NU 643 Exam 3 V1 | NU 643 Advanced
Psychopharmacology | Actual Q&A with Rationale
(NU643 Exam 3) | Regis University
1. Which of the following is the therapeutic serum level range for Lithium in the maintenance
phase of treating Bipolar Disorder?
A. 0.6 - 1.2 mEq/L
B. 0.4 - 0.8 mEq/L
C. 1.0 - 1.5 mEq/L
D. 1.5 - 2.0 mEq/L
Correct Answer: A
Explanation: The standard therapeutic range for lithium maintenance is generally
accepted as 0.6 to 1.2 mEq/L to balance efficacy and safety. Levels below this range
increase the risk of relapse, while levels above 1.5 mEq/L significantly increase the risk of
toxicity. Clinicians must monitor renal function and thyroid levels regularly during
treatment.
2. When initiating Lamotrigine, what is the most critical monitoring parameter to prevent life-
threatening adverse reactions?
A. Serum drug levels
B. White blood cell count
,C. Liver function tests
D. Skin assessment for rash
Correct Answer: D
Explanation: Lamotrigine carries a black box warning for Stevens-Johnson Syndrome and
Toxic Epidermal Necrolysis, making skin assessment the priority. The risk is minimized by
a slow titration schedule, which must be strictly followed by the patient. Any sign of a new
rash should be reported immediately and typically requires discontinuation of the
medication.
3. A patient taking Valproic Acid (Depakote) for Bipolar I disorder reports feeling excessively
fatigued and notes a yellowing of the sclera. Which laboratory test is the highest priority?
A. Liver Function Tests (LFTs)
B. Complete Blood Count
C. Amylase and Lipase
D. Serum Valproate level
Correct Answer: A
Explanation: Valproic Acid is associated with a risk of hepatotoxicity, particularly in the
first six months of treatment. Symptoms like jaundice and fatigue are clinical indicators of
potential liver failure or dysfunction. Monitoring LFTs is essential for early detection of
drug-induced liver injury.
, 4. Which antipsychotic medication is most likely to cause significant weight gain and
metabolic syndrome?
A. Olanzapine
B. Aripiprazole
C. Ziprasidone
D. Lurasidone
Correct Answer: A
Explanation: Olanzapine and Clozapine are the second-generation antipsychotics
associated with the highest risk of weight gain and metabolic disturbances. Patients on
these medications require regular monitoring of BMI, waist circumference, fasting glucose,
and lipid profiles. Other agents like Aripiprazole and Ziprasidone are considered more
metabolic-neutral.
5. In the treatment of Schizophrenia, which dopamine pathway is primarily targeted to
reduce positive symptoms?
A. Tuberoinfundibular pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Mesolimbic pathway
Correct Answer: D
Psychopharmacology | Actual Q&A with Rationale
(NU643 Exam 3) | Regis University
1. Which of the following is the therapeutic serum level range for Lithium in the maintenance
phase of treating Bipolar Disorder?
A. 0.6 - 1.2 mEq/L
B. 0.4 - 0.8 mEq/L
C. 1.0 - 1.5 mEq/L
D. 1.5 - 2.0 mEq/L
Correct Answer: A
Explanation: The standard therapeutic range for lithium maintenance is generally
accepted as 0.6 to 1.2 mEq/L to balance efficacy and safety. Levels below this range
increase the risk of relapse, while levels above 1.5 mEq/L significantly increase the risk of
toxicity. Clinicians must monitor renal function and thyroid levels regularly during
treatment.
2. When initiating Lamotrigine, what is the most critical monitoring parameter to prevent life-
threatening adverse reactions?
A. Serum drug levels
B. White blood cell count
,C. Liver function tests
D. Skin assessment for rash
Correct Answer: D
Explanation: Lamotrigine carries a black box warning for Stevens-Johnson Syndrome and
Toxic Epidermal Necrolysis, making skin assessment the priority. The risk is minimized by
a slow titration schedule, which must be strictly followed by the patient. Any sign of a new
rash should be reported immediately and typically requires discontinuation of the
medication.
3. A patient taking Valproic Acid (Depakote) for Bipolar I disorder reports feeling excessively
fatigued and notes a yellowing of the sclera. Which laboratory test is the highest priority?
A. Liver Function Tests (LFTs)
B. Complete Blood Count
C. Amylase and Lipase
D. Serum Valproate level
Correct Answer: A
Explanation: Valproic Acid is associated with a risk of hepatotoxicity, particularly in the
first six months of treatment. Symptoms like jaundice and fatigue are clinical indicators of
potential liver failure or dysfunction. Monitoring LFTs is essential for early detection of
drug-induced liver injury.
, 4. Which antipsychotic medication is most likely to cause significant weight gain and
metabolic syndrome?
A. Olanzapine
B. Aripiprazole
C. Ziprasidone
D. Lurasidone
Correct Answer: A
Explanation: Olanzapine and Clozapine are the second-generation antipsychotics
associated with the highest risk of weight gain and metabolic disturbances. Patients on
these medications require regular monitoring of BMI, waist circumference, fasting glucose,
and lipid profiles. Other agents like Aripiprazole and Ziprasidone are considered more
metabolic-neutral.
5. In the treatment of Schizophrenia, which dopamine pathway is primarily targeted to
reduce positive symptoms?
A. Tuberoinfundibular pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Mesolimbic pathway
Correct Answer: D
