NSG 552 Exam 4 V2 | NSG 552
Psychopharmacology | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG552
Exam 4 2026)
1. A 7-year-old male is diagnosed with ADHD, combined type. Which of the following is the
first-line FDA-approved pharmacological treatment according to the American Academy of
Pediatrics?
A. Methylphenidate
B. Guanfacine ER
C. Atomoxetine
D. Bupropion
Answer: A
Rationale: Stimulants like methylphenidate are considered first-line treatments for ADHD
in children aged 6 and older due to their high efficacy and safety profile. Atomoxetine and
alpha-2 agonists are generally reserved for when stimulants are ineffective or
contraindicated. Bupropion is used off-label but is not a first-line FDA-approved agent for
this population.
2. When prescribing Lithium for a pregnant patient in the first trimester, the provider must be
aware of the increased risk for which congenital malformation?
A. Ebstein’s anomaly
,B. Neural tube defects
C. Cleft palate
D. Spina bifida
Answer: A
Rationale: Ebstein’s anomaly is a rare cardiac defect associated specifically with lithium
exposure during the first trimester of pregnancy. While the absolute risk is relatively low, it
is significantly higher than in the general population. Prescribers must balance the risks of
untreated bipolar disorder against the potential for teratogenic effects.
3. Which physiological change in geriatric patients leads to an increased half-life of lipophilic
medications like diazepam?
A. Increased total body water
B. Decreased body fat percentage
C. Increased hepatic blood flow
D. Increased proportion of body fat
Answer: D
Rationale: As patients age, they typically experience an increase in the proportion of body
fat and a decrease in total body water. Lipophilic drugs like benzodiazepines distribute
more widely into fat stores, which increases their volume of distribution and prolongs their
half-life. This change necessitates cautious dosing to avoid toxicity and prolonged sedation.
, 4. A 10-year-old child with Autism Spectrum Disorder (ASD) presents with severe irritability
and aggression. Which medication is FDA-approved for this specific indication in children?
A. Risperidone
B. Fluoxetine
C. Lithium
D. Sertraline
Answer: A
Rationale: Risperidone was the first medication FDA-approved for the treatment of
irritability associated with Autism Spectrum Disorder in children aged 5 to 16. Aripiprazole
is also approved for this indication in children aged 6 to 17. SSRIs like fluoxetine are used
for comorbid anxiety or OCD but not for the primary irritability symptom of ASD.
5. According to the Beers Criteria, which of the following medication classes should be
avoided in older adults due to the risk of falls and fractures?
A. ACE inhibitors
B. Beta-blockers
C. Statins
D. Benzodiazepines
Answer: D
Psychopharmacology | Wilkes University |
2026 Q&A with Rationale (Wilkes NSG552
Exam 4 2026)
1. A 7-year-old male is diagnosed with ADHD, combined type. Which of the following is the
first-line FDA-approved pharmacological treatment according to the American Academy of
Pediatrics?
A. Methylphenidate
B. Guanfacine ER
C. Atomoxetine
D. Bupropion
Answer: A
Rationale: Stimulants like methylphenidate are considered first-line treatments for ADHD
in children aged 6 and older due to their high efficacy and safety profile. Atomoxetine and
alpha-2 agonists are generally reserved for when stimulants are ineffective or
contraindicated. Bupropion is used off-label but is not a first-line FDA-approved agent for
this population.
2. When prescribing Lithium for a pregnant patient in the first trimester, the provider must be
aware of the increased risk for which congenital malformation?
A. Ebstein’s anomaly
,B. Neural tube defects
C. Cleft palate
D. Spina bifida
Answer: A
Rationale: Ebstein’s anomaly is a rare cardiac defect associated specifically with lithium
exposure during the first trimester of pregnancy. While the absolute risk is relatively low, it
is significantly higher than in the general population. Prescribers must balance the risks of
untreated bipolar disorder against the potential for teratogenic effects.
3. Which physiological change in geriatric patients leads to an increased half-life of lipophilic
medications like diazepam?
A. Increased total body water
B. Decreased body fat percentage
C. Increased hepatic blood flow
D. Increased proportion of body fat
Answer: D
Rationale: As patients age, they typically experience an increase in the proportion of body
fat and a decrease in total body water. Lipophilic drugs like benzodiazepines distribute
more widely into fat stores, which increases their volume of distribution and prolongs their
half-life. This change necessitates cautious dosing to avoid toxicity and prolonged sedation.
, 4. A 10-year-old child with Autism Spectrum Disorder (ASD) presents with severe irritability
and aggression. Which medication is FDA-approved for this specific indication in children?
A. Risperidone
B. Fluoxetine
C. Lithium
D. Sertraline
Answer: A
Rationale: Risperidone was the first medication FDA-approved for the treatment of
irritability associated with Autism Spectrum Disorder in children aged 5 to 16. Aripiprazole
is also approved for this indication in children aged 6 to 17. SSRIs like fluoxetine are used
for comorbid anxiety or OCD but not for the primary irritability symptom of ASD.
5. According to the Beers Criteria, which of the following medication classes should be
avoided in older adults due to the risk of falls and fractures?
A. ACE inhibitors
B. Beta-blockers
C. Statins
D. Benzodiazepines
Answer: D
