NR 546 Week 6 Exam V3 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
6 Exam) | Chamberlain University
1. A 28-year-old female patient is being started on Lithium for Bipolar I Disorder. Which of the
following baseline laboratory tests is the most critical before initiating therapy?
A. Liver function tests (LFTs)
B. Serum creatinine and BUN
C. Amylase and lipase
D. Complete blood count (CBC) with differential
Correct Answer: B
Explanation: Lithium is excreted almost entirely by the kidneys, making renal function
assessment essential. Baseline serum creatinine and BUN help determine the patient’s
filtration capacity and set a reference for future monitoring. Long-term lithium use is
associated with a decrease in glomerular filtration rate and potential nephrogenic diabetes
insipidus.
2. When educating a patient about starting Lamotrigine (Lamictal), which instruction is most
vital to prevent serious adverse effects?
A. Take the medication with a high-fat meal to increase absorption.
B. Increase the dose every three days until the target dose is reached.
,C. Avoid drinking grapefruit juice while on this medication.
D. Report any new skin rash or mucosal sores immediately.
Correct Answer: D
Explanation: Lamotrigine carries a boxed warning for Stevens-Johnson Syndrome (SJS)
and Toxic Epidermal Necrolysis (TEN). Patients must be educated to stop the medication
and seek medical attention if a rash develops. Strict adherence to the slow titration
schedule is required to minimize the risk of these life-threatening dermatological reactions.
3. Which mood stabilizer is most strongly associated with the development of Polycystic
Ovary Syndrome (PCOS) in young female patients?
A. Lithium
B. Lamotrigine (Lamictal)
C. Oxcarbazepine (Trileptal)
D. Valproic Acid (Depakote)
Correct Answer: D
Explanation: Valproic Acid has been linked to an increased risk of PCOS, characterized by
hyperandrogenism and insulin resistance. This association is particularly concerning in
women under the age of 20 starting the medication. Monitoring for weight gain, menstrual
irregularities, and hirsutism is a standard part of clinical care for these patients.
, 4. A patient taking Carbamazepine (Tegretol) requires monitoring for which of the following
hematologic complications?
A. Iron deficiency anemia
B. Polycythemia vera
C. Hemophilia
D. Aplastic anemia and agranulocytosis
Correct Answer: D
Explanation: Carbamazepine is associated with rare but serious hematologic effects
including aplastic anemia and agranulocytosis. A baseline CBC should be obtained, and
periodic monitoring is recommended to detect early signs of bone marrow suppression.
Patients should be taught to report symptoms like fever, sore throat, or unusual bruising
immediately.
5. Which of the following describes the mechanism of action for Lithium?
A. Direct antagonism of D2 receptors in the mesolimbic pathway.
B. Selective inhibition of serotonin reuptake.
C. Inhibition of the enzyme inositol monophosphatase.
D. Irreversible binding to monoamine oxidase.
Correct Answer: C
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
6 Exam) | Chamberlain University
1. A 28-year-old female patient is being started on Lithium for Bipolar I Disorder. Which of the
following baseline laboratory tests is the most critical before initiating therapy?
A. Liver function tests (LFTs)
B. Serum creatinine and BUN
C. Amylase and lipase
D. Complete blood count (CBC) with differential
Correct Answer: B
Explanation: Lithium is excreted almost entirely by the kidneys, making renal function
assessment essential. Baseline serum creatinine and BUN help determine the patient’s
filtration capacity and set a reference for future monitoring. Long-term lithium use is
associated with a decrease in glomerular filtration rate and potential nephrogenic diabetes
insipidus.
2. When educating a patient about starting Lamotrigine (Lamictal), which instruction is most
vital to prevent serious adverse effects?
A. Take the medication with a high-fat meal to increase absorption.
B. Increase the dose every three days until the target dose is reached.
,C. Avoid drinking grapefruit juice while on this medication.
D. Report any new skin rash or mucosal sores immediately.
Correct Answer: D
Explanation: Lamotrigine carries a boxed warning for Stevens-Johnson Syndrome (SJS)
and Toxic Epidermal Necrolysis (TEN). Patients must be educated to stop the medication
and seek medical attention if a rash develops. Strict adherence to the slow titration
schedule is required to minimize the risk of these life-threatening dermatological reactions.
3. Which mood stabilizer is most strongly associated with the development of Polycystic
Ovary Syndrome (PCOS) in young female patients?
A. Lithium
B. Lamotrigine (Lamictal)
C. Oxcarbazepine (Trileptal)
D. Valproic Acid (Depakote)
Correct Answer: D
Explanation: Valproic Acid has been linked to an increased risk of PCOS, characterized by
hyperandrogenism and insulin resistance. This association is particularly concerning in
women under the age of 20 starting the medication. Monitoring for weight gain, menstrual
irregularities, and hirsutism is a standard part of clinical care for these patients.
, 4. A patient taking Carbamazepine (Tegretol) requires monitoring for which of the following
hematologic complications?
A. Iron deficiency anemia
B. Polycythemia vera
C. Hemophilia
D. Aplastic anemia and agranulocytosis
Correct Answer: D
Explanation: Carbamazepine is associated with rare but serious hematologic effects
including aplastic anemia and agranulocytosis. A baseline CBC should be obtained, and
periodic monitoring is recommended to detect early signs of bone marrow suppression.
Patients should be taught to report symptoms like fever, sore throat, or unusual bruising
immediately.
5. Which of the following describes the mechanism of action for Lithium?
A. Direct antagonism of D2 receptors in the mesolimbic pathway.
B. Selective inhibition of serotonin reuptake.
C. Inhibition of the enzyme inositol monophosphatase.
D. Irreversible binding to monoamine oxidase.
Correct Answer: C
