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 has a serum level of 3.5 mEq/L and is unresponsive. Which intervention
is required?
A. Activated charcoal
B. Hemodialysis
C. Sodium bicarbonate
D. Flumazenil
Correct Answer: B
Rationale: Severe lithium toxicity (level >2.5 mEq/L with severe symptoms) requires
hemodialysis. Lithium is a small molecule that is effectively removed by dialysis.
Q2: Which medication is FDA-approved for acute mania?
A. Lamotrigine
B. Aripiprazole
C. Fluoxetine
D. Buspirone
Correct Answer: B
Rationale: Aripiprazole (Abilify) is FDA-approved for acute mania and maintenance of bipolar
disorder. Lamotrigine is for maintenance, not acute mania.
,Q3: A patient on valproic acid is planning to become pregnant. Which fetal risk should the nurse
discuss?
A. Ebstein's anomaly
B. Neural tube defects (spina bifida)
C. Cleft palate
D. Limb defects
Correct Answer: B
Rationale: Valproic acid is associated with neural tube defects, particularly spina bifida. Folic
acid supplementation and alternative medications should be discussed.
Q4: Which medication is approved for bipolar depression?
A. Olanzapine-fluoxetine combination
B. Haloperidol
C. Clonazepam
D. Atomoxetine
Correct Answer: A
Rationale: Olanzapine-fluoxetine combination (Symbyax) is FDA-approved for bipolar
depression. It combines an atypical antipsychotic with an SSRI.
Q5: A patient on carbamazepine is prescribed oral contraceptives. Which effect should the nurse
anticipate?
A. Increased contraceptive efficacy
B. Decreased carbamazepine levels
C. Decreased contraceptive efficacy
D. No interaction
Correct Answer: C
Rationale: Carbamazepine is a potent CYP3A4 inducer that accelerates the metabolism of oral
contraceptives, decreasing their efficacy. Alternative contraception should be recommended.
Q6: Which medication requires a gradual taper to prevent withdrawal seizures?
, A. Lithium
B. Carbamazepine
C. Fluoxetine
D. Buspirone
Correct Answer: B
Rationale: Carbamazepine requires a gradual taper to prevent withdrawal seizures. Abrupt
discontinuation can also cause rebound mania.
Q7: Which medication is first-line for panic disorder?
A. Alprazolam
B. Sertraline
C. Clonazepam
D. Hydroxyzine
Correct Answer: B
Rationale: SSRIs like sertraline are first-line for panic disorder. Benzodiazepines may be used
short-term but are not first-line due to dependence risk.
Q8: Which medication is first-line for social anxiety disorder?
A. Paroxetine
B. Alprazolam
C. Lorazepam
D. Propranolol
Correct Answer: A
Rationale: Paroxetine and sertraline are FDA-approved for social anxiety disorder. Beta-blockers
like propranolol are used for performance anxiety, not generalized social anxiety.
Q9: How do SSRI doses for OCD compare to doses for depression?
A. OCD requires lower doses.
B. OCD requires higher doses.
C. Doses are identical.
D. OCD does not respond to SSRIs.
Correct Answer: B
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 has a serum level of 3.5 mEq/L and is unresponsive. Which intervention
is required?
A. Activated charcoal
B. Hemodialysis
C. Sodium bicarbonate
D. Flumazenil
Correct Answer: B
Rationale: Severe lithium toxicity (level >2.5 mEq/L with severe symptoms) requires
hemodialysis. Lithium is a small molecule that is effectively removed by dialysis.
Q2: Which medication is FDA-approved for acute mania?
A. Lamotrigine
B. Aripiprazole
C. Fluoxetine
D. Buspirone
Correct Answer: B
Rationale: Aripiprazole (Abilify) is FDA-approved for acute mania and maintenance of bipolar
disorder. Lamotrigine is for maintenance, not acute mania.
,Q3: A patient on valproic acid is planning to become pregnant. Which fetal risk should the nurse
discuss?
A. Ebstein's anomaly
B. Neural tube defects (spina bifida)
C. Cleft palate
D. Limb defects
Correct Answer: B
Rationale: Valproic acid is associated with neural tube defects, particularly spina bifida. Folic
acid supplementation and alternative medications should be discussed.
Q4: Which medication is approved for bipolar depression?
A. Olanzapine-fluoxetine combination
B. Haloperidol
C. Clonazepam
D. Atomoxetine
Correct Answer: A
Rationale: Olanzapine-fluoxetine combination (Symbyax) is FDA-approved for bipolar
depression. It combines an atypical antipsychotic with an SSRI.
Q5: A patient on carbamazepine is prescribed oral contraceptives. Which effect should the nurse
anticipate?
A. Increased contraceptive efficacy
B. Decreased carbamazepine levels
C. Decreased contraceptive efficacy
D. No interaction
Correct Answer: C
Rationale: Carbamazepine is a potent CYP3A4 inducer that accelerates the metabolism of oral
contraceptives, decreasing their efficacy. Alternative contraception should be recommended.
Q6: Which medication requires a gradual taper to prevent withdrawal seizures?
, A. Lithium
B. Carbamazepine
C. Fluoxetine
D. Buspirone
Correct Answer: B
Rationale: Carbamazepine requires a gradual taper to prevent withdrawal seizures. Abrupt
discontinuation can also cause rebound mania.
Q7: Which medication is first-line for panic disorder?
A. Alprazolam
B. Sertraline
C. Clonazepam
D. Hydroxyzine
Correct Answer: B
Rationale: SSRIs like sertraline are first-line for panic disorder. Benzodiazepines may be used
short-term but are not first-line due to dependence risk.
Q8: Which medication is first-line for social anxiety disorder?
A. Paroxetine
B. Alprazolam
C. Lorazepam
D. Propranolol
Correct Answer: A
Rationale: Paroxetine and sertraline are FDA-approved for social anxiety disorder. Beta-blockers
like propranolol are used for performance anxiety, not generalized social anxiety.
Q9: How do SSRI doses for OCD compare to doses for depression?
A. OCD requires lower doses.
B. OCD requires higher doses.
C. Doses are identical.
D. OCD does not respond to SSRIs.
Correct Answer: B
