NUR 752/PSYCHOPHARMACOLOGY EXAM 4 NUR 752(PMHNP)
NEWEST EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS A NEW UPDATED VERSION LATEST 2026-2027(
VERIFIED ANSWERS) ALREADY GRADED A+ BRAND NEW!!!!
1. A 45-year-old male with bipolar I disorder presents with acute mania despite being on lithium. He is
started on valproate. Which laboratory value must be monitored at baseline and throughout treatment?
A. Serum creatinine
B. Thyroid function tests
C. Liver function tests and ammonia level
D. Cardiac troponin
2. A patient with bipolar depression has failed trials of lamotrigine and quetiapine. You consider
lurasidone. What metabolic parameter is most favorable with lurasidone compared to olanzapine?
A. Less weight gain and minimal effect on lipids
B. Higher risk of akathisia
C. Lower incidence of sedation
D. Increased prolactin
3. A 60-year-old female on carbamazepine for trigeminal neuralgia develops hyponatremia. Which
mechanism explains this adverse effect?
A. Antidiuretic hormone (ADH) potentiation at renal tubules
B. Direct renal sodium wasting
C. Syndrome of inappropriate antidiuretic hormone (SIADH)-like effect
D. Increased thirst and water intake
,4. Which medication used in bipolar disorder requires a slow dose titration to reduce the risk of serious
rash, including Stevens-Johnson syndrome?
A. Lithium
B. Valproate
C. Lamotrigine
D. Oxcarbazepine
5. A patient on clozapine for treatment-resistant schizophrenia develops fever, tachycardia, and rigid
muscles. Creatine kinase is elevated. What is the next step?
A. Add benztropine
B. Obtain C-reactive protein
C. Stop clozapine and transfer to emergency department
D. Increase clozapine dose
6. Which anticonvulsant is most strongly associated with dose-dependent hyponatremia and should be
avoided in elderly patients with low baseline sodium?
A. Gabapentin
B. Pregabalin
C. Oxcarbazepine
D. Topiramate
7. A patient on lithium for 10 years develops polyuria and polydipsia. A water deprivation test
confirms nephrogenic diabetes insipidus. What is the best management step?
A. Add hydrochlorothiazide
B. Switch to valproate
C. Discontinue lithium and switch to another mood stabilizer
D. Add amiloride without stopping lithium
, 8. Which statement best describes the mechanism of aripiprazole’s partial agonism at D2 receptors?
A. Reduces dopamine release presynaptically
B. Stabilizes dopamine activity, acting as an antagonist in hyperdopaminergic states and an agonist in
hypodopaminergic states
C. Blocks D2 receptors irreversibly
D. Enhances serotonin 5-HT2A antagonism
9. A patient with bipolar II disorder on lamotrigine presents with new-onset ataxia, nystagmus, and
confusion. Serum lamotrigine level is 35 mcg/mL (therapeutic 3–14). What is the most likely cause?
A. Drug-induced aseptic meningitis
B. Concomitant valproate use increasing lamotrigine levels
C. Lamotrigine-induced cerebellar degeneration
D. Carbamazepine autoinduction
10. A 28-year-old female of childbearing potential with bipolar disorder requires mood stabilization.
Which agent is considered the safest in the first trimester based on teratogenicity data?
A. Valproate
B. Carbamazepine
C. Lamotrigine
D. Lithium
11. A patient on clozapine has a white blood cell count of 2800/mm³ and absolute neutrophil count
(ANC) of 1100/mm³. According to REMS guidelines, what action is required?
A. Continue clozapine with twice-weekly CBC
B. Discontinue clozapine permanently
C. Reduce clozapine dose by 50%
D. Add lithium to increase WBC
12. Which of the following is an FDA-approved indication for quetiapine monotherapy?
A. Bipolar I mania only
B. Bipolar I depression only
NEWEST EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS A NEW UPDATED VERSION LATEST 2026-2027(
VERIFIED ANSWERS) ALREADY GRADED A+ BRAND NEW!!!!
1. A 45-year-old male with bipolar I disorder presents with acute mania despite being on lithium. He is
started on valproate. Which laboratory value must be monitored at baseline and throughout treatment?
A. Serum creatinine
B. Thyroid function tests
C. Liver function tests and ammonia level
D. Cardiac troponin
2. A patient with bipolar depression has failed trials of lamotrigine and quetiapine. You consider
lurasidone. What metabolic parameter is most favorable with lurasidone compared to olanzapine?
A. Less weight gain and minimal effect on lipids
B. Higher risk of akathisia
C. Lower incidence of sedation
D. Increased prolactin
3. A 60-year-old female on carbamazepine for trigeminal neuralgia develops hyponatremia. Which
mechanism explains this adverse effect?
A. Antidiuretic hormone (ADH) potentiation at renal tubules
B. Direct renal sodium wasting
C. Syndrome of inappropriate antidiuretic hormone (SIADH)-like effect
D. Increased thirst and water intake
,4. Which medication used in bipolar disorder requires a slow dose titration to reduce the risk of serious
rash, including Stevens-Johnson syndrome?
A. Lithium
B. Valproate
C. Lamotrigine
D. Oxcarbazepine
5. A patient on clozapine for treatment-resistant schizophrenia develops fever, tachycardia, and rigid
muscles. Creatine kinase is elevated. What is the next step?
A. Add benztropine
B. Obtain C-reactive protein
C. Stop clozapine and transfer to emergency department
D. Increase clozapine dose
6. Which anticonvulsant is most strongly associated with dose-dependent hyponatremia and should be
avoided in elderly patients with low baseline sodium?
A. Gabapentin
B. Pregabalin
C. Oxcarbazepine
D. Topiramate
7. A patient on lithium for 10 years develops polyuria and polydipsia. A water deprivation test
confirms nephrogenic diabetes insipidus. What is the best management step?
A. Add hydrochlorothiazide
B. Switch to valproate
C. Discontinue lithium and switch to another mood stabilizer
D. Add amiloride without stopping lithium
, 8. Which statement best describes the mechanism of aripiprazole’s partial agonism at D2 receptors?
A. Reduces dopamine release presynaptically
B. Stabilizes dopamine activity, acting as an antagonist in hyperdopaminergic states and an agonist in
hypodopaminergic states
C. Blocks D2 receptors irreversibly
D. Enhances serotonin 5-HT2A antagonism
9. A patient with bipolar II disorder on lamotrigine presents with new-onset ataxia, nystagmus, and
confusion. Serum lamotrigine level is 35 mcg/mL (therapeutic 3–14). What is the most likely cause?
A. Drug-induced aseptic meningitis
B. Concomitant valproate use increasing lamotrigine levels
C. Lamotrigine-induced cerebellar degeneration
D. Carbamazepine autoinduction
10. A 28-year-old female of childbearing potential with bipolar disorder requires mood stabilization.
Which agent is considered the safest in the first trimester based on teratogenicity data?
A. Valproate
B. Carbamazepine
C. Lamotrigine
D. Lithium
11. A patient on clozapine has a white blood cell count of 2800/mm³ and absolute neutrophil count
(ANC) of 1100/mm³. According to REMS guidelines, what action is required?
A. Continue clozapine with twice-weekly CBC
B. Discontinue clozapine permanently
C. Reduce clozapine dose by 50%
D. Add lithium to increase WBC
12. Which of the following is an FDA-approved indication for quetiapine monotherapy?
A. Bipolar I mania only
B. Bipolar I depression only
