NR 546 Week 7 Exam V1 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
7 Exam) | Chamberlain University
1. What is the primary mechanism of action for Selective Serotonin Reuptake Inhibitors
(SSRIs)?
A. Inhibition of Monoamine Oxidase
B. Antagonism of the 5HT2A receptor
C. Potentiation of GABA-A receptors
D. Inhibition of the serotonin transporter (SERT)
Correct Answer: D
Explanation: SSRIs function by binding to the serotonin transporter (SERT), thereby
preventing the reuptake of serotonin into the presynaptic neuron. This action increases the
concentration of serotonin in the synaptic cleft, leading to enhanced neurotransmission.
Over several weeks, this process facilitates down-regulation of postsynaptic receptors and
clinical improvement of depressive symptoms.
2. Which laboratory monitoring is mandatory for a patient prescribed Clozapine?
A. Serum potassium levels
B. Thyroid Stimulating Hormone (TSH)
C. Absolute Neutrophil Count (ANC)
,D. Liver function tests (LFTs)
Correct Answer: C
Explanation: Clozapine is associated with a risk of life-threatening agranulocytosis,
requiring strict hematologic monitoring. The Absolute Neutrophil Count (ANC) must be
checked weekly during the first six months of therapy to ensure safety. Treatment must be
interrupted if the ANC falls below specific regulatory thresholds to prevent severe
infection.
3. A patient taking Lithium presents with coarse hand tremors, ataxia, and confusion. What is
the most likely serum lithium concentration?
A. 0.6 mEq/L
B. 0.8 mEq/L
C. 1.0 mEq/L
D. > 1.5 mEq/L
Correct Answer: D
Explanation: Lithium has a narrow therapeutic index, with toxic symptoms typically
appearing at levels above 1.5 mEq/L. Coarse tremors, ataxia, and mental status changes are
classic clinical indicators of lithium toxicity. The PMHNP must immediately order a serum
lithium level and instruct the patient to stop the medication.
, 4. Which antidepressant is strictly contraindicated in patients with a history of seizure
disorders?
A. Fluoxetine
B. Bupropion
C. Sertraline
D. Venlafaxine
Correct Answer: B
Explanation: Bupropion is known to lower the seizure threshold, particularly at higher
doses or in immediate-release formulations. It is contraindicated in patients with epilepsy
or those at high risk for seizures, such as individuals with eating disorders. The PMHNP
must screen for a history of bulimia or anorexia before initiating this medication.
5. What is the black box warning associated with all antidepressant medications in children
and young adults?
A. Risk of weight gain
B. Increased risk of suicidal ideation and behavior
C. Risk of cardiac arrhythmias
D. Risk of hepatotoxicity
Correct Answer: B
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
7 Exam) | Chamberlain University
1. What is the primary mechanism of action for Selective Serotonin Reuptake Inhibitors
(SSRIs)?
A. Inhibition of Monoamine Oxidase
B. Antagonism of the 5HT2A receptor
C. Potentiation of GABA-A receptors
D. Inhibition of the serotonin transporter (SERT)
Correct Answer: D
Explanation: SSRIs function by binding to the serotonin transporter (SERT), thereby
preventing the reuptake of serotonin into the presynaptic neuron. This action increases the
concentration of serotonin in the synaptic cleft, leading to enhanced neurotransmission.
Over several weeks, this process facilitates down-regulation of postsynaptic receptors and
clinical improvement of depressive symptoms.
2. Which laboratory monitoring is mandatory for a patient prescribed Clozapine?
A. Serum potassium levels
B. Thyroid Stimulating Hormone (TSH)
C. Absolute Neutrophil Count (ANC)
,D. Liver function tests (LFTs)
Correct Answer: C
Explanation: Clozapine is associated with a risk of life-threatening agranulocytosis,
requiring strict hematologic monitoring. The Absolute Neutrophil Count (ANC) must be
checked weekly during the first six months of therapy to ensure safety. Treatment must be
interrupted if the ANC falls below specific regulatory thresholds to prevent severe
infection.
3. A patient taking Lithium presents with coarse hand tremors, ataxia, and confusion. What is
the most likely serum lithium concentration?
A. 0.6 mEq/L
B. 0.8 mEq/L
C. 1.0 mEq/L
D. > 1.5 mEq/L
Correct Answer: D
Explanation: Lithium has a narrow therapeutic index, with toxic symptoms typically
appearing at levels above 1.5 mEq/L. Coarse tremors, ataxia, and mental status changes are
classic clinical indicators of lithium toxicity. The PMHNP must immediately order a serum
lithium level and instruct the patient to stop the medication.
, 4. Which antidepressant is strictly contraindicated in patients with a history of seizure
disorders?
A. Fluoxetine
B. Bupropion
C. Sertraline
D. Venlafaxine
Correct Answer: B
Explanation: Bupropion is known to lower the seizure threshold, particularly at higher
doses or in immediate-release formulations. It is contraindicated in patients with epilepsy
or those at high risk for seizures, such as individuals with eating disorders. The PMHNP
must screen for a history of bulimia or anorexia before initiating this medication.
5. What is the black box warning associated with all antidepressant medications in children
and young adults?
A. Risk of weight gain
B. Increased risk of suicidal ideation and behavior
C. Risk of cardiac arrhythmias
D. Risk of hepatotoxicity
Correct Answer: B
