NSG 552 Psychopharmacology Exam 3 Study Guide 2026/2027 Wilkes
University
1. Which laboratory value is the most critical to monitor for a patient starting
Clozapine (Clozaril)?
A. Liver function tests (LFTs)
B. Absolute Neutrophil Count (ANC)
C. Serum Creatinine
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Rationale: Clozapine carries a black box warning for agranulocytosis. The Absolute
Neutrophil Count (ANC) must be monitored regularly to prevent life-threatening infections.
2. A patient taking Lithium presents with coarse tremors, confusion, and ataxia.
What is the most likely blood level for this patient?
A. 1.5 mEq/L or higher
B. 1.0 mEq/L
C. 0.6 mEq/L
D. 0.2 mEq/L
Answer: A
Rationale: Lithium toxicity generally occurs at levels above 1.5 mEq/L. Symptoms include
coarse tremors, ataxia, confusion, and vomiting.
,3. Which mechanism of action best describes typical (first-generation)
antipsychotics?
A. 5-HT2A receptor antagonism
B. D2 receptor antagonism
C. NMDA receptor antagonism
D. GABA-A receptor modulation
Answer: B
Rationale: First-generation antipsychotics work primarily by blocking D2 receptors in the
mesolimbic pathway.
4. Which medication is considered first-line for the treatment of acute alcohol
withdrawal to prevent seizures and delirium tremens?
A. Diazepam
B. Naltrexone
C. Disulfiram
D. Acamprosate
Answer: A
Rationale: Benzodiazepines like Diazepam or Lorazepam are the gold standard for
managing alcohol withdrawal symptoms and preventing seizures.
5. A patient on Haloperidol experiences acute dystonia. Which medication
should be administered immediately?
A. Benztropine
B. Propranolol
C. Amantadine
D. Buspirone
Answer: A
Rationale: Anticholinergic medications like Benztropine or Diphenhydramine are used to
reverse acute dystonic reactions.
, 6. What is the primary mechanism of action of Buprenorphine in the treatment
of opioid use disorder?
A. Partial mu-opioid agonist
B. Mu-opioid antagonist
C. Full mu-opioid agonist
D. Kappa-opioid antagonist
Answer: A
Rationale: Buprenorphine is a partial mu-opioid agonist, which provides a ceiling effect on
respiratory depression and reduces cravings.
7. Which anticonvulsant is associated with a high risk of Stevens-Johnson
Syndrome (SJS), requiring a very slow titration?
A. Valproate
B. Lamotrigine
C. Carbamazepine
D. Gabapentin
Answer: B
Rationale: Lamotrigine requires slow titration to minimize the risk of a life-threatening
rash known as Stevens-Johnson Syndrome.
8. A patient on an SSRI and an MAOI presents with hyperthermia, muscle
rigidity, and hyperreflexia. This is indicative of:
A. Neuroleptic Malignant Syndrome
B. Tardive Dyskinesia
C. Anticholinergic Toxicity
D. Serotonin Syndrome
Answer: D
Rationale: Serotonin Syndrome is characterized by the triad of autonomic instability,
neuromuscular hyperactivity (like hyperreflexia), and mental status changes.
University
1. Which laboratory value is the most critical to monitor for a patient starting
Clozapine (Clozaril)?
A. Liver function tests (LFTs)
B. Absolute Neutrophil Count (ANC)
C. Serum Creatinine
D. Thyroid Stimulating Hormone (TSH)
Answer: B
Rationale: Clozapine carries a black box warning for agranulocytosis. The Absolute
Neutrophil Count (ANC) must be monitored regularly to prevent life-threatening infections.
2. A patient taking Lithium presents with coarse tremors, confusion, and ataxia.
What is the most likely blood level for this patient?
A. 1.5 mEq/L or higher
B. 1.0 mEq/L
C. 0.6 mEq/L
D. 0.2 mEq/L
Answer: A
Rationale: Lithium toxicity generally occurs at levels above 1.5 mEq/L. Symptoms include
coarse tremors, ataxia, confusion, and vomiting.
,3. Which mechanism of action best describes typical (first-generation)
antipsychotics?
A. 5-HT2A receptor antagonism
B. D2 receptor antagonism
C. NMDA receptor antagonism
D. GABA-A receptor modulation
Answer: B
Rationale: First-generation antipsychotics work primarily by blocking D2 receptors in the
mesolimbic pathway.
4. Which medication is considered first-line for the treatment of acute alcohol
withdrawal to prevent seizures and delirium tremens?
A. Diazepam
B. Naltrexone
C. Disulfiram
D. Acamprosate
Answer: A
Rationale: Benzodiazepines like Diazepam or Lorazepam are the gold standard for
managing alcohol withdrawal symptoms and preventing seizures.
5. A patient on Haloperidol experiences acute dystonia. Which medication
should be administered immediately?
A. Benztropine
B. Propranolol
C. Amantadine
D. Buspirone
Answer: A
Rationale: Anticholinergic medications like Benztropine or Diphenhydramine are used to
reverse acute dystonic reactions.
, 6. What is the primary mechanism of action of Buprenorphine in the treatment
of opioid use disorder?
A. Partial mu-opioid agonist
B. Mu-opioid antagonist
C. Full mu-opioid agonist
D. Kappa-opioid antagonist
Answer: A
Rationale: Buprenorphine is a partial mu-opioid agonist, which provides a ceiling effect on
respiratory depression and reduces cravings.
7. Which anticonvulsant is associated with a high risk of Stevens-Johnson
Syndrome (SJS), requiring a very slow titration?
A. Valproate
B. Lamotrigine
C. Carbamazepine
D. Gabapentin
Answer: B
Rationale: Lamotrigine requires slow titration to minimize the risk of a life-threatening
rash known as Stevens-Johnson Syndrome.
8. A patient on an SSRI and an MAOI presents with hyperthermia, muscle
rigidity, and hyperreflexia. This is indicative of:
A. Neuroleptic Malignant Syndrome
B. Tardive Dyskinesia
C. Anticholinergic Toxicity
D. Serotonin Syndrome
Answer: D
Rationale: Serotonin Syndrome is characterized by the triad of autonomic instability,
neuromuscular hyperactivity (like hyperreflexia), and mental status changes.
