ADVANCED PHARMACOLOGY FINAL -
PRACTICE QUIZ QUESTIONS
Escitalopram4may4cause4serious,4potentially4fatal4reactions4when4used4with4__________
_____.4(select4all4that4apply)4-4ans--Duloxetine,4amitriptilyne,4sertraline,4St.4John's4Wort4
Mixing4two4serotonin4agents4can4cause4serotonin4syndrome.
The4therapeutic4effects4of4imipramine4develop4over4_____________.4-4ans--
Several4weeks
The4FDA-approved4indications4for4fluoxetine4include:4(select4all4that4apply)4-4ans--
Obsessive4compulsive4disorder,4major4depressive4disorder,4bulimia4nervosa
Taking4food4with4buspirone4alters4absorption.4-4ans--False
May4be4taken4with4food4to4minimize4gastric4irritation
Venlafaxine4is4extensively4metabolized4on4first4pass4through4the4___________.4-4ans--
Liver
Signs4and4symptoms4of4lithium4toxicity4include:4(select4all4that4apply)4-4ans--
Slurred4speech,4drowsiness
Valproate4acid4has4FDA-approved4indications4for:4(select4all4that4apply)4-4ans--
Acute4mania,4simple4and4complex4absence4seizures,4prevention4of4migraine4headaches
Atomoxetine4selectively4____________4the4presynaptic4reuptake4of4norepinephrine4resu
lting4in4a(n)4________________4attention4span.4-4ans--Inhibits,4improved
Phenelzine4does4not4need4to4be4discontinued4several4days4before4elective4surgery4that4r
equires4anesthesia.4-4ans--False
Bupropion4can4be4used4for4smoking4cessation.4-4ans--True
Methylphenidate4is4not4effective4for4narcoleptic4patients.4-4ans--False
Clozapine4may4cause:4(select4all4that4apply)4-4ans--
Syncope,4orthostatic4hypotension,4cardiac4arrest4
,Causes4bradycardia4which4could4lead4to4syncope4and4cardiac4arrest
Administering4risperidone4with4levodopa4is4contraindicated.4-4ans--True4
It4decreases4the4effects4of4levodopa
The4___________4form4of4ziprasidone4is4frequently4used4for4control4of4acutely4agitated4p
atients.4-4ans--Intramuscular4(IM)
Anticonvulsants4are4frequently4used4as4mood4stabilizers4for4the4treatment4of4mania4and4
bipolar4spectrum4disorders4because4they:4-4ans--Reduce4synaptic4kindling
A4patient4was4started4on4fluoxetine4for4depression434days4ago.4She4now4complains4that4i
t4"doesn't4help"4and4refuses4to4take4it.4Understanding4the4psychopharmacology,4the4nurs
e's4best4first4action4is4to:4-4ans--
Discuss4with4the4patient4that4these4types4of4medications4often4take4several4weeks4before
4seeing4the4results.
Which4of4the4following4is4a4common4side4effect4of4both4first-4and4second-
generation4antipsychotic4drugs?4(select4all4that4apply)4-4ans--
Extrapyramidal4side4effects4such4as4pseudo-
parkinsonism4or4acute4dystonia,4neuroleptic4malignant4syndrome,4excessive4sedation
A4male4patient4who4is4taking4the4second-
generation4antipsychotic4reports4to4the4nurse4that4he4has4observed4a4clear4fluid4leaking4f
rom4his4right4nipple4for4the4past4month.4The4nurse's4best4initial4intervention4is:4-4ans--
Inform4the4patient4that4this4could4be4a4side4effect4of4the4medication
The4physician4discusses4the4appropriateness4of4prescribing4a4serotonin/
norepinephrine4reuptake4inhibitor4(SNRI)4for4a4patient.4Which4of4the4following4medication
s4are4in4this4category?4-4ans--Venlafaxine4and4duloxetine
A4patient4has4been4prescribed4a4selective4serotonin4reuptake4inhibitor4(SSRI)4for4depres
sion.4The4nurse4should4counsel4the4patient4about4which4of4the4following4possible4side4eff
ects,4among4others?4-4ans--Fever,4sweating,4agitation,4rapid4heartbeat
A4nurse4counsels4a4patient4who4has4been4prescribed4a4monoamine4oxidase4inhibitor4(M
AOI)4to4treat4depression4to4avoid4foods4containing4tyramine.4Which4of4the4following4food
s4should4the4patient4avoid?4(select4all4that4apply)4-4ans--Yogurt,4tofu,4pepperoni
A4patient4with4severe4kidney4disease4is4started4on4lithium4by4a4new4resident.4As4the4nurs
e4on4duty4your4best4initial4response4would4be4to:4-4ans--
Contact4the4resident4to4remind4him4that4the4client4has4kidney4disease4and4lithium4is4contr
aindicated
,Which4of4the4following4is4generally4true4of4medications4used4to4treat4anxiety4disorders?4-
4ans--
Just4as4with4depression,4the4most4common4medications4prescribed4are4serotonin4reupta
ke4inhibitors4(SSRIs)4and4selective4norepinephrine4reuptake4inhibitors4(SNRIs).
For4which4one4of4the4following4types4of4drugs4is4the4consumption4of4grapefruit4juice4contr
aindicated?4-4ans--Second-generation4antipsychotics
Psychopharmaceutical4agents4are4prescribed4for4individuals4with4substance4use4disorde
rs4for4all4of4the4following4reasons4except:4-4ans--
To4elevate4the4patient's4mood4in4a4manner4comparable4to4the4action4of4the4misused4sub
stance
A4patient4has4been4prescribed4disulfiram.4The4nurse4would4most4appropriately4counsel4t
he4patient4about4which4of4the4following?4-4ans--A4toxic4reaction4if4alcohol4is4consumed
When4a4patient4is4prescribed4risperidone4for4schizoaffective4disorder,4the4nurse4must4ale
rt4the4patient4to4the4potential4for4neuroleptic4malignant4syndrome.4Which4of4the4following4
would4be4accurate4information4to4give4the4patient?4-4ans--
Neuroleptic4malignant4syndrome4is4potentially4fatal.4It4usually4occurs4during4the4first424w
eeks4after4starting4an4antipsychotic4drug4or4increasing4the4dose4and4is4characterized4by4
high4fever,4muscle4stiffness,4paranoia,4sweating,4and4large4changes4in4blood4pressure.
A4client4with4depression4is4taking4phenelzine.4The4nurse4advises4the4client4to4avoid4cons
uming4which4foods4while4taking4the4medication4-4ans--Yogurt
Methylphenidate4is4a4CNS4stimulant4and4is4the4drug4of4choice4for4individuals4with4attenti
on-deficit/
hyperactivity4disorder4(ADHD).4The4desired4effects4of4methylphenidate4may4be4noted4as:
4-4ans--Increased4attention4span4and4concentration
The4risk4of4experiencing4serotonin4syndrome4when4selective4serotonin4reuptake4inhibitor
s4(SSRIs)4are4given4with4monoamine4oxidase4inhibitors4(MAOIs)4such4as4phenelzine.4Se
rotonin4syndrome4is4best4characterized4in4which4of4the4following?4-4ans--
Muscle4rigidity4and4high4fever
A419-year-
old4female4client4with4depression4who4has4been4taking4amitriptyline4for4three4weeks4retur
ns4to4the4clinic4for4a4follow-
up.4The4nurse4anticipates4the4possibility4of4observing4which4of4the4following4symptoms?
4-4ans--Suicidal4thoughts
A4newly4admitted4client4has4started4taking4bupropion.4The4nurse4understands4which4of4t
he4following4side4effects4that4would4indicate4an4overdose4of4the4medication?4-4ans--
Seizure
, A4client4taking4lithium4carbonate4started4complaining4of4nausea,4vomiting,4diarrhea,4drow
siness,4muscle4weakness,4tremor,4blurred4vision4and4ringing4in4the4ears.4The4lithium4ser
um4level4is424mEq/L.4The4nurse4interprets4this4value4as:4-4ans--Toxic4level
Which4of4the4following4symptoms4is4a4sign4of4mild4lithium4toxicity:4-4ans--
Course4tremor4and4lethargy
A4nurse4notes4that4a4client4with4schizophrenia4and4receiving4an4antipsychotic4medication
4is4having4uncontrolled4movement4of4the4lips4and4tongue.4The4nurse4determines4that4the4
client4is4experiencing?4-4ans--Tardive4dyskinesia
A4client4with4schizophrenia4has4been4started4on4medication4therapy4with4clozapine.4A4nu
rse4assesses4the4results4of4which4laboratory4study4to4monitor4for4adverse4effect4related4t
o4this4medication?4-4ans--White4blood4cell
Methylphenidate4is4prescribed4to4an48-year-old4child4for4the4treatment4of4attention-
deficit/
hyperactivity4disorder4(ADHD).4The4nurse4plans4to4monitor4which4of4the4following4during4
the4medication4therapy?4-4ans--Height4and4weight4
Can4cause4slow4growth4and4reduced4appetite
A4client4who4has4been4taking4buspirone4for4two4months4returns4to4the4clinic4for4a4follow-
up.4The4nurse4determines4that4the4medication4is4effective4if4there4is4an4absent4display4of.
..4-4ans--Feelings4of4panic,4fear,4and4uneasiness
Your4patient4is4taking4the4antipsychotic4medications4clozapine4and4divalproex4sodium4(D
epakote),4both4of4which4can4contribute4to4weight4gain.4For4what4should4this4patient4be4ca
refully4monitored?4-4ans--Increased4blood4glucose
Nurse4Trini4knows4that4the4following4drugs4have4been4known4to4be4effective4in4treating4o
bsessive-compulsive4disorder4(OCD):4-4ans--Fluvoxamine4and4clomipramine
A4patient4diagnosed4with4schizophrenia4has4taken4thiothixene454mg/
day4for444years4with4good4symptom4control.4Today,4the4patient4is4admitted4with4paranoia4
and4auditory4hallucinations.4The4nurse4should4determine4if4the4patient's4symptoms4are4r
elated4to:4-4ans--Not4taking4the4drug4as4prescribed
When4a4patient4is4taking4a4traditional4antipsychotic4medication,4the4nurse4should4assess4
carefully4for4extrapyramidal4side4effects4(EPSEs)4particularly:4-4ans--Akathisia
Nortriptyline4was4prescribed4for4a468-year-
old4patient4diagnosed4with4depression4and4insomnia.4Benefits4specific4to4use4of4nortriptyl
ine4would4include:4-4ans--Improved4sleep4pattern
PRACTICE QUIZ QUESTIONS
Escitalopram4may4cause4serious,4potentially4fatal4reactions4when4used4with4__________
_____.4(select4all4that4apply)4-4ans--Duloxetine,4amitriptilyne,4sertraline,4St.4John's4Wort4
Mixing4two4serotonin4agents4can4cause4serotonin4syndrome.
The4therapeutic4effects4of4imipramine4develop4over4_____________.4-4ans--
Several4weeks
The4FDA-approved4indications4for4fluoxetine4include:4(select4all4that4apply)4-4ans--
Obsessive4compulsive4disorder,4major4depressive4disorder,4bulimia4nervosa
Taking4food4with4buspirone4alters4absorption.4-4ans--False
May4be4taken4with4food4to4minimize4gastric4irritation
Venlafaxine4is4extensively4metabolized4on4first4pass4through4the4___________.4-4ans--
Liver
Signs4and4symptoms4of4lithium4toxicity4include:4(select4all4that4apply)4-4ans--
Slurred4speech,4drowsiness
Valproate4acid4has4FDA-approved4indications4for:4(select4all4that4apply)4-4ans--
Acute4mania,4simple4and4complex4absence4seizures,4prevention4of4migraine4headaches
Atomoxetine4selectively4____________4the4presynaptic4reuptake4of4norepinephrine4resu
lting4in4a(n)4________________4attention4span.4-4ans--Inhibits,4improved
Phenelzine4does4not4need4to4be4discontinued4several4days4before4elective4surgery4that4r
equires4anesthesia.4-4ans--False
Bupropion4can4be4used4for4smoking4cessation.4-4ans--True
Methylphenidate4is4not4effective4for4narcoleptic4patients.4-4ans--False
Clozapine4may4cause:4(select4all4that4apply)4-4ans--
Syncope,4orthostatic4hypotension,4cardiac4arrest4
,Causes4bradycardia4which4could4lead4to4syncope4and4cardiac4arrest
Administering4risperidone4with4levodopa4is4contraindicated.4-4ans--True4
It4decreases4the4effects4of4levodopa
The4___________4form4of4ziprasidone4is4frequently4used4for4control4of4acutely4agitated4p
atients.4-4ans--Intramuscular4(IM)
Anticonvulsants4are4frequently4used4as4mood4stabilizers4for4the4treatment4of4mania4and4
bipolar4spectrum4disorders4because4they:4-4ans--Reduce4synaptic4kindling
A4patient4was4started4on4fluoxetine4for4depression434days4ago.4She4now4complains4that4i
t4"doesn't4help"4and4refuses4to4take4it.4Understanding4the4psychopharmacology,4the4nurs
e's4best4first4action4is4to:4-4ans--
Discuss4with4the4patient4that4these4types4of4medications4often4take4several4weeks4before
4seeing4the4results.
Which4of4the4following4is4a4common4side4effect4of4both4first-4and4second-
generation4antipsychotic4drugs?4(select4all4that4apply)4-4ans--
Extrapyramidal4side4effects4such4as4pseudo-
parkinsonism4or4acute4dystonia,4neuroleptic4malignant4syndrome,4excessive4sedation
A4male4patient4who4is4taking4the4second-
generation4antipsychotic4reports4to4the4nurse4that4he4has4observed4a4clear4fluid4leaking4f
rom4his4right4nipple4for4the4past4month.4The4nurse's4best4initial4intervention4is:4-4ans--
Inform4the4patient4that4this4could4be4a4side4effect4of4the4medication
The4physician4discusses4the4appropriateness4of4prescribing4a4serotonin/
norepinephrine4reuptake4inhibitor4(SNRI)4for4a4patient.4Which4of4the4following4medication
s4are4in4this4category?4-4ans--Venlafaxine4and4duloxetine
A4patient4has4been4prescribed4a4selective4serotonin4reuptake4inhibitor4(SSRI)4for4depres
sion.4The4nurse4should4counsel4the4patient4about4which4of4the4following4possible4side4eff
ects,4among4others?4-4ans--Fever,4sweating,4agitation,4rapid4heartbeat
A4nurse4counsels4a4patient4who4has4been4prescribed4a4monoamine4oxidase4inhibitor4(M
AOI)4to4treat4depression4to4avoid4foods4containing4tyramine.4Which4of4the4following4food
s4should4the4patient4avoid?4(select4all4that4apply)4-4ans--Yogurt,4tofu,4pepperoni
A4patient4with4severe4kidney4disease4is4started4on4lithium4by4a4new4resident.4As4the4nurs
e4on4duty4your4best4initial4response4would4be4to:4-4ans--
Contact4the4resident4to4remind4him4that4the4client4has4kidney4disease4and4lithium4is4contr
aindicated
,Which4of4the4following4is4generally4true4of4medications4used4to4treat4anxiety4disorders?4-
4ans--
Just4as4with4depression,4the4most4common4medications4prescribed4are4serotonin4reupta
ke4inhibitors4(SSRIs)4and4selective4norepinephrine4reuptake4inhibitors4(SNRIs).
For4which4one4of4the4following4types4of4drugs4is4the4consumption4of4grapefruit4juice4contr
aindicated?4-4ans--Second-generation4antipsychotics
Psychopharmaceutical4agents4are4prescribed4for4individuals4with4substance4use4disorde
rs4for4all4of4the4following4reasons4except:4-4ans--
To4elevate4the4patient's4mood4in4a4manner4comparable4to4the4action4of4the4misused4sub
stance
A4patient4has4been4prescribed4disulfiram.4The4nurse4would4most4appropriately4counsel4t
he4patient4about4which4of4the4following?4-4ans--A4toxic4reaction4if4alcohol4is4consumed
When4a4patient4is4prescribed4risperidone4for4schizoaffective4disorder,4the4nurse4must4ale
rt4the4patient4to4the4potential4for4neuroleptic4malignant4syndrome.4Which4of4the4following4
would4be4accurate4information4to4give4the4patient?4-4ans--
Neuroleptic4malignant4syndrome4is4potentially4fatal.4It4usually4occurs4during4the4first424w
eeks4after4starting4an4antipsychotic4drug4or4increasing4the4dose4and4is4characterized4by4
high4fever,4muscle4stiffness,4paranoia,4sweating,4and4large4changes4in4blood4pressure.
A4client4with4depression4is4taking4phenelzine.4The4nurse4advises4the4client4to4avoid4cons
uming4which4foods4while4taking4the4medication4-4ans--Yogurt
Methylphenidate4is4a4CNS4stimulant4and4is4the4drug4of4choice4for4individuals4with4attenti
on-deficit/
hyperactivity4disorder4(ADHD).4The4desired4effects4of4methylphenidate4may4be4noted4as:
4-4ans--Increased4attention4span4and4concentration
The4risk4of4experiencing4serotonin4syndrome4when4selective4serotonin4reuptake4inhibitor
s4(SSRIs)4are4given4with4monoamine4oxidase4inhibitors4(MAOIs)4such4as4phenelzine.4Se
rotonin4syndrome4is4best4characterized4in4which4of4the4following?4-4ans--
Muscle4rigidity4and4high4fever
A419-year-
old4female4client4with4depression4who4has4been4taking4amitriptyline4for4three4weeks4retur
ns4to4the4clinic4for4a4follow-
up.4The4nurse4anticipates4the4possibility4of4observing4which4of4the4following4symptoms?
4-4ans--Suicidal4thoughts
A4newly4admitted4client4has4started4taking4bupropion.4The4nurse4understands4which4of4t
he4following4side4effects4that4would4indicate4an4overdose4of4the4medication?4-4ans--
Seizure
, A4client4taking4lithium4carbonate4started4complaining4of4nausea,4vomiting,4diarrhea,4drow
siness,4muscle4weakness,4tremor,4blurred4vision4and4ringing4in4the4ears.4The4lithium4ser
um4level4is424mEq/L.4The4nurse4interprets4this4value4as:4-4ans--Toxic4level
Which4of4the4following4symptoms4is4a4sign4of4mild4lithium4toxicity:4-4ans--
Course4tremor4and4lethargy
A4nurse4notes4that4a4client4with4schizophrenia4and4receiving4an4antipsychotic4medication
4is4having4uncontrolled4movement4of4the4lips4and4tongue.4The4nurse4determines4that4the4
client4is4experiencing?4-4ans--Tardive4dyskinesia
A4client4with4schizophrenia4has4been4started4on4medication4therapy4with4clozapine.4A4nu
rse4assesses4the4results4of4which4laboratory4study4to4monitor4for4adverse4effect4related4t
o4this4medication?4-4ans--White4blood4cell
Methylphenidate4is4prescribed4to4an48-year-old4child4for4the4treatment4of4attention-
deficit/
hyperactivity4disorder4(ADHD).4The4nurse4plans4to4monitor4which4of4the4following4during4
the4medication4therapy?4-4ans--Height4and4weight4
Can4cause4slow4growth4and4reduced4appetite
A4client4who4has4been4taking4buspirone4for4two4months4returns4to4the4clinic4for4a4follow-
up.4The4nurse4determines4that4the4medication4is4effective4if4there4is4an4absent4display4of.
..4-4ans--Feelings4of4panic,4fear,4and4uneasiness
Your4patient4is4taking4the4antipsychotic4medications4clozapine4and4divalproex4sodium4(D
epakote),4both4of4which4can4contribute4to4weight4gain.4For4what4should4this4patient4be4ca
refully4monitored?4-4ans--Increased4blood4glucose
Nurse4Trini4knows4that4the4following4drugs4have4been4known4to4be4effective4in4treating4o
bsessive-compulsive4disorder4(OCD):4-4ans--Fluvoxamine4and4clomipramine
A4patient4diagnosed4with4schizophrenia4has4taken4thiothixene454mg/
day4for444years4with4good4symptom4control.4Today,4the4patient4is4admitted4with4paranoia4
and4auditory4hallucinations.4The4nurse4should4determine4if4the4patient's4symptoms4are4r
elated4to:4-4ans--Not4taking4the4drug4as4prescribed
When4a4patient4is4taking4a4traditional4antipsychotic4medication,4the4nurse4should4assess4
carefully4for4extrapyramidal4side4effects4(EPSEs)4particularly:4-4ans--Akathisia
Nortriptyline4was4prescribed4for4a468-year-
old4patient4diagnosed4with4depression4and4insomnia.4Benefits4specific4to4use4of4nortriptyl
ine4would4include:4-4ans--Improved4sleep4pattern
