NR 546 FINAL EXAM – ADVANCED
PSYCHOPHARMACOLOGY FOR THE
PMHNP QUESTIONS & ANSWERS
(CHAMBERLAIN) 100% GUARANTEE
PASS
1. A 32-year-old female patient diagnosed with schizophrenia is being started on Clozapine.
What is the absolute neutrophil count (ANC) threshold at which the medication must be
discontinued?
A. < 1,000/mm³
B. < 1,500/mm³
C. < 2,000/mm³
D. < 500/mm³
Answer: A
Conceptual Explanation: According to the Clozapine REMS program, the medication must
be interrupted if the ANC drops below 1,000/mm³ due to the risk of severe neutropenia
and agranulocytosis.
2. Which dopamine pathway is primarily responsible for the development of Extrapyramidal
Symptoms (EPS) when blocked by first-generation antipsychotics?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The Nigrostriatal pathway controls motor movements. Blockade
of D2 receptors in this pathway leads to EPS such as dystonia and parkinsonism.
3. Lithium levels can be significantly increased when co-administered with which of the
following drug classes?
A. Calcium Channel Blockers
B. NSAIDs (e.g., Ibuprofen)
C. Typical Antipsychotics
D. Stimulants
Answer: B
Conceptual Explanation: NSAIDs decrease renal blood flow and lithium clearance, which
can lead to toxic lithium levels. Acetaminophen is generally preferred for pain.
4. A patient taking Phenelzine (an MAOI) presents to the ER with a severe headache,
palpitations, and a BP of 210/120 mmHg after eating aged cheese. What is the most likely
diagnosis?
A. Serotonin Syndrome
, B. Pheochromocytoma
C. Neuroleptic Malignant Syndrome
D. Hypertensive Crisis
Answer: D
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Ingesting high-
tyramine foods like aged cheese causes a massive release of norepinephrine, leading to a
hypertensive crisis.
5. What is the mechanism of action of Atomoxetine (Strattera) in the treatment of ADHD?
A. Dopamine Reuptake Inhibition
B. GABA Potentiation
C. Alpha-2 Adrenergic Agonism
D. Selective Norepinephrine Reuptake Inhibition
Answer: D
Conceptual Explanation: Atomoxetine is a non-stimulant that works specifically by
inhibiting the presynaptic norepinephrine transporter (NET).
6. Which antidepressant has the longest half-life, requiring a 5-week washout period before
starting an MAOI?
A. Sertraline
B. Paroxetine
PSYCHOPHARMACOLOGY FOR THE
PMHNP QUESTIONS & ANSWERS
(CHAMBERLAIN) 100% GUARANTEE
PASS
1. A 32-year-old female patient diagnosed with schizophrenia is being started on Clozapine.
What is the absolute neutrophil count (ANC) threshold at which the medication must be
discontinued?
A. < 1,000/mm³
B. < 1,500/mm³
C. < 2,000/mm³
D. < 500/mm³
Answer: A
Conceptual Explanation: According to the Clozapine REMS program, the medication must
be interrupted if the ANC drops below 1,000/mm³ due to the risk of severe neutropenia
and agranulocytosis.
2. Which dopamine pathway is primarily responsible for the development of Extrapyramidal
Symptoms (EPS) when blocked by first-generation antipsychotics?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The Nigrostriatal pathway controls motor movements. Blockade
of D2 receptors in this pathway leads to EPS such as dystonia and parkinsonism.
3. Lithium levels can be significantly increased when co-administered with which of the
following drug classes?
A. Calcium Channel Blockers
B. NSAIDs (e.g., Ibuprofen)
C. Typical Antipsychotics
D. Stimulants
Answer: B
Conceptual Explanation: NSAIDs decrease renal blood flow and lithium clearance, which
can lead to toxic lithium levels. Acetaminophen is generally preferred for pain.
4. A patient taking Phenelzine (an MAOI) presents to the ER with a severe headache,
palpitations, and a BP of 210/120 mmHg after eating aged cheese. What is the most likely
diagnosis?
A. Serotonin Syndrome
, B. Pheochromocytoma
C. Neuroleptic Malignant Syndrome
D. Hypertensive Crisis
Answer: D
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Ingesting high-
tyramine foods like aged cheese causes a massive release of norepinephrine, leading to a
hypertensive crisis.
5. What is the mechanism of action of Atomoxetine (Strattera) in the treatment of ADHD?
A. Dopamine Reuptake Inhibition
B. GABA Potentiation
C. Alpha-2 Adrenergic Agonism
D. Selective Norepinephrine Reuptake Inhibition
Answer: D
Conceptual Explanation: Atomoxetine is a non-stimulant that works specifically by
inhibiting the presynaptic norepinephrine transporter (NET).
6. Which antidepressant has the longest half-life, requiring a 5-week washout period before
starting an MAOI?
A. Sertraline
B. Paroxetine
