NU 670
Advanced Psychopharmacology & Health
Promotion
Latest Midterm Exam Review
(With Solutions)
2026
1
,1. Case: A 45-year-old patient with treatment-resistant depression is
prescribed ketamine infusion therapy.
Question: Which mechanism best explains ketamine’s rapid
antidepressant effect?
- A. Dopamine D2 receptor antagonism
- B. NMDA receptor antagonism with AMPA receptor activation
- C. GABA-A receptor potentiation
- D. Serotonin reuptake inhibition
Answer: B
Rationale: Ketamine blocks NMDA receptors, enhancing glutamate
transmission via AMPA receptors, leading to synaptic plasticity and rapid
antidepressant effects.
---
2. Case: A patient with schizophrenia develops severe muscle rigidity and
autonomic instability after haloperidol.
Question: What is the most likely diagnosis?
- A. Serotonin syndrome
- B. Neuroleptic malignant syndrome
- C. Tardive dyskinesia
- D. Akathisia
Answer: B
Rationale: NMS presents with rigidity, hyperthermia, autonomic
instability, and altered mental status due to dopamine blockade.
---
3. Case: A 60-year-old with bipolar disorder is prescribed lithium.
Question: Which lab test is most critical for monitoring long-term
lithium therapy?
- A. Liver function tests
- B. Thyroid function tests
2
, - C. Hemoglobin A1c
- D. Vitamin D levels
Answer: B
Rationale: Lithium can cause hypothyroidism; thyroid function must be
monitored regularly.
---
4. Case: A patient on clozapine presents with fever and sore throat.
Question: What is the immediate nursing action?
- A. Administer acetaminophen
- B. Continue medication and monitor
- C. Order CBC with differential
- D. Increase fluid intake
Answer: C
Rationale: Clozapine can cause agranulocytosis; CBC is essential to
detect neutropenia.
---
5. Case: A patient with generalized anxiety disorder is prescribed
buspirone.
Question: Which property differentiates buspirone from
benzodiazepines?
- A. Risk of dependence
- B. Sedative effect
- C. Partial agonism at 5-HT1A receptors
- D. Rapid onset of action
Answer: C
Rationale: Buspirone acts as a serotonin 5-HT1A partial agonist, with
low abuse potential and delayed onset.
---
3
Advanced Psychopharmacology & Health
Promotion
Latest Midterm Exam Review
(With Solutions)
2026
1
,1. Case: A 45-year-old patient with treatment-resistant depression is
prescribed ketamine infusion therapy.
Question: Which mechanism best explains ketamine’s rapid
antidepressant effect?
- A. Dopamine D2 receptor antagonism
- B. NMDA receptor antagonism with AMPA receptor activation
- C. GABA-A receptor potentiation
- D. Serotonin reuptake inhibition
Answer: B
Rationale: Ketamine blocks NMDA receptors, enhancing glutamate
transmission via AMPA receptors, leading to synaptic plasticity and rapid
antidepressant effects.
---
2. Case: A patient with schizophrenia develops severe muscle rigidity and
autonomic instability after haloperidol.
Question: What is the most likely diagnosis?
- A. Serotonin syndrome
- B. Neuroleptic malignant syndrome
- C. Tardive dyskinesia
- D. Akathisia
Answer: B
Rationale: NMS presents with rigidity, hyperthermia, autonomic
instability, and altered mental status due to dopamine blockade.
---
3. Case: A 60-year-old with bipolar disorder is prescribed lithium.
Question: Which lab test is most critical for monitoring long-term
lithium therapy?
- A. Liver function tests
- B. Thyroid function tests
2
, - C. Hemoglobin A1c
- D. Vitamin D levels
Answer: B
Rationale: Lithium can cause hypothyroidism; thyroid function must be
monitored regularly.
---
4. Case: A patient on clozapine presents with fever and sore throat.
Question: What is the immediate nursing action?
- A. Administer acetaminophen
- B. Continue medication and monitor
- C. Order CBC with differential
- D. Increase fluid intake
Answer: C
Rationale: Clozapine can cause agranulocytosis; CBC is essential to
detect neutropenia.
---
5. Case: A patient with generalized anxiety disorder is prescribed
buspirone.
Question: Which property differentiates buspirone from
benzodiazepines?
- A. Risk of dependence
- B. Sedative effect
- C. Partial agonism at 5-HT1A receptors
- D. Rapid onset of action
Answer: C
Rationale: Buspirone acts as a serotonin 5-HT1A partial agonist, with
low abuse potential and delayed onset.
---
3
