NR 546 FINAL EXAM - ADVANCED
PSYCHOPHARMACOLOGY QUESTIONS
AND VERIFIED ANSWERS |GRADE A+|
JUST RELEASED CHAMBERLAIN
COLLEGE OF NURSING
1. A patient on Clozapine therapy presents with an Absolute Neutrophil Count (ANC) of
900/mm³. According to the Clozapine REMS program, what is the most appropriate clinical
action?
A. Continue treatment and recheck ANC in one week.
B. Increase the dose of Clozapine to boost white blood cell production.
C. Switch the patient to Olanzapine immediately without monitoring.
D. Interrupt treatment, notify the REMS registry, and monitor ANC daily until it exceeds
1000/mm³.
Answer: D
Conceptual Explanation: An ANC below 1000/mm³ is categorized as moderate to severe
neutropenia (depending on baseline), requiring treatment interruption and daily
monitoring to prevent agranulocytosis.
,2. Which dopamine pathway is associated with the development of Extrapyramidal
Symptoms (EPS) when D2 receptors are antagonized by typical antipsychotics?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The Nigrostriatal pathway controls motor function; D2 blockade
here leads to EPS, including dystonia and parkinsonism.
3. A patient taking Phenelzine (an MAOI) consumes a meal rich in tyramine. Which
hypertensive crisis mechanism is most likely to occur?
A. Direct activation of alpha-2 adrenergic receptors.
B. Excessive release of stored norepinephrine from presynaptic vesicles.
C. Inhibition of serotonin reuptake.
D. Rapid depletion of dopamine in the basal ganglia.
Answer: B
Conceptual Explanation: Tyramine displaces stored norepinephrine into the synapse, and
because MAO is inhibited, the norepinephrine is not degraded, causing massive
vasoconstriction.
, 4. Which mood stabilizer is most closely associated with a risk of Stevens-Johnson Syndrome
(SJS), particularly if titrated too rapidly?
A. Lithium
B. Valproic acid
C. Lamotrigine
D. Gabapentin
Answer: C
Conceptual Explanation: Lamotrigine carries a black box warning for SJS/TEN,
necessitating a very slow dose titration over several weeks.
5. In the treatment of Alzheimer’s disease, what is the primary mechanism of action of
Memantine?
A. Reversible acetylcholinesterase inhibition.
B. GABA-A receptor agonism.
C. 5-HT2A receptor antagonism.
D. Uncompetitive NMDA receptor antagonism.
Answer: D
Conceptual Explanation: Memantine regulates glutamate activity by binding to NMDA
receptors, preventing ‘noise’ from excessive glutamate release while allowing normal
signal transmission.
PSYCHOPHARMACOLOGY QUESTIONS
AND VERIFIED ANSWERS |GRADE A+|
JUST RELEASED CHAMBERLAIN
COLLEGE OF NURSING
1. A patient on Clozapine therapy presents with an Absolute Neutrophil Count (ANC) of
900/mm³. According to the Clozapine REMS program, what is the most appropriate clinical
action?
A. Continue treatment and recheck ANC in one week.
B. Increase the dose of Clozapine to boost white blood cell production.
C. Switch the patient to Olanzapine immediately without monitoring.
D. Interrupt treatment, notify the REMS registry, and monitor ANC daily until it exceeds
1000/mm³.
Answer: D
Conceptual Explanation: An ANC below 1000/mm³ is categorized as moderate to severe
neutropenia (depending on baseline), requiring treatment interruption and daily
monitoring to prevent agranulocytosis.
,2. Which dopamine pathway is associated with the development of Extrapyramidal
Symptoms (EPS) when D2 receptors are antagonized by typical antipsychotics?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The Nigrostriatal pathway controls motor function; D2 blockade
here leads to EPS, including dystonia and parkinsonism.
3. A patient taking Phenelzine (an MAOI) consumes a meal rich in tyramine. Which
hypertensive crisis mechanism is most likely to occur?
A. Direct activation of alpha-2 adrenergic receptors.
B. Excessive release of stored norepinephrine from presynaptic vesicles.
C. Inhibition of serotonin reuptake.
D. Rapid depletion of dopamine in the basal ganglia.
Answer: B
Conceptual Explanation: Tyramine displaces stored norepinephrine into the synapse, and
because MAO is inhibited, the norepinephrine is not degraded, causing massive
vasoconstriction.
, 4. Which mood stabilizer is most closely associated with a risk of Stevens-Johnson Syndrome
(SJS), particularly if titrated too rapidly?
A. Lithium
B. Valproic acid
C. Lamotrigine
D. Gabapentin
Answer: C
Conceptual Explanation: Lamotrigine carries a black box warning for SJS/TEN,
necessitating a very slow dose titration over several weeks.
5. In the treatment of Alzheimer’s disease, what is the primary mechanism of action of
Memantine?
A. Reversible acetylcholinesterase inhibition.
B. GABA-A receptor agonism.
C. 5-HT2A receptor antagonism.
D. Uncompetitive NMDA receptor antagonism.
Answer: D
Conceptual Explanation: Memantine regulates glutamate activity by binding to NMDA
receptors, preventing ‘noise’ from excessive glutamate release while allowing normal
signal transmission.
