NR 546 PSYCHOPHARMACOLOGY
EXAM 4 - ADVANCED PRACTICE
NURSING QUESTIONS & ANSWERS
(CHAMBERLAIN) 100% GUARANTEE
PASS
1. A patient taking Clozapine presents with a sudden onset of high fever, sore throat, and
mouth sores. What is the most critical diagnostic test to perform immediately?
A. Electrocardiogram (ECG)
B. Liver Function Tests (LFTs)
C. Complete Blood Count (CBC) with Absolute Neutrophil Count (ANC)
D. Fast Blood Glucose and HbA1c
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
sudden drop in ANC can lead to severe infections, manifested by fever and sore throat.
Monitoring ANC is mandatory for patients on Clozapine.
2. Which neurobiological pathway is primarily responsible for the development of
Extrapyramidal Symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
,B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The Nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway by antipsychotics leads to EPS and tardive dyskinesia.
3. A 24-year-old female patient is being treated for Bipolar Disorder with Lithium. Which of
the following sets of lab tests is most important for routine monitoring?
A. Lipid panel and Electrolytes
B. CBC, LFTs, and Amylase
C. Serum Cr/BUN, TSH, and Pregnancy test
D. Troponin and Vitamin B12
Answer: C
Conceptual Explanation: Lithium is renally excreted (requiring Cr/BUN monitoring), can
cause hypothyroidism (requiring TSH), and is teratogenic (Ebstein’s anomaly, requiring
pregnancy tests).
4. Which antidepressant is specifically contraindicated in patients with a history of seizures or
eating disorders?
A. Fluoxetine
, B. Bupropion
C. Sertraline
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion lowers the seizure threshold and has a significantly
higher risk of inducing seizures in patients with bulimia or anorexia nervosa due to
electrolyte imbalances.
5. A patient experiences ‘muscle rigidity, high fever, autonomic instability, and altered mental
status’ shortly after starting Haloperidol. What is the likely diagnosis?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin Syndrome
C. Anticholinergic Toxicity
D. Acute Dystonia
Answer: A
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by ‘lead-pipe’ rigidity, hyperthermia, and autonomic dysfunction. Serotonin
syndrome typically involves hyperreflexia rather than lead-pipe rigidity.
EXAM 4 - ADVANCED PRACTICE
NURSING QUESTIONS & ANSWERS
(CHAMBERLAIN) 100% GUARANTEE
PASS
1. A patient taking Clozapine presents with a sudden onset of high fever, sore throat, and
mouth sores. What is the most critical diagnostic test to perform immediately?
A. Electrocardiogram (ECG)
B. Liver Function Tests (LFTs)
C. Complete Blood Count (CBC) with Absolute Neutrophil Count (ANC)
D. Fast Blood Glucose and HbA1c
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
sudden drop in ANC can lead to severe infections, manifested by fever and sore throat.
Monitoring ANC is mandatory for patients on Clozapine.
2. Which neurobiological pathway is primarily responsible for the development of
Extrapyramidal Symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
,B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The Nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway by antipsychotics leads to EPS and tardive dyskinesia.
3. A 24-year-old female patient is being treated for Bipolar Disorder with Lithium. Which of
the following sets of lab tests is most important for routine monitoring?
A. Lipid panel and Electrolytes
B. CBC, LFTs, and Amylase
C. Serum Cr/BUN, TSH, and Pregnancy test
D. Troponin and Vitamin B12
Answer: C
Conceptual Explanation: Lithium is renally excreted (requiring Cr/BUN monitoring), can
cause hypothyroidism (requiring TSH), and is teratogenic (Ebstein’s anomaly, requiring
pregnancy tests).
4. Which antidepressant is specifically contraindicated in patients with a history of seizures or
eating disorders?
A. Fluoxetine
, B. Bupropion
C. Sertraline
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion lowers the seizure threshold and has a significantly
higher risk of inducing seizures in patients with bulimia or anorexia nervosa due to
electrolyte imbalances.
5. A patient experiences ‘muscle rigidity, high fever, autonomic instability, and altered mental
status’ shortly after starting Haloperidol. What is the likely diagnosis?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin Syndrome
C. Anticholinergic Toxicity
D. Acute Dystonia
Answer: A
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by ‘lead-pipe’ rigidity, hyperthermia, and autonomic dysfunction. Serotonin
syndrome typically involves hyperreflexia rather than lead-pipe rigidity.
