NSG 552 Exam 3 Psychopharmacology – 200
Questions & Answers (2 Versions) – Wilkes
University – Latest 2026/2027 – Graded A+ |
instant pdf download
Intro
This comprehensive resource contains 200 original practice questions (2 complete versions) for NSG
552 Psychopharmacology Exam 3 at Wilkes University. Covers alcohol use disorder, opioid use
disorder, cocaine intoxication, smoking cessation, ADHD stimulant/non-stimulant medications,
autism spectrum disorder (risperidone/aripiprazole), dementia (donepezil/memantine), sexual
dysfunction, and special populations (elderly, hepatic impairment). Answers in bold italic with
detailed italicized rationales.
VERSION A (Questions 1-100)
1. What is the mechanism of action of Naloxone (Narcan)?
A) Mu receptor partial agonist
B) Mu receptor full agonist
C) Pure opioid antagonist that competes and displaces opioids at receptor sites
D) NMDA receptor antagonist
Answer: C
*Naloxone is a pure opioid antagonist with high affinity for mu receptors. It competitively
binds and displaces opioid agonists, rapidly reversing respiratory depression and sedation.
Its short half-life (30-60 minutes) may require repeat dosing.*
2. Which medications are FDA-approved for the treatment of opioid use disorder
(OUD)?
A) Naltrexone, Disulfiram, Acamprosate
,B) Methadone, Buprenorphine, Naltrexone
C) Buprenorphine, Naloxone, Diazepam
D) Clonidine, Naltrexone, Bupropion
Answer: B
Methadone (full agonist), buprenorphine (partial agonist), and naltrexone (antagonist) are
the three FDA-approved medications for OUD. Methadone and buprenorphine reduce
withdrawal and cravings; naltrexone blocks opioid effects.
3. Which medication for opioid use disorder is preferred in a patient with comorbid
chronic pain?
A) Methadone
B) Naltrexone
C) Buprenorphine/Naloxone (Suboxone)
D) Naloxone alone
Answer: C
Buprenorphine provides partial mu agonist activity that treats both OUD and chronic pain. It
has a ceiling effect for respiratory depression, making it safer than methadone. The
naloxone component deters IV misuse but is not orally bioavailable.
4. What serious adverse effect is associated with taking buprenorphine too soon after
last opioid use?
A) Respiratory depression
B) Precipitated withdrawal
C) Serotonin syndrome
D) Hypertension
Answer: B
Buprenorphine has high mu receptor affinity and displaces full agonists, causing immediate
withdrawal when given too soon. Patients should be in moderate withdrawal (COWS score
>12) before induction. Precipitated withdrawal is severe and distressing.
5. What are the delivery methods for Naltrexone in treating substance use disorders?
A) Oral tablet only
B) Injectable only
C) Oral, injectable, and implant
D) Transdermal patch only
Answer: C
Naltrexone is available as daily oral tablets (Revia), monthly IM injection (Vivitrol), and
,sustained-release implant (requiring inpatient insertion). Long-acting formulations improve
adherence. Implants are typically limited to inpatient settings.
6. What is the mechanism of action of disulfiram (Antabuse) for alcohol use disorder?
A) NMDA receptor antagonism
B) Positive reinforcement of sobriety
C) Negative reinforcement through aversive effects when alcohol is consumed
D) GABA potentiation
Answer: C
Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation when
alcohol is ingested. This produces unpleasant effects (flushing, nausea, vomiting,
headache), creating negative reinforcement to avoid drinking. Requires patient motivation
and monitoring.
7. Which medication for alcohol use disorder is cleared renally and therefore safe in
patients with hepatic dysfunction?
A) Disulfiram
B) Naltrexone
C) Acamprosate (Campral)
D) Diazepam
Answer: C
Acamprosate is excreted unchanged by the kidneys, making it safe in liver disease. It
modulates glutamate activity (NMDA antagonist) and reduces protracted withdrawal
symptoms and cravings. Dose adjustment needed for renal impairment (CrCl <50).
8. What is the mechanism of action of Varenicline (Chantix) for smoking cessation?
A) Nicotinic receptor full agonist
B) Nicotinic receptor partial agonist
C) Dopamine reuptake inhibitor
D) GABA agonist
Answer: B
*Varenicline is a partial agonist at α4β2 nicotinic acetylcholine receptors. It reduces cravings
and withdrawal symptoms (agonist effect) while blocking nicotine's reinforcing effects
(antagonist effect). Start 1-2 weeks before quit date.*
9. Which smoking cessation medication carries a black box warning for serious
neuropsychiatric symptoms?
A) Nicotine patch
, B) Nicotine gum
C) Varenicline (Chantix) and Bupropion (Zyban)
D) Clonidine
Answer: C
Both varenicline and bupropion carry FDA black box warnings for neuropsychiatric events
including behavior changes, hostility, agitation, depressed mood, suicidal ideation, and
completed suicide. Monitor closely, especially during treatment initiation.
10. A patient presents with dilated pupils, tachycardia, hypertension, tremor,
hyperreflexia, and chest pain after cocaine use. What is the first-line treatment for
cocaine intoxication?
A) Beta-blockers
B) Benzodiazepines
C) Haloperidol
D) Naloxone
Answer: B
Benzodiazepines (lorazepam, diazepam) are first-line for cocaine intoxication. They reduce
CNS excitation, lower blood pressure and heart rate, prevent seizures, and manage
agitation. Beta-blockers are contraindicated (unopposed alpha stimulation worsens
vasospasm).
11. Why are beta-blockers contraindicated in cocaine-induced chest pain or
myocardial infarction?
A) They increase heart rate
B) They cause unopposed alpha-adrenergic stimulation, worsening coronary vasospasm
C) They are ineffective for cardiac pain
D) They increase seizure risk
Answer: B
Cocaine blocks norepinephrine reuptake, increasing alpha-adrenergic tone. Beta-blockade
leaves alpha receptors unopposed, causing further vasoconstriction, hypertension, and
coronary artery spasm. Treatment includes benzodiazepines, aspirin, nitroglycerin, and
calcium channel blockers (verapamil).
12. What withdrawal symptoms are characteristic of opioid withdrawal? (Select all
that apply)
A) Miosis (pinpoint pupils)
B) Diarrhea and vomiting
Questions & Answers (2 Versions) – Wilkes
University – Latest 2026/2027 – Graded A+ |
instant pdf download
Intro
This comprehensive resource contains 200 original practice questions (2 complete versions) for NSG
552 Psychopharmacology Exam 3 at Wilkes University. Covers alcohol use disorder, opioid use
disorder, cocaine intoxication, smoking cessation, ADHD stimulant/non-stimulant medications,
autism spectrum disorder (risperidone/aripiprazole), dementia (donepezil/memantine), sexual
dysfunction, and special populations (elderly, hepatic impairment). Answers in bold italic with
detailed italicized rationales.
VERSION A (Questions 1-100)
1. What is the mechanism of action of Naloxone (Narcan)?
A) Mu receptor partial agonist
B) Mu receptor full agonist
C) Pure opioid antagonist that competes and displaces opioids at receptor sites
D) NMDA receptor antagonist
Answer: C
*Naloxone is a pure opioid antagonist with high affinity for mu receptors. It competitively
binds and displaces opioid agonists, rapidly reversing respiratory depression and sedation.
Its short half-life (30-60 minutes) may require repeat dosing.*
2. Which medications are FDA-approved for the treatment of opioid use disorder
(OUD)?
A) Naltrexone, Disulfiram, Acamprosate
,B) Methadone, Buprenorphine, Naltrexone
C) Buprenorphine, Naloxone, Diazepam
D) Clonidine, Naltrexone, Bupropion
Answer: B
Methadone (full agonist), buprenorphine (partial agonist), and naltrexone (antagonist) are
the three FDA-approved medications for OUD. Methadone and buprenorphine reduce
withdrawal and cravings; naltrexone blocks opioid effects.
3. Which medication for opioid use disorder is preferred in a patient with comorbid
chronic pain?
A) Methadone
B) Naltrexone
C) Buprenorphine/Naloxone (Suboxone)
D) Naloxone alone
Answer: C
Buprenorphine provides partial mu agonist activity that treats both OUD and chronic pain. It
has a ceiling effect for respiratory depression, making it safer than methadone. The
naloxone component deters IV misuse but is not orally bioavailable.
4. What serious adverse effect is associated with taking buprenorphine too soon after
last opioid use?
A) Respiratory depression
B) Precipitated withdrawal
C) Serotonin syndrome
D) Hypertension
Answer: B
Buprenorphine has high mu receptor affinity and displaces full agonists, causing immediate
withdrawal when given too soon. Patients should be in moderate withdrawal (COWS score
>12) before induction. Precipitated withdrawal is severe and distressing.
5. What are the delivery methods for Naltrexone in treating substance use disorders?
A) Oral tablet only
B) Injectable only
C) Oral, injectable, and implant
D) Transdermal patch only
Answer: C
Naltrexone is available as daily oral tablets (Revia), monthly IM injection (Vivitrol), and
,sustained-release implant (requiring inpatient insertion). Long-acting formulations improve
adherence. Implants are typically limited to inpatient settings.
6. What is the mechanism of action of disulfiram (Antabuse) for alcohol use disorder?
A) NMDA receptor antagonism
B) Positive reinforcement of sobriety
C) Negative reinforcement through aversive effects when alcohol is consumed
D) GABA potentiation
Answer: C
Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation when
alcohol is ingested. This produces unpleasant effects (flushing, nausea, vomiting,
headache), creating negative reinforcement to avoid drinking. Requires patient motivation
and monitoring.
7. Which medication for alcohol use disorder is cleared renally and therefore safe in
patients with hepatic dysfunction?
A) Disulfiram
B) Naltrexone
C) Acamprosate (Campral)
D) Diazepam
Answer: C
Acamprosate is excreted unchanged by the kidneys, making it safe in liver disease. It
modulates glutamate activity (NMDA antagonist) and reduces protracted withdrawal
symptoms and cravings. Dose adjustment needed for renal impairment (CrCl <50).
8. What is the mechanism of action of Varenicline (Chantix) for smoking cessation?
A) Nicotinic receptor full agonist
B) Nicotinic receptor partial agonist
C) Dopamine reuptake inhibitor
D) GABA agonist
Answer: B
*Varenicline is a partial agonist at α4β2 nicotinic acetylcholine receptors. It reduces cravings
and withdrawal symptoms (agonist effect) while blocking nicotine's reinforcing effects
(antagonist effect). Start 1-2 weeks before quit date.*
9. Which smoking cessation medication carries a black box warning for serious
neuropsychiatric symptoms?
A) Nicotine patch
, B) Nicotine gum
C) Varenicline (Chantix) and Bupropion (Zyban)
D) Clonidine
Answer: C
Both varenicline and bupropion carry FDA black box warnings for neuropsychiatric events
including behavior changes, hostility, agitation, depressed mood, suicidal ideation, and
completed suicide. Monitor closely, especially during treatment initiation.
10. A patient presents with dilated pupils, tachycardia, hypertension, tremor,
hyperreflexia, and chest pain after cocaine use. What is the first-line treatment for
cocaine intoxication?
A) Beta-blockers
B) Benzodiazepines
C) Haloperidol
D) Naloxone
Answer: B
Benzodiazepines (lorazepam, diazepam) are first-line for cocaine intoxication. They reduce
CNS excitation, lower blood pressure and heart rate, prevent seizures, and manage
agitation. Beta-blockers are contraindicated (unopposed alpha stimulation worsens
vasospasm).
11. Why are beta-blockers contraindicated in cocaine-induced chest pain or
myocardial infarction?
A) They increase heart rate
B) They cause unopposed alpha-adrenergic stimulation, worsening coronary vasospasm
C) They are ineffective for cardiac pain
D) They increase seizure risk
Answer: B
Cocaine blocks norepinephrine reuptake, increasing alpha-adrenergic tone. Beta-blockade
leaves alpha receptors unopposed, causing further vasoconstriction, hypertension, and
coronary artery spasm. Treatment includes benzodiazepines, aspirin, nitroglycerin, and
calcium channel blockers (verapamil).
12. What withdrawal symptoms are characteristic of opioid withdrawal? (Select all
that apply)
A) Miosis (pinpoint pupils)
B) Diarrhea and vomiting
