NSG 526 ADVANCED
PSYCHOPHARMACOLOGY EXAM
REVIEW QUESTIONS WITH VERIFIED
ANSWERS 2026/2027
1. A patient taking Clozapine presents with a fever, sore throat, and mouth sores. What is the
most critical laboratory value to assess immediately?
A. Liver Function Tests (LFTs)
B. Absolute Neutrophil Count (ANC)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: B
Conceptual Explanation: Clozapine carries a Black Box Warning for agranulocytosis.
Fever and sore throat are signs of infection due to low white blood cell counts, specifically
neutrophils.
2. Which neurotransmitter is primarily implicated in the Reward Pathway and the
development of substance use disorders?
A. Serotonin
B. Dopamine
,C. Norepinephrine
D. GABA
Answer: B
Conceptual Explanation: Dopamine release in the Nucleus Accumbens via the mesolimbic
pathway is the primary mechanism associated with the reinforcing properties of addictive
substances.
3. A patient on Lithium therapy presents with coarse hand tremors, ataxia, and confusion.
The Lithium level is 2.2 mEq/L. What is the priority intervention?
A. Administer the next dose as scheduled
B. Increase fluid intake and monitor
C. Hold the dose and prepare for possible hemodialysis
D. Switch the patient to Valproate
Answer: C
Conceptual Explanation: A lithium level of 2.2 mEq/L indicates moderate to severe
toxicity. Management includes stopping the drug, hydrating, and potentially using
hemodialysis for levels over 2.5 mEq/L or severe symptoms.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Bupropion
, B. Sertraline
C. Fluoxetine
D. Mirtazapine
Answer: A
Conceptual Explanation: Bupropion lowers the seizure threshold, especially in patients
with electrolyte imbalances common in Bulimia or Anorexia Nervosa.
5. What is the primary mechanism of action of typical (first-generation) antipsychotics?
A. D2 receptor antagonism
B. 5-HT2A receptor antagonism
C. NMDA receptor agonism
D. GABA modulation
Answer: A
Conceptual Explanation: Typical antipsychotics primarily block D2 receptors in the
mesolimbic pathway to treat positive symptoms, but also block D2 in the nigrostriatal
pathway causing EPS.
6. Which medication is an FDA-approved non-stimulant for the treatment of ADHD?
A. Lisdexamfetamine
B. Methylphenidate
PSYCHOPHARMACOLOGY EXAM
REVIEW QUESTIONS WITH VERIFIED
ANSWERS 2026/2027
1. A patient taking Clozapine presents with a fever, sore throat, and mouth sores. What is the
most critical laboratory value to assess immediately?
A. Liver Function Tests (LFTs)
B. Absolute Neutrophil Count (ANC)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: B
Conceptual Explanation: Clozapine carries a Black Box Warning for agranulocytosis.
Fever and sore throat are signs of infection due to low white blood cell counts, specifically
neutrophils.
2. Which neurotransmitter is primarily implicated in the Reward Pathway and the
development of substance use disorders?
A. Serotonin
B. Dopamine
,C. Norepinephrine
D. GABA
Answer: B
Conceptual Explanation: Dopamine release in the Nucleus Accumbens via the mesolimbic
pathway is the primary mechanism associated with the reinforcing properties of addictive
substances.
3. A patient on Lithium therapy presents with coarse hand tremors, ataxia, and confusion.
The Lithium level is 2.2 mEq/L. What is the priority intervention?
A. Administer the next dose as scheduled
B. Increase fluid intake and monitor
C. Hold the dose and prepare for possible hemodialysis
D. Switch the patient to Valproate
Answer: C
Conceptual Explanation: A lithium level of 2.2 mEq/L indicates moderate to severe
toxicity. Management includes stopping the drug, hydrating, and potentially using
hemodialysis for levels over 2.5 mEq/L or severe symptoms.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Bupropion
, B. Sertraline
C. Fluoxetine
D. Mirtazapine
Answer: A
Conceptual Explanation: Bupropion lowers the seizure threshold, especially in patients
with electrolyte imbalances common in Bulimia or Anorexia Nervosa.
5. What is the primary mechanism of action of typical (first-generation) antipsychotics?
A. D2 receptor antagonism
B. 5-HT2A receptor antagonism
C. NMDA receptor agonism
D. GABA modulation
Answer: A
Conceptual Explanation: Typical antipsychotics primarily block D2 receptors in the
mesolimbic pathway to treat positive symptoms, but also block D2 in the nigrostriatal
pathway causing EPS.
6. Which medication is an FDA-approved non-stimulant for the treatment of ADHD?
A. Lisdexamfetamine
B. Methylphenidate
