NSG 552 Exam 4 V1 | NSG 552
Psychopharmacology | Actual Q&A with Rationale
(NSG 552 Exam 4) | Wilkes
1. Which of the following describes the mechanism of action for Methylphenidate in the
treatment of ADHD?
A. It blocks the reuptake of dopamine and norepinephrine by inhibiting their transporters.
B. It causes the release of dopamine directly from the presynaptic vesicles.
C. It acts as a potent agonist at the Alpha-2A adrenergic receptor.
D. It inhibits Monoamine Oxidase Type B to increase synaptic catecholamines.
Correct Answer: A
Explanation: Methylphenidate works by binding to and blocking the dopamine
transporter (DAT) and norepinephrine transporter (NET). Unlike amphetamines, it does
not promote the release of stored dopamine but rather prevents its clearance from the
synapse. This mechanism helps to increase the tonic levels of these neurotransmitters in
the prefrontal cortex.
2. A patient with Alcohol Use Disorder is prescribed Acamprosate. Which laboratory value is
most critical to monitor for this patient?
A. Liver Function Tests (ALT/AST)
B. Thyroid Stimulating Hormone (TSH)
,C. Complete Blood Count (CBC)
D. Serum Creatinine and GFR
Correct Answer: D
Explanation: Acamprosate is primarily excreted unchanged by the kidneys and is
contraindicated in patients with severe renal impairment (CrCl < 30 mL/min). A dose
adjustment is required for patients with moderate renal impairment. Unlike Naltrexone or
Disulfiram, it does not undergo significant hepatic metabolism.
3. Which non-stimulant medication for ADHD is classified as a selective norepinephrine
reuptake inhibitor (SNRI)?
A. Guanfacine
B. Atomoxetine
C. Clonidine
D. Modafinil
Correct Answer: B
Explanation: Atomoxetine is a non-stimulant that specifically inhibits the reuptake of
norepinephrine. It has no significant affinity for other noradrenergic receptors or other
neurotransmitter transporters. It is considered a second-line treatment for ADHD,
especially when there is a concern for stimulant abuse.
, 4. What is the primary mechanism by which Varenicline assists in smoking cessation?
A. Full antagonism of the Alpha-4 Beta-2 nicotinic acetylcholine receptors.
B. Irreversible inhibition of monoamine oxidase.
C. Inhibition of the reuptake of dopamine and norepinephrine.
D. Partial agonism of the Alpha-4 Beta-2 nicotinic acetylcholine receptors.
Correct Answer: D
Explanation: Varenicline acts as a partial agonist at the Alpha-4 Beta-2 nicotinic
acetylcholine receptors, providing a lower level of dopamine release than nicotine. This
helps reduce withdrawal symptoms while simultaneously blocking the reinforcing effects
of nicotine if the patient smokes. It is highly effective but requires monitoring for
neuropsychiatric side effects.
5. Lisdexamfetamine (Vyvanse) is unique among stimulants because it:
A. Does not cause cardiovascular side effects like tachycardia.
B. Crosses the blood-brain barrier faster than other amphetamines.
C. Is not a controlled substance due to its low abuse potential.
D. Is a prodrug that requires enzymatic conversion in the blood.
Correct Answer: D
Explanation: Lisdexamfetamine is a prodrug where d-amphetamine is covalently bonded
to the amino acid l-lysine. It remains inactive until the lysine is cleaved off by enzymes in
Psychopharmacology | Actual Q&A with Rationale
(NSG 552 Exam 4) | Wilkes
1. Which of the following describes the mechanism of action for Methylphenidate in the
treatment of ADHD?
A. It blocks the reuptake of dopamine and norepinephrine by inhibiting their transporters.
B. It causes the release of dopamine directly from the presynaptic vesicles.
C. It acts as a potent agonist at the Alpha-2A adrenergic receptor.
D. It inhibits Monoamine Oxidase Type B to increase synaptic catecholamines.
Correct Answer: A
Explanation: Methylphenidate works by binding to and blocking the dopamine
transporter (DAT) and norepinephrine transporter (NET). Unlike amphetamines, it does
not promote the release of stored dopamine but rather prevents its clearance from the
synapse. This mechanism helps to increase the tonic levels of these neurotransmitters in
the prefrontal cortex.
2. A patient with Alcohol Use Disorder is prescribed Acamprosate. Which laboratory value is
most critical to monitor for this patient?
A. Liver Function Tests (ALT/AST)
B. Thyroid Stimulating Hormone (TSH)
,C. Complete Blood Count (CBC)
D. Serum Creatinine and GFR
Correct Answer: D
Explanation: Acamprosate is primarily excreted unchanged by the kidneys and is
contraindicated in patients with severe renal impairment (CrCl < 30 mL/min). A dose
adjustment is required for patients with moderate renal impairment. Unlike Naltrexone or
Disulfiram, it does not undergo significant hepatic metabolism.
3. Which non-stimulant medication for ADHD is classified as a selective norepinephrine
reuptake inhibitor (SNRI)?
A. Guanfacine
B. Atomoxetine
C. Clonidine
D. Modafinil
Correct Answer: B
Explanation: Atomoxetine is a non-stimulant that specifically inhibits the reuptake of
norepinephrine. It has no significant affinity for other noradrenergic receptors or other
neurotransmitter transporters. It is considered a second-line treatment for ADHD,
especially when there is a concern for stimulant abuse.
, 4. What is the primary mechanism by which Varenicline assists in smoking cessation?
A. Full antagonism of the Alpha-4 Beta-2 nicotinic acetylcholine receptors.
B. Irreversible inhibition of monoamine oxidase.
C. Inhibition of the reuptake of dopamine and norepinephrine.
D. Partial agonism of the Alpha-4 Beta-2 nicotinic acetylcholine receptors.
Correct Answer: D
Explanation: Varenicline acts as a partial agonist at the Alpha-4 Beta-2 nicotinic
acetylcholine receptors, providing a lower level of dopamine release than nicotine. This
helps reduce withdrawal symptoms while simultaneously blocking the reinforcing effects
of nicotine if the patient smokes. It is highly effective but requires monitoring for
neuropsychiatric side effects.
5. Lisdexamfetamine (Vyvanse) is unique among stimulants because it:
A. Does not cause cardiovascular side effects like tachycardia.
B. Crosses the blood-brain barrier faster than other amphetamines.
C. Is not a controlled substance due to its low abuse potential.
D. Is a prodrug that requires enzymatic conversion in the blood.
Correct Answer: D
Explanation: Lisdexamfetamine is a prodrug where d-amphetamine is covalently bonded
to the amino acid l-lysine. It remains inactive until the lysine is cleaved off by enzymes in
