NSG 552 Psychopharmacology Exam 4
2026/2027 Complete Test Bank: 300
Questions with Correct Answers, NGN Case
Scenarios & Detailed Rationales | Substance
Use, ADHD, Dementia & Advanced Practice
Study Guide | Guaranteed Pass
1. Which antipsychotic is most associated with agranulocytosis?
A) Haloperidol
B) Clozapine
C) Risperidone
D) Olanzapine
Answer: B
Rationale: Clozapine requires weekly ANC monitoring for 6 months due to risk of
agranulocytosis.
2. A patient on haloperidol develops a stiff neck and tongue protrusion.
Which medication should be given?
A) Benztropine
B) Benztropine or diphenhydramine
C) Propranolol
D) Lorazepam
,Answer: B
Rationale: Acute dystonia is treated with anticholinergic medications like
benztropine or diphenhydramine.
3. Which atypical antipsychotic has the highest risk of metabolic syndrome?
A) Ziprasidone
B) Olanzapine
C) Aripiprazole
D) Lurasidone
Answer: B
Rationale: Olanzapine is associated with significant weight gain, hyperglycemia,
and dyslipidemia.
4. A patient on lithium has a level of 2.0 mEq/L. Which finding is expected?
A) Fine hand tremor
B) Coarse tremor, vomiting, and confusion
C) Polyuria
D) Weight gain
Answer: B
Rationale: Lithium levels >1.5 mEq/L indicate toxicity with GI and neurologic
symptoms.
2
,5. Which laboratory test must be monitored for a patient on valproate?
A) CBC and LFTs
B) CBC, LFTs, and ammonia
C) Renal function
D) Thyroid function
Answer: B
Rationale: Valproate can cause hepatotoxicity, thrombocytopenia, and
hyperammonemia.
6. A patient on lamotrigine develops a rash. What is the priority action?
A) Apply hydrocortisone cream
B) Stop the medication and notify the provider immediately
C) Continue and monitor
D) Give diphenhydramine
Answer: B
Rationale: Lamotrigine can cause Stevens-Johnson syndrome; any rash requires
immediate discontinuation.
7. Which SSRI is most likely to cause sexual dysfunction?
A) Bupropion
B) Paroxetine
C) Mirtazapine
D) Trazodone
3
, Answer: B
Rationale: SSRIs like paroxetine commonly cause sexual side effects; bupropion
has lower risk.
8. A patient on fluoxetine reports feeling agitated and has hyperreflexia.
Which syndrome is suspected?
A) Neuroleptic malignant syndrome
B) Serotonin syndrome
C) Malignant hyperthermia
D) Anticholinergic toxicity
Answer: B
Rationale: Serotonin syndrome includes mental status changes, autonomic
instability, and neuromuscular hyperexcitability.
9. Which benzodiazepine has the longest half-life?
A) Lorazepam
B) Diazepam
C) Alprazolam
D) Midazolam
Answer: B
Rationale: Diazepam has a long half-life and active metabolites, allowing gradual
taper.
4
2026/2027 Complete Test Bank: 300
Questions with Correct Answers, NGN Case
Scenarios & Detailed Rationales | Substance
Use, ADHD, Dementia & Advanced Practice
Study Guide | Guaranteed Pass
1. Which antipsychotic is most associated with agranulocytosis?
A) Haloperidol
B) Clozapine
C) Risperidone
D) Olanzapine
Answer: B
Rationale: Clozapine requires weekly ANC monitoring for 6 months due to risk of
agranulocytosis.
2. A patient on haloperidol develops a stiff neck and tongue protrusion.
Which medication should be given?
A) Benztropine
B) Benztropine or diphenhydramine
C) Propranolol
D) Lorazepam
,Answer: B
Rationale: Acute dystonia is treated with anticholinergic medications like
benztropine or diphenhydramine.
3. Which atypical antipsychotic has the highest risk of metabolic syndrome?
A) Ziprasidone
B) Olanzapine
C) Aripiprazole
D) Lurasidone
Answer: B
Rationale: Olanzapine is associated with significant weight gain, hyperglycemia,
and dyslipidemia.
4. A patient on lithium has a level of 2.0 mEq/L. Which finding is expected?
A) Fine hand tremor
B) Coarse tremor, vomiting, and confusion
C) Polyuria
D) Weight gain
Answer: B
Rationale: Lithium levels >1.5 mEq/L indicate toxicity with GI and neurologic
symptoms.
2
,5. Which laboratory test must be monitored for a patient on valproate?
A) CBC and LFTs
B) CBC, LFTs, and ammonia
C) Renal function
D) Thyroid function
Answer: B
Rationale: Valproate can cause hepatotoxicity, thrombocytopenia, and
hyperammonemia.
6. A patient on lamotrigine develops a rash. What is the priority action?
A) Apply hydrocortisone cream
B) Stop the medication and notify the provider immediately
C) Continue and monitor
D) Give diphenhydramine
Answer: B
Rationale: Lamotrigine can cause Stevens-Johnson syndrome; any rash requires
immediate discontinuation.
7. Which SSRI is most likely to cause sexual dysfunction?
A) Bupropion
B) Paroxetine
C) Mirtazapine
D) Trazodone
3
, Answer: B
Rationale: SSRIs like paroxetine commonly cause sexual side effects; bupropion
has lower risk.
8. A patient on fluoxetine reports feeling agitated and has hyperreflexia.
Which syndrome is suspected?
A) Neuroleptic malignant syndrome
B) Serotonin syndrome
C) Malignant hyperthermia
D) Anticholinergic toxicity
Answer: B
Rationale: Serotonin syndrome includes mental status changes, autonomic
instability, and neuromuscular hyperexcitability.
9. Which benzodiazepine has the longest half-life?
A) Lorazepam
B) Diazepam
C) Alprazolam
D) Midazolam
Answer: B
Rationale: Diazepam has a long half-life and active metabolites, allowing gradual
taper.
4
