NR 546 Week 9 Exam V3 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
9 Exam) | Chamberlain University
1. A 75-year-old patient with Alzheimer’s disease is prescribed Donepezil (Aricept). What is
the primary mechanism of action for this medication?
A. NMDA receptor antagonism
B. Dopamine D2 receptor blockade
C. Reversible inhibition of acetylcholinesterase
D. Selective serotonin reuptake inhibition
Correct Answer: C
Explanation: Donepezil works by inhibiting the enzyme acetylcholinesterase, which is
responsible for breaking down acetylcholine in the synaptic cleft. By preventing this
breakdown, it increases the availability of acetylcholine for neurotransmission. This
mechanism is intended to improve cognitive function and slow the progression of
symptoms in patients with mild to moderate Alzheimer’s disease.
2. When prescribing stimulants for a child with ADHD, which of the following is a primary
concern regarding physical growth?
A. Increased bone density
B. Excessive muscle hypertrophy
,C. Suppression of height and weight gain
D. Precocious puberty
Correct Answer: C
Explanation: Stimulants such as methylphenidate and amphetamines are associated with a
potential reduction in growth velocity in pediatric patients. Clinicians must monitor height
and weight regularly throughout the duration of treatment to ensure the child stays within
their growth percentiles. Although the effect is often modest, ‘drug holidays’ are sometimes
utilized during summer breaks to allow for catch-up growth.
3. Which medication is FDA-approved for the treatment of irritability associated with Autism
Spectrum Disorder (ASD) in children aged 5 to 16?
A. Fluoxetine
B. Risperidone
C. Methylphenidate
D. Lithium
Correct Answer: B
Explanation: Risperidone was the first medication to receive FDA approval for the
treatment of irritability and aggression in children with Autism Spectrum Disorder. It is an
atypical antipsychotic that helps manage symptoms such as temper tantrums, self-injury,
and changing moods. Monitoring for metabolic side effects and prolactin elevation is
essential when using this medication in pediatric populations.
,4. A geriatric patient is being evaluated for insomnia. According to the Beers Criteria, which
class of medication should be avoided if possible?
A. Benzodiazepines
B. Melatonin agonists
C. Orexin receptor antagonists
D. Trazodone
Correct Answer: A
Explanation: Benzodiazepines are listed in the Beers Criteria as potentially inappropriate
for older adults due to an increased risk of cognitive impairment, delirium, and falls. The
aging process alters the metabolism and clearance of these drugs, leading to prolonged
half-lives and greater sensitivity. Non-pharmacological interventions or safer alternatives
like Ramelteon are preferred first-line treatments.
5. What is the primary mechanism of action of Memantine (Namenda) in the treatment of
moderate to severe Alzheimer’s disease?
A. Increasing serotonin in the synapse
B. Inhibition of MAO-B
C. NMDA receptor antagonism
D. Beta-amyloid plaque dissolution
Correct Answer: C
, Explanation: Memantine acts as an uncompetitive NMDA receptor antagonist by blocking
the effects of excessive glutamate. Chronic overexposure to glutamate is thought to lead to
excitotoxicity and neuronal cell death in dementia. By regulating glutamate activity,
Memantine helps protect neurons and may improve functional ability in later stages of the
disease.
6. Which of the following is a Black Box Warning for all SSRIs prescribed to children and
adolescents?
A. Increased risk of hepatotoxicity
B. Risk of agranulocytosis
C. Potential for Steven-Johnson Syndrome
D. Risk of suicidal ideation and behavior
Correct Answer: D
Explanation: In 2004, the FDA issued a black box warning for all antidepressant
medications regarding an increased risk of suicidal thinking and behavior in children,
adolescents, and young adults. This warning requires providers to closely monitor patients
during the first few months of treatment or following dose changes. It is vital to educate
families on recognizing signs of worsening depression or behavioral changes.
7. A patient with ADHD is prescribed Atomoxetine (Strattera). How does this medication
differ from methylphenidate?
A. It is a non-stimulant selective norepinephrine reuptake inhibitor
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
9 Exam) | Chamberlain University
1. A 75-year-old patient with Alzheimer’s disease is prescribed Donepezil (Aricept). What is
the primary mechanism of action for this medication?
A. NMDA receptor antagonism
B. Dopamine D2 receptor blockade
C. Reversible inhibition of acetylcholinesterase
D. Selective serotonin reuptake inhibition
Correct Answer: C
Explanation: Donepezil works by inhibiting the enzyme acetylcholinesterase, which is
responsible for breaking down acetylcholine in the synaptic cleft. By preventing this
breakdown, it increases the availability of acetylcholine for neurotransmission. This
mechanism is intended to improve cognitive function and slow the progression of
symptoms in patients with mild to moderate Alzheimer’s disease.
2. When prescribing stimulants for a child with ADHD, which of the following is a primary
concern regarding physical growth?
A. Increased bone density
B. Excessive muscle hypertrophy
,C. Suppression of height and weight gain
D. Precocious puberty
Correct Answer: C
Explanation: Stimulants such as methylphenidate and amphetamines are associated with a
potential reduction in growth velocity in pediatric patients. Clinicians must monitor height
and weight regularly throughout the duration of treatment to ensure the child stays within
their growth percentiles. Although the effect is often modest, ‘drug holidays’ are sometimes
utilized during summer breaks to allow for catch-up growth.
3. Which medication is FDA-approved for the treatment of irritability associated with Autism
Spectrum Disorder (ASD) in children aged 5 to 16?
A. Fluoxetine
B. Risperidone
C. Methylphenidate
D. Lithium
Correct Answer: B
Explanation: Risperidone was the first medication to receive FDA approval for the
treatment of irritability and aggression in children with Autism Spectrum Disorder. It is an
atypical antipsychotic that helps manage symptoms such as temper tantrums, self-injury,
and changing moods. Monitoring for metabolic side effects and prolactin elevation is
essential when using this medication in pediatric populations.
,4. A geriatric patient is being evaluated for insomnia. According to the Beers Criteria, which
class of medication should be avoided if possible?
A. Benzodiazepines
B. Melatonin agonists
C. Orexin receptor antagonists
D. Trazodone
Correct Answer: A
Explanation: Benzodiazepines are listed in the Beers Criteria as potentially inappropriate
for older adults due to an increased risk of cognitive impairment, delirium, and falls. The
aging process alters the metabolism and clearance of these drugs, leading to prolonged
half-lives and greater sensitivity. Non-pharmacological interventions or safer alternatives
like Ramelteon are preferred first-line treatments.
5. What is the primary mechanism of action of Memantine (Namenda) in the treatment of
moderate to severe Alzheimer’s disease?
A. Increasing serotonin in the synapse
B. Inhibition of MAO-B
C. NMDA receptor antagonism
D. Beta-amyloid plaque dissolution
Correct Answer: C
, Explanation: Memantine acts as an uncompetitive NMDA receptor antagonist by blocking
the effects of excessive glutamate. Chronic overexposure to glutamate is thought to lead to
excitotoxicity and neuronal cell death in dementia. By regulating glutamate activity,
Memantine helps protect neurons and may improve functional ability in later stages of the
disease.
6. Which of the following is a Black Box Warning for all SSRIs prescribed to children and
adolescents?
A. Increased risk of hepatotoxicity
B. Risk of agranulocytosis
C. Potential for Steven-Johnson Syndrome
D. Risk of suicidal ideation and behavior
Correct Answer: D
Explanation: In 2004, the FDA issued a black box warning for all antidepressant
medications regarding an increased risk of suicidal thinking and behavior in children,
adolescents, and young adults. This warning requires providers to closely monitor patients
during the first few months of treatment or following dose changes. It is vital to educate
families on recognizing signs of worsening depression or behavioral changes.
7. A patient with ADHD is prescribed Atomoxetine (Strattera). How does this medication
differ from methylphenidate?
A. It is a non-stimulant selective norepinephrine reuptake inhibitor
