NR 546 Week 6 Exam V2 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
6 Exam) | Chamberlain University
1. A patient with Bipolar I Disorder is currently taking Lithium. Which of the following lab
values would most likely indicate Lithium toxicity?
A. Serum Lithium level of 0.8 mEq/L
B. Serum Lithium level of 1.8 mEq/L
C. Serum Lithium level of 1.2 mEq/L
D. Serum Lithium level of 0.4 mEq/L
Correct Answer: B
Explanation: A serum lithium level of 1.8 mEq/L is considered toxic as the therapeutic
range is generally 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L can lead to symptoms such as
tremors, ataxia, and confusion. Close monitoring of renal function and electrolytes is
essential to prevent such toxicity during treatment.
2. When prescribing Lamotrigine for a patient with Bipolar II Disorder, what is the most
important education point regarding the ‘Lamotrigine rash’?
A. The rash is a common side effect and usually disappears within two days.
B. Increasing the dose rapidly helps the skin acclimate to the drug.
,C. The rash only occurs if the medication is taken with food.
D. If a rash appears, the patient should stop the medication and seek immediate medical
attention.
Correct Answer: D
Explanation: The Lamotrigine rash can be a sign of Stevens-Johnson Syndrome (SJS),
which is a life-threatening medical emergency. Patients must be educated to discontinue
the medication at the first sign of any skin changes. Titration must be slow to minimize the
risk of developing this severe dermatological reaction.
3. A PMHNP is considering Valproate for a female patient of childbearing age. What is a
significant risk associated with this medication in this population?
A. Increased risk of osteoporosis
B. Permanent hair loss
C. Potential for Polycystic Ovary Syndrome (PCOS)
D. Hyperthyroidism
Correct Answer: C
Explanation: Valproate is associated with an increased risk of Polycystic Ovary Syndrome
(PCOS) in young women, characterized by weight gain and hormonal imbalances. It is also
a known teratogen, increasing the risk of neural tube defects in the fetus. Clinicians should
discuss effective contraception and alternative mood stabilizers with female patients of
reproductive age.
, 4. Which antipsychotic medication is known to have the highest risk for weight gain and
metabolic syndrome?
A. Aripiprazole
B. Olanzapine
C. Ziprasidone
D. Lurasidone
Correct Answer: B
Explanation: Olanzapine is notorious for causing significant weight gain and metabolic
disturbances, including dyslipidemia and hyperglycemia. It is categorized as a high-risk
medication for metabolic syndrome alongside Clozapine. Patients on this medication
require frequent monitoring of BMI, waist circumference, and fasting glucose.
5. Which dopamine pathway is responsible for the ‘positive symptoms’ of schizophrenia, such
as hallucinations and delusions?
A. Mesocortical pathway
B. Tuberoinfundibular pathway
C. Nigrostriatal pathway
D. Mesolimbic pathway
Correct Answer: D
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
6 Exam) | Chamberlain University
1. A patient with Bipolar I Disorder is currently taking Lithium. Which of the following lab
values would most likely indicate Lithium toxicity?
A. Serum Lithium level of 0.8 mEq/L
B. Serum Lithium level of 1.8 mEq/L
C. Serum Lithium level of 1.2 mEq/L
D. Serum Lithium level of 0.4 mEq/L
Correct Answer: B
Explanation: A serum lithium level of 1.8 mEq/L is considered toxic as the therapeutic
range is generally 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L can lead to symptoms such as
tremors, ataxia, and confusion. Close monitoring of renal function and electrolytes is
essential to prevent such toxicity during treatment.
2. When prescribing Lamotrigine for a patient with Bipolar II Disorder, what is the most
important education point regarding the ‘Lamotrigine rash’?
A. The rash is a common side effect and usually disappears within two days.
B. Increasing the dose rapidly helps the skin acclimate to the drug.
,C. The rash only occurs if the medication is taken with food.
D. If a rash appears, the patient should stop the medication and seek immediate medical
attention.
Correct Answer: D
Explanation: The Lamotrigine rash can be a sign of Stevens-Johnson Syndrome (SJS),
which is a life-threatening medical emergency. Patients must be educated to discontinue
the medication at the first sign of any skin changes. Titration must be slow to minimize the
risk of developing this severe dermatological reaction.
3. A PMHNP is considering Valproate for a female patient of childbearing age. What is a
significant risk associated with this medication in this population?
A. Increased risk of osteoporosis
B. Permanent hair loss
C. Potential for Polycystic Ovary Syndrome (PCOS)
D. Hyperthyroidism
Correct Answer: C
Explanation: Valproate is associated with an increased risk of Polycystic Ovary Syndrome
(PCOS) in young women, characterized by weight gain and hormonal imbalances. It is also
a known teratogen, increasing the risk of neural tube defects in the fetus. Clinicians should
discuss effective contraception and alternative mood stabilizers with female patients of
reproductive age.
, 4. Which antipsychotic medication is known to have the highest risk for weight gain and
metabolic syndrome?
A. Aripiprazole
B. Olanzapine
C. Ziprasidone
D. Lurasidone
Correct Answer: B
Explanation: Olanzapine is notorious for causing significant weight gain and metabolic
disturbances, including dyslipidemia and hyperglycemia. It is categorized as a high-risk
medication for metabolic syndrome alongside Clozapine. Patients on this medication
require frequent monitoring of BMI, waist circumference, and fasting glucose.
5. Which dopamine pathway is responsible for the ‘positive symptoms’ of schizophrenia, such
as hallucinations and delusions?
A. Mesocortical pathway
B. Tuberoinfundibular pathway
C. Nigrostriatal pathway
D. Mesolimbic pathway
Correct Answer: D
