NU 150 Exam 2 | NU 150 Pharmacology |
Questions and Answers with Rationales
2026/2027 Update
QUESTION 1
Which class of antidepressant medications requires strict dietary restrictions
regarding tyramine-containing foods to prevent a hypertensive crisis?
A. Selective serotonin reuptake inhibitors
B. Tricyclic antidepressants
C. Monoamine oxidase inhibitors
D. Atypical antidepressants
ANSWER: C
RATIONALE: Monoamine oxidase inhibitors inhibit the breakdown of tyramine in
the gut. Accumulation of dietary tyramine triggers massive norepinephrine
release, leading to a severe hypertensive crisis.
QUESTION 2
What is the primary mechanism of action of lithium carbonate when used in the
management of bipolar affective disorder?
A. Inhibiting monoamine oxidase irreversibly in the synaptic cleft
B. Altering sodium transport across cell membranes and influencing
catecholamine neurotransmission
C. Blocking dopamine receptors exclusively in the mesolimbic pathway
D. Potentiating GABA-mediated chloride ion influx in the spinal cord
ANSWER: B
,RATIONALE: Lithium alters sodium ion transport across cell membranes in nerve
and muscle cells and modulates the release and reuptake of norepinephrine and
serotonin, stabilizing mood in bipolar disorder.
QUESTION 3
Which laboratory parameter must be monitored regularly due to the narrow
therapeutic index of lithium therapy?
A. Serum lithium levels, thyroid-stimulating hormone, and renal function tests
B. Complete blood count and absolute neutrophil count weekly
C. Serum amylase and lipase levels biweekly
D. Prothrombin time and international normalized ratio
ANSWER: A
RATIONALE: Lithium has a narrow therapeutic range (0.6 to 1.2 mEq/L). Because it
is cleared entirely by the kidneys and can cause hypothyroidism and nephrogenic
diabetes insipidus, routine monitoring of lithium levels, thyroid function, and
kidney function is mandatory.
QUESTION 4
What is the primary mechanism of action of typical antipsychotic medications
(such as haloperidol)?
A. Blockade of central dopamine D2 receptors in the brain
B. Reuptake inhibition of serotonin and norepinephrine
C. Stimulation of gamma-aminobutyric acid receptors
D. Inhibition of acetylcholinesterase in cortical synapses
ANSWER: A
RATIONALE: Typical antipsychotics exert their therapeutic effect primarily by
blocking dopamine D2 receptors in the brain, which reduces positive symptoms of
schizophrenia but can lead to extrapyramidal side effects.
QUESTION 5
,Which extrapyramidal adverse effect involves involuntary, rhythmic movements
of the tongue, face, mouth, and jaw resulting from long-term antipsychotic
therapy?
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Pseudoparkinsonism
ANSWER: C
RATIONALE: Tardive dyskinesia is a late-onset, potentially irreversible
extrapyramidal syndrome characterized by involuntary choreoathetoid
movements of the face, tongue, mouth, and extremities caused by chronic
dopamine receptor blockade.
QUESTION 6
What is the immediate pharmacological treatment for acute dystonic reactions
characterized by severe muscle spasms of the neck, jaw, and back?
A. Administration of an anticholinergic agent such as benztropine or
diphenhydramine
B. Administration of oral lithium carbonate
C. Immediate increase in the dose of the antipsychotic drug
D. Intravenous administration of a beta-blocker
ANSWER: A
RATIONALE: Acute dystonic reactions result from an imbalance between
dopamine blockade and relative cholinergic excess in the basal ganglia.
Anticholinergic drugs like benztropine or diphenhydramine rapidly restore this
balance and relieve spasms.
QUESTION 7
, Which life-threatening adverse reaction to antipsychotic drugs presents with
extreme hyperthermia, severe muscle rigidity, autonomic instability, and altered
mental status?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant hyperthermia
D. Cholinergic crisis
ANSWER: B
RATIONALE: Neuroleptic malignant syndrome is a rare, life-threatening reaction
to antipsychotic medications marked by extreme hyperthermia (lead-pipe muscle
rigidity), labile blood pressure, tachycardia, and altered consciousness.
QUESTION 8
What is the primary mechanism of action of selective serotonin reuptake
inhibitors (such as fluoxetine)?
A. Selectively blocking the reuptake of serotonin into presynaptic nerve terminals,
increasing its concentration in the synaptic cleft
B. Irreversibly inhibiting monoamine oxidase enzymes
C. Blocking postsynaptic dopamine receptors directly
D. Stimulating central norepinephrine synthesis
ANSWER: A
RATIONALE: Selective serotonin reuptake inhibitors selectively block the reuptake
transporter for serotonin, prolonging the presence of serotonin in the synaptic
cleft to enhance neurotransmission and alleviate depression.
QUESTION 9
Which serious syndrome can occur when selective serotonin reuptake inhibitors
are combined with monoamine oxidase inhibitors or other serotonergic drugs?
A. Serotonin syndrome
Questions and Answers with Rationales
2026/2027 Update
QUESTION 1
Which class of antidepressant medications requires strict dietary restrictions
regarding tyramine-containing foods to prevent a hypertensive crisis?
A. Selective serotonin reuptake inhibitors
B. Tricyclic antidepressants
C. Monoamine oxidase inhibitors
D. Atypical antidepressants
ANSWER: C
RATIONALE: Monoamine oxidase inhibitors inhibit the breakdown of tyramine in
the gut. Accumulation of dietary tyramine triggers massive norepinephrine
release, leading to a severe hypertensive crisis.
QUESTION 2
What is the primary mechanism of action of lithium carbonate when used in the
management of bipolar affective disorder?
A. Inhibiting monoamine oxidase irreversibly in the synaptic cleft
B. Altering sodium transport across cell membranes and influencing
catecholamine neurotransmission
C. Blocking dopamine receptors exclusively in the mesolimbic pathway
D. Potentiating GABA-mediated chloride ion influx in the spinal cord
ANSWER: B
,RATIONALE: Lithium alters sodium ion transport across cell membranes in nerve
and muscle cells and modulates the release and reuptake of norepinephrine and
serotonin, stabilizing mood in bipolar disorder.
QUESTION 3
Which laboratory parameter must be monitored regularly due to the narrow
therapeutic index of lithium therapy?
A. Serum lithium levels, thyroid-stimulating hormone, and renal function tests
B. Complete blood count and absolute neutrophil count weekly
C. Serum amylase and lipase levels biweekly
D. Prothrombin time and international normalized ratio
ANSWER: A
RATIONALE: Lithium has a narrow therapeutic range (0.6 to 1.2 mEq/L). Because it
is cleared entirely by the kidneys and can cause hypothyroidism and nephrogenic
diabetes insipidus, routine monitoring of lithium levels, thyroid function, and
kidney function is mandatory.
QUESTION 4
What is the primary mechanism of action of typical antipsychotic medications
(such as haloperidol)?
A. Blockade of central dopamine D2 receptors in the brain
B. Reuptake inhibition of serotonin and norepinephrine
C. Stimulation of gamma-aminobutyric acid receptors
D. Inhibition of acetylcholinesterase in cortical synapses
ANSWER: A
RATIONALE: Typical antipsychotics exert their therapeutic effect primarily by
blocking dopamine D2 receptors in the brain, which reduces positive symptoms of
schizophrenia but can lead to extrapyramidal side effects.
QUESTION 5
,Which extrapyramidal adverse effect involves involuntary, rhythmic movements
of the tongue, face, mouth, and jaw resulting from long-term antipsychotic
therapy?
A. Acute dystonia
B. Akathisia
C. Tardive dyskinesia
D. Pseudoparkinsonism
ANSWER: C
RATIONALE: Tardive dyskinesia is a late-onset, potentially irreversible
extrapyramidal syndrome characterized by involuntary choreoathetoid
movements of the face, tongue, mouth, and extremities caused by chronic
dopamine receptor blockade.
QUESTION 6
What is the immediate pharmacological treatment for acute dystonic reactions
characterized by severe muscle spasms of the neck, jaw, and back?
A. Administration of an anticholinergic agent such as benztropine or
diphenhydramine
B. Administration of oral lithium carbonate
C. Immediate increase in the dose of the antipsychotic drug
D. Intravenous administration of a beta-blocker
ANSWER: A
RATIONALE: Acute dystonic reactions result from an imbalance between
dopamine blockade and relative cholinergic excess in the basal ganglia.
Anticholinergic drugs like benztropine or diphenhydramine rapidly restore this
balance and relieve spasms.
QUESTION 7
, Which life-threatening adverse reaction to antipsychotic drugs presents with
extreme hyperthermia, severe muscle rigidity, autonomic instability, and altered
mental status?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Malignant hyperthermia
D. Cholinergic crisis
ANSWER: B
RATIONALE: Neuroleptic malignant syndrome is a rare, life-threatening reaction
to antipsychotic medications marked by extreme hyperthermia (lead-pipe muscle
rigidity), labile blood pressure, tachycardia, and altered consciousness.
QUESTION 8
What is the primary mechanism of action of selective serotonin reuptake
inhibitors (such as fluoxetine)?
A. Selectively blocking the reuptake of serotonin into presynaptic nerve terminals,
increasing its concentration in the synaptic cleft
B. Irreversibly inhibiting monoamine oxidase enzymes
C. Blocking postsynaptic dopamine receptors directly
D. Stimulating central norepinephrine synthesis
ANSWER: A
RATIONALE: Selective serotonin reuptake inhibitors selectively block the reuptake
transporter for serotonin, prolonging the presence of serotonin in the synaptic
cleft to enhance neurotransmission and alleviate depression.
QUESTION 9
Which serious syndrome can occur when selective serotonin reuptake inhibitors
are combined with monoamine oxidase inhibitors or other serotonergic drugs?
A. Serotonin syndrome
