NSG 526 EXAM 3 - ADVANCED
PSYCHOPHARMACOLOGY AND
THERAPEUTIC MODALITIES
QUESTIONS WITH VERIFIED ANSWERS
2026/2027
1. A 28-year-old female patient diagnosed with bipolar I disorder is started on Lithium. Which
of the following lab values would be most concerning prior to initiation?
A. Creatinine of 2.1 mg/dL
B. Serum sodium of 140 mEq/L
C. White blood cell count of 9,000/mm3
D. Potassium of 4.0 mEq/L
Answer: A
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys. A creatinine
of 2.1 indicates significant renal impairment, which increases the risk of lithium toxicity.
2. Which neuroanatomical pathway is primarily associated with the negative symptoms of
schizophrenia and is hypothesized to have low dopamine activity?
A. Mesolimbic pathway
B. Mesocortical pathway
,C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The mesocortical pathway is associated with cognitive and
negative symptoms (like withdrawal and flat affect) due to dopamine deficiency.
3. A patient taking Phenelzine (Nardil) attends a party and consumes aged cheeses and red
wine. Which physiological response is most likely to occur?
A. Hypotensive crisis
B. Hypertensive crisis
C. Serotonin syndrome
D. Metabolic syndrome
Answer: B
Conceptual Explanation: MAOIs like Phenelzine inhibit the breakdown of tyramine.
Ingesting tyramine-rich foods causes a massive release of norepinephrine, leading to a
hypertensive crisis.
4. Which atypical antipsychotic has the highest risk for causing agranulocytosis and requires
mandatory ANC monitoring?
A. Risperidone
B. Olanzapine
, C. Clozapine
D. Quetiapine
Answer: C
Conceptual Explanation: Clozapine is associated with a risk of life-threatening
agranulocytosis. The Absolute Neutrophil Count (ANC) must be monitored regularly to
continue treatment.
5. In the context of Dialectical Behavior Therapy (DBT), the concept of ‘Wise Mind’ refers to
the integration of which two states of mind?
A. Conscious mind and Subconscious mind
B. Child mind and Adult mind
C. Rational mind and Emotional mind
D. External mind and Internal mind
Answer: C
Conceptual Explanation: Wise Mind is the synthesis of the Reasonable (Rational) Mind
and the Emotional Mind, allowing for balanced decision-making and mindfulness.
6. A patient presents with a fever of 104°F, ‘lead-pipe’ muscle rigidity, and autonomic
instability after starting Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
PSYCHOPHARMACOLOGY AND
THERAPEUTIC MODALITIES
QUESTIONS WITH VERIFIED ANSWERS
2026/2027
1. A 28-year-old female patient diagnosed with bipolar I disorder is started on Lithium. Which
of the following lab values would be most concerning prior to initiation?
A. Creatinine of 2.1 mg/dL
B. Serum sodium of 140 mEq/L
C. White blood cell count of 9,000/mm3
D. Potassium of 4.0 mEq/L
Answer: A
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys. A creatinine
of 2.1 indicates significant renal impairment, which increases the risk of lithium toxicity.
2. Which neuroanatomical pathway is primarily associated with the negative symptoms of
schizophrenia and is hypothesized to have low dopamine activity?
A. Mesolimbic pathway
B. Mesocortical pathway
,C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The mesocortical pathway is associated with cognitive and
negative symptoms (like withdrawal and flat affect) due to dopamine deficiency.
3. A patient taking Phenelzine (Nardil) attends a party and consumes aged cheeses and red
wine. Which physiological response is most likely to occur?
A. Hypotensive crisis
B. Hypertensive crisis
C. Serotonin syndrome
D. Metabolic syndrome
Answer: B
Conceptual Explanation: MAOIs like Phenelzine inhibit the breakdown of tyramine.
Ingesting tyramine-rich foods causes a massive release of norepinephrine, leading to a
hypertensive crisis.
4. Which atypical antipsychotic has the highest risk for causing agranulocytosis and requires
mandatory ANC monitoring?
A. Risperidone
B. Olanzapine
, C. Clozapine
D. Quetiapine
Answer: C
Conceptual Explanation: Clozapine is associated with a risk of life-threatening
agranulocytosis. The Absolute Neutrophil Count (ANC) must be monitored regularly to
continue treatment.
5. In the context of Dialectical Behavior Therapy (DBT), the concept of ‘Wise Mind’ refers to
the integration of which two states of mind?
A. Conscious mind and Subconscious mind
B. Child mind and Adult mind
C. Rational mind and Emotional mind
D. External mind and Internal mind
Answer: C
Conceptual Explanation: Wise Mind is the synthesis of the Reasonable (Rational) Mind
and the Emotional Mind, allowing for balanced decision-making and mindfulness.
6. A patient presents with a fever of 104°F, ‘lead-pipe’ muscle rigidity, and autonomic
instability after starting Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
