covering
psychotropic medication classes, mechanisms of action, therapeutic uses, adverse
effects, drug interactions, safety considerations, and evidence-based
pharmacological management of mental health conditions. Use it to reinforce
essential concepts, assess your understanding, and build confidence before test day.
An excellent study aid for Wilkes University nursing students preparing for the NSG
552 Psychopharmacology Exam 3.
MULTIPLE CHOICE.
SECTION 1: OPIOID USE DISORDER (Questions 1–20)
Question 1: The geometric formula for the area of a triangle is:
A. (1/2)bh
B. πr²
C. 2πr
D. l × w
Correct answer: A. (1/2)bh
Rationale: The area of a triangle is calculated using (1/2) × base × height.
Question 2: A patient with opioid use disorder is brought to the emergency
department with respiratory depression and pinpoint pupils. What is the
priority pharmacologic intervention?
A. Administer buprenorphine
B. Administer naloxone
C. Administer naltrexone
D. Administer methadone
, Page 2 of 35
Correct answer: B. Administer naloxone
Rationale: Naloxone is a pure opioid antagonist that competes with and
displaces opioids at opioid receptor sites, reversing respiratory depression
and other effects of opioid overdose. It is the treatment of choice for
suspected opioid overdose.
Question 3: A patient is prescribed buprenorphine/naloxone (Suboxone) for
opioid use disorder. The patient asks why naloxone is included in the
medication. What is the most accurate response?
A. "Naloxone helps the buprenorphine work longer."
B. "Naloxone prevents misuse by injection. If injected, it will precipitate
withdrawal."
C. "Naloxone treats the constipation caused by buprenorphine."
D. "Naloxone increases the half-life of buprenorphine."
Correct answer: B. "Naloxone prevents misuse by injection. If injected, it
will precipitate withdrawal."
Rationale: Naloxone is included in Suboxone to deter intravenous misuse. If
the combination is crushed and injected, the naloxone precipitates
withdrawal. Buprenorphine itself is the partial agonist used for withdrawal and
maintenance.
Question 4: A patient with opioid use disorder and comorbid chronic pain is
being initiated on medication-assisted treatment. Which medication is most
appropriate?
A. Methadone
B. Naltrexone
C. Buprenorphine + Naloxone
D. Disulfiram
Correct answer: C. Buprenorphine + Naloxone
Rationale: Buprenorphine provides pain relief due to its partial agonist
activity, making it preferred when opioid use disorder co-occurs with chronic
pain. The naloxone component deters injection misuse.
Question 5: A patient is being initiated on buprenorphine/naloxone for opioid
use disorder. He last used heroin 6 hours ago and is mildly uncomfortable.
What is the most appropriate action?
, Page 3 of 35
A. Start Suboxone immediately
B. Delay buprenorphine until objective withdrawal is present to avoid
precipitated withdrawal
C. Give methadone first to transition to buprenorphine
D. Give naltrexone oral challenge today
Correct answer: B. Delay buprenorphine until objective withdrawal is
present to avoid precipitated withdrawal
Rationale: Buprenorphine has higher mu receptor affinity than full agonists
like heroin or oxycodone. When taken while a full agonist is still bound, it
displaces the full agonist, causing rapid-onset, severe withdrawal. Patients
must be in moderate withdrawal before induction.
Question 6: A patient on methadone maintenance asks why he has to go to a
special clinic daily. The NP responds that this is because methadone:
A. Is only effective when taken with food
B. Is restricted to federally licensed opioid treatment programs
C. Is more sedating than buprenorphine
D. Is approved only for inpatient use
Correct answer: B. Is restricted to federally licensed opioid treatment
programs
Rationale: Methadone is a long-acting full opioid agonist restricted to
federally licensed substance abuse treatment programs, whereas
buprenorphine can be prescribed in office-based outpatient settings.
Question 7: A patient on methadone maintenance develops QTc prolongation
on ECG. The PMHNP should:
A. Discontinue methadone immediately
B. Monitor QTc and consider dose reduction or switching to buprenorphine
C. Add an antiarrhythmic medication
D. Increase the methadone dose to achieve stability
Correct answer: B. Monitor QTc and consider dose reduction or switching
to buprenorphine
Rationale: Methadone can cause QTc prolongation, increasing the risk of
torsades de pointes. Monitoring the QTc and considering dose reduction or
switching to an alternative medication like buprenorphine is appropriate.
, Page 4 of 35
Question 8: What is the mechanism of action of buprenorphine?
A. Full mu-opioid receptor agonist
B. Mu-opioid receptor partial agonist
C. Mu-opioid receptor antagonist
D. Kappa-opioid receptor antagonist
Correct answer: B. Mu-opioid receptor partial agonist
Rationale: Buprenorphine acts on the mu-opioid receptors as a partial
agonist. Its partial agonist activity produces a ceiling effect, reducing
overdose risk compared to full agonists.
Question 9: What symptoms are characteristic of opioid intoxication? (Select
All That Apply)
A. Dilated pupils
B. Miosis (small pupils)
C. Respiratory depression
D. Tachycardia
E. Euphoria
Correct answer: B, C, E (Miosis, Respiratory depression, Euphoria)
Rationale: Opioid intoxication presents with miosis (pinpoint pupils),
respiratory depression, constipation, itching, euphoria, and sedation.
Tachycardia and dilated pupils are NOT characteristic; they occur in
withdrawal or stimulant intoxication.
Question 10: What symptoms are characteristic of opioid withdrawal? (Select
All That Apply)
A. Constricted pupils
B. Dilated pupils
C. Rhinorrhea and lacrimation
D. Bradycardia
E. Nausea, vomiting, diarrhea
Correct answer: B, C, E (Dilated pupils, Rhinorrhea and lacrimation,
Nausea, vomiting, diarrhea)
Rationale: Opioid withdrawal symptoms include dilated pupils, rhinorrhea,
lacrimation, yawning, piloerection, nausea/vomiting/diarrhea, tachycardia,
and hypertension.
NSG 552 EXAM 3 – 2026 WILKES
PSYCHOPHARMACOLOGY COMPLETE (110) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NSG
Prepare for the NSG 552 Exam 3 – Wilkes Psychopharmacology with this
comprehensive practice resource designed to strengthen your psychiatric medication
knowledge and exam readiness. It features exam-style questions covering
psychotropic medication classes, mechanisms of action, therapeutic uses, adverse
effects, drug interactions, safety considerations, and evidence-based
pharmacological management of mental health conditions. Use it to reinforce
essential concepts, assess your understanding, and build confidence before test day.
An excellent study aid for Wilkes University nursing students preparing for the NSG
552 Psychopharmacology Exam 3.
MULTIPLE CHOICE.
SECTION 1: OPIOID USE DISORDER (Questions 1–20)
Question 1: The geometric formula for the area of a triangle is:
A. (1/2)bh
B. πr²
C. 2πr
D. l × w
Correct answer: A. (1/2)bh
Rationale: The area of a triangle is calculated using (1/2) × base × height.
Question 2: A patient with opioid use disorder is brought to the emergency
department with respiratory depression and pinpoint pupils. What is the
priority pharmacologic intervention?
A. Administer buprenorphine
B. Administer naloxone
C. Administer naltrexone
D. Administer methadone
, Page 2 of 35
Correct answer: B. Administer naloxone
Rationale: Naloxone is a pure opioid antagonist that competes with and
displaces opioids at opioid receptor sites, reversing respiratory depression
and other effects of opioid overdose. It is the treatment of choice for
suspected opioid overdose.
Question 3: A patient is prescribed buprenorphine/naloxone (Suboxone) for
opioid use disorder. The patient asks why naloxone is included in the
medication. What is the most accurate response?
A. "Naloxone helps the buprenorphine work longer."
B. "Naloxone prevents misuse by injection. If injected, it will precipitate
withdrawal."
C. "Naloxone treats the constipation caused by buprenorphine."
D. "Naloxone increases the half-life of buprenorphine."
Correct answer: B. "Naloxone prevents misuse by injection. If injected, it
will precipitate withdrawal."
Rationale: Naloxone is included in Suboxone to deter intravenous misuse. If
the combination is crushed and injected, the naloxone precipitates
withdrawal. Buprenorphine itself is the partial agonist used for withdrawal and
maintenance.
Question 4: A patient with opioid use disorder and comorbid chronic pain is
being initiated on medication-assisted treatment. Which medication is most
appropriate?
A. Methadone
B. Naltrexone
C. Buprenorphine + Naloxone
D. Disulfiram
Correct answer: C. Buprenorphine + Naloxone
Rationale: Buprenorphine provides pain relief due to its partial agonist
activity, making it preferred when opioid use disorder co-occurs with chronic
pain. The naloxone component deters injection misuse.
Question 5: A patient is being initiated on buprenorphine/naloxone for opioid
use disorder. He last used heroin 6 hours ago and is mildly uncomfortable.
What is the most appropriate action?
, Page 3 of 35
A. Start Suboxone immediately
B. Delay buprenorphine until objective withdrawal is present to avoid
precipitated withdrawal
C. Give methadone first to transition to buprenorphine
D. Give naltrexone oral challenge today
Correct answer: B. Delay buprenorphine until objective withdrawal is
present to avoid precipitated withdrawal
Rationale: Buprenorphine has higher mu receptor affinity than full agonists
like heroin or oxycodone. When taken while a full agonist is still bound, it
displaces the full agonist, causing rapid-onset, severe withdrawal. Patients
must be in moderate withdrawal before induction.
Question 6: A patient on methadone maintenance asks why he has to go to a
special clinic daily. The NP responds that this is because methadone:
A. Is only effective when taken with food
B. Is restricted to federally licensed opioid treatment programs
C. Is more sedating than buprenorphine
D. Is approved only for inpatient use
Correct answer: B. Is restricted to federally licensed opioid treatment
programs
Rationale: Methadone is a long-acting full opioid agonist restricted to
federally licensed substance abuse treatment programs, whereas
buprenorphine can be prescribed in office-based outpatient settings.
Question 7: A patient on methadone maintenance develops QTc prolongation
on ECG. The PMHNP should:
A. Discontinue methadone immediately
B. Monitor QTc and consider dose reduction or switching to buprenorphine
C. Add an antiarrhythmic medication
D. Increase the methadone dose to achieve stability
Correct answer: B. Monitor QTc and consider dose reduction or switching
to buprenorphine
Rationale: Methadone can cause QTc prolongation, increasing the risk of
torsades de pointes. Monitoring the QTc and considering dose reduction or
switching to an alternative medication like buprenorphine is appropriate.
, Page 4 of 35
Question 8: What is the mechanism of action of buprenorphine?
A. Full mu-opioid receptor agonist
B. Mu-opioid receptor partial agonist
C. Mu-opioid receptor antagonist
D. Kappa-opioid receptor antagonist
Correct answer: B. Mu-opioid receptor partial agonist
Rationale: Buprenorphine acts on the mu-opioid receptors as a partial
agonist. Its partial agonist activity produces a ceiling effect, reducing
overdose risk compared to full agonists.
Question 9: What symptoms are characteristic of opioid intoxication? (Select
All That Apply)
A. Dilated pupils
B. Miosis (small pupils)
C. Respiratory depression
D. Tachycardia
E. Euphoria
Correct answer: B, C, E (Miosis, Respiratory depression, Euphoria)
Rationale: Opioid intoxication presents with miosis (pinpoint pupils),
respiratory depression, constipation, itching, euphoria, and sedation.
Tachycardia and dilated pupils are NOT characteristic; they occur in
withdrawal or stimulant intoxication.
Question 10: What symptoms are characteristic of opioid withdrawal? (Select
All That Apply)
A. Constricted pupils
B. Dilated pupils
C. Rhinorrhea and lacrimation
D. Bradycardia
E. Nausea, vomiting, diarrhea
Correct answer: B, C, E (Dilated pupils, Rhinorrhea and lacrimation,
Nausea, vomiting, diarrhea)
Rationale: Opioid withdrawal symptoms include dilated pupils, rhinorrhea,
lacrimation, yawning, piloerection, nausea/vomiting/diarrhea, tachycardia,
and hypertension.
