NSG 552: EXAM 2
ADVANCED PSYCHOPHARMACOLY
COVERAGE : MODULES 4,5 & 6
2026/2027/2028 TESTING CYCLE
VERIFIED Q & A, WITH EXPERT RATIONALES
GUARANTEED PASS | GRADED A+
Q1: A patient on lithium is prescribed an NSAID for arthritis. Which effect should the nurse
anticipate?
A. Decreased lithium levels
B. No interaction
C. Increased lithium levels and toxicity
D. Decreased NSAID efficacy
Correct Answer: C
Rationale: NSAIDs reduce renal blood flow and lithium clearance by increasing proximal tubular
reabsorption, leading to toxic lithium accumulation. Acetaminophen is a safer alternative for
pain.
Q2: Which medication is FDA-approved for bipolar depression?
A. Fluoxetine monotherapy
B. Quetiapine
C. Sertraline monotherapy
D. Paroxetine monotherapy
Correct Answer: B
Rationale: Quetiapine (Seroquel) and lurasidone (Latuda) are FDA-approved for bipolar
depression. SSRI monotherapy is contraindicated due to the risk of inducing mania.
,Q3: A pregnant patient on lithium should be monitored for which fetal risk?
A. Neural tube defects
B. Ebstein's anomaly
C. Cleft palate
D. Limb defects
Correct Answer: B
Rationale: Lithium is associated with Ebstein's anomaly, a congenital heart defect. Beta-hCG
testing is mandatory before initiation in women of childbearing age.
Q4: Which medication is most likely to cause hypothyroidism?
A. Valproic acid
B. Lamotrigine
C. Lithium
D. Carbamazepine
Correct Answer: C
Rationale: Lithium can cause hypothyroidism by inhibiting thyroid hormone synthesis. TSH
monitoring is required at baseline and periodically during therapy.
Q5: A patient on carbamazepine reports fever, sore throat, and mouth ulcers. Which action
should the nurse take FIRST?
A. Administer an antibiotic
B. Obtain a CBC and notify the provider
C. Apply topical anesthetic
D. Encourage fluids
Correct Answer: B
Rationale: Fever, sore throat, and mouth ulcers may indicate aplastic anemia or agranulocytosis,
which are rare but serious adverse effects of carbamazepine. Immediate CBC and provider
notification are required.
Q6: A patient on valproic acid is prescribed lamotrigine. Which effect should the nurse
anticipate?
, A. Decreased lamotrigine levels
B. No interaction
C. Increased lamotrigine levels and SJS risk
D. Decreased valproic acid levels
Correct Answer: C
Rationale: Valproic acid inhibits lamotrigine metabolism, doubling lamotrigine levels and
increasing the risk of Stevens-Johnson Syndrome. Lamotrigine must be started at half the usual
dose when combined with valproate.
Q7: Which medication is first-line for PTSD?
A. Sertraline
B. Alprazolam
C. Clonazepam
D. Lorazepam
Correct Answer: A
Rationale: SSRIs like sertraline and paroxetine are first-line for PTSD. Benzodiazepines are
contraindicated because they interfere with trauma-focused therapy.
Q8: Which medication is used for PTSD-related nightmares?
A. Prazosin
B. Propranolol
C. Hydroxyzine
D. Buspirone
Correct Answer: A
Rationale: Prazosin, an alpha-1 adrenergic antagonist, is used to reduce PTSD-related
nightmares. It is not FDA-approved for PTSD but is used off-label.
Q9: How long does buspirone take to reach full therapeutic effect?
A. 1–2 days
B. 1–2 weeks
C. 2–4 weeks
D. 6–8 weeks
ADVANCED PSYCHOPHARMACOLY
COVERAGE : MODULES 4,5 & 6
2026/2027/2028 TESTING CYCLE
VERIFIED Q & A, WITH EXPERT RATIONALES
GUARANTEED PASS | GRADED A+
Q1: A patient on lithium is prescribed an NSAID for arthritis. Which effect should the nurse
anticipate?
A. Decreased lithium levels
B. No interaction
C. Increased lithium levels and toxicity
D. Decreased NSAID efficacy
Correct Answer: C
Rationale: NSAIDs reduce renal blood flow and lithium clearance by increasing proximal tubular
reabsorption, leading to toxic lithium accumulation. Acetaminophen is a safer alternative for
pain.
Q2: Which medication is FDA-approved for bipolar depression?
A. Fluoxetine monotherapy
B. Quetiapine
C. Sertraline monotherapy
D. Paroxetine monotherapy
Correct Answer: B
Rationale: Quetiapine (Seroquel) and lurasidone (Latuda) are FDA-approved for bipolar
depression. SSRI monotherapy is contraindicated due to the risk of inducing mania.
,Q3: A pregnant patient on lithium should be monitored for which fetal risk?
A. Neural tube defects
B. Ebstein's anomaly
C. Cleft palate
D. Limb defects
Correct Answer: B
Rationale: Lithium is associated with Ebstein's anomaly, a congenital heart defect. Beta-hCG
testing is mandatory before initiation in women of childbearing age.
Q4: Which medication is most likely to cause hypothyroidism?
A. Valproic acid
B. Lamotrigine
C. Lithium
D. Carbamazepine
Correct Answer: C
Rationale: Lithium can cause hypothyroidism by inhibiting thyroid hormone synthesis. TSH
monitoring is required at baseline and periodically during therapy.
Q5: A patient on carbamazepine reports fever, sore throat, and mouth ulcers. Which action
should the nurse take FIRST?
A. Administer an antibiotic
B. Obtain a CBC and notify the provider
C. Apply topical anesthetic
D. Encourage fluids
Correct Answer: B
Rationale: Fever, sore throat, and mouth ulcers may indicate aplastic anemia or agranulocytosis,
which are rare but serious adverse effects of carbamazepine. Immediate CBC and provider
notification are required.
Q6: A patient on valproic acid is prescribed lamotrigine. Which effect should the nurse
anticipate?
, A. Decreased lamotrigine levels
B. No interaction
C. Increased lamotrigine levels and SJS risk
D. Decreased valproic acid levels
Correct Answer: C
Rationale: Valproic acid inhibits lamotrigine metabolism, doubling lamotrigine levels and
increasing the risk of Stevens-Johnson Syndrome. Lamotrigine must be started at half the usual
dose when combined with valproate.
Q7: Which medication is first-line for PTSD?
A. Sertraline
B. Alprazolam
C. Clonazepam
D. Lorazepam
Correct Answer: A
Rationale: SSRIs like sertraline and paroxetine are first-line for PTSD. Benzodiazepines are
contraindicated because they interfere with trauma-focused therapy.
Q8: Which medication is used for PTSD-related nightmares?
A. Prazosin
B. Propranolol
C. Hydroxyzine
D. Buspirone
Correct Answer: A
Rationale: Prazosin, an alpha-1 adrenergic antagonist, is used to reduce PTSD-related
nightmares. It is not FDA-approved for PTSD but is used off-label.
Q9: How long does buspirone take to reach full therapeutic effect?
A. 1–2 days
B. 1–2 weeks
C. 2–4 weeks
D. 6–8 weeks
