NR 546 Exam 4 V1 | NR 546 Advanced
Psychopharmacology | Chamberlain | Q&A
with Rationale (Chamberlain NR546 Exam
4)
1. Which of the following is considered the first-line pharmacological treatment for a 7-year-
old child diagnosed with ADHD, according to the American Academy of Pediatrics (AAP)
guidelines?
A. Methylphenidate (Ritalin)
B. Atomoxetine (Strattera)
C. Guanfacine (Tenex)
D. Modafinil (Provigil)
Answer: A
Rationale: Stimulants like methylphenidate are established as the first-line medication for
children aged 6 and older with ADHD due to their high efficacy rates. While behavioral
therapy is recommended as the initial step for preschoolers, school-aged children typically
require medication for symptom management. Non-stimulants like atomoxetine are usually
reserved for cases where stimulants are ineffective or contraindicated.
2. A 72-year-old male with Alzheimer’s disease is experiencing mild cognitive impairment.
Which mechanism of action describes the medication Donepezil (Aricept)?
A. NMDA receptor antagonist
,B. Reversible acetylcholinesterase inhibitor
C. Dopamine agonist
D. Selective serotonin reuptake inhibitor
Answer: B
Rationale: Donepezil works by inhibiting the enzyme acetylcholinesterase, which is
responsible for breaking down acetylcholine in the synaptic cleft. By preventing this
breakdown, the medication increases the concentration of acetylcholine available for nerve
impulse transmission. This mechanism aims to improve cognitive function or slow the rate
of decline in patients with Alzheimer’s disease.
3. When prescribing stimulants for ADHD in a pediatric patient, which baseline assessment is
mandatory to monitor for potential side effects?
A. Serum creatinine and BUN
B. Height, weight, and blood pressure
C. Liver function tests
D. Electroencephalogram (EEG)
Answer: B
Rationale: Stimulants are known to potentially suppress growth and increase
cardiovascular load in pediatric populations. Monitoring height and weight at every visit
ensures that the child is maintaining an appropriate growth trajectory. Blood pressure and
,heart rate monitoring are also essential to detect any stimulant-induced hypertension or
tachycardia early.
4. Which medication used in the treatment of Alcohol Use Disorder acts as an irreversible
inhibitor of aldehyde dehydrogenase?
A. Naltrexone
B. Disulfiram
C. Acamprosate
D. Topiramate
Answer: B
Rationale: Disulfiram works by blocking the enzyme aldehyde dehydrogenase, leading to
the accumulation of acetaldehyde if alcohol is consumed. This accumulation results in a
highly unpleasant ‘disulfiram reaction’ involving flushing, nausea, and palpitations. It
serves as a psychological deterrent rather than a physiological craving reducer.
5. A pregnant patient in her second trimester requires treatment for moderate depression.
Which of the following SSRIs is generally avoided due to a higher risk of cardiovascular
malformations in the fetus?
A. Sertraline
B. Fluoxetine
C. Paroxetine
, D. Citalopram
Answer: C
Rationale: Paroxetine (Paxil) has been associated with a slightly increased risk of fetal
cardiac malformations, particularly ventricular septal defects, when taken during the first
trimester. Most clinical guidelines suggest avoiding paroxetine in women planning
pregnancy or those who are pregnant. Sertraline is often preferred in pregnancy and
lactation due to its safety profile and low infant exposure.
6. Which medication is FDA-approved for the treatment of irritability associated with Autism
Spectrum Disorder (ASD) in children and adolescents?
A. Risperidone
B. Lithium
C. Buspirone
D. Venlafaxine
Answer: A
Rationale: Risperidone and Aripiprazole are currently the only two medications FDA-
approved for treating irritability, aggression, and self-injurious behaviors in children with
ASD. These atypical antipsychotics help manage behavioral symptoms but do not treat the
core social deficits of autism. Close monitoring for metabolic side effects and
extrapyramidal symptoms is required when using these agents in pediatric patients.
Psychopharmacology | Chamberlain | Q&A
with Rationale (Chamberlain NR546 Exam
4)
1. Which of the following is considered the first-line pharmacological treatment for a 7-year-
old child diagnosed with ADHD, according to the American Academy of Pediatrics (AAP)
guidelines?
A. Methylphenidate (Ritalin)
B. Atomoxetine (Strattera)
C. Guanfacine (Tenex)
D. Modafinil (Provigil)
Answer: A
Rationale: Stimulants like methylphenidate are established as the first-line medication for
children aged 6 and older with ADHD due to their high efficacy rates. While behavioral
therapy is recommended as the initial step for preschoolers, school-aged children typically
require medication for symptom management. Non-stimulants like atomoxetine are usually
reserved for cases where stimulants are ineffective or contraindicated.
2. A 72-year-old male with Alzheimer’s disease is experiencing mild cognitive impairment.
Which mechanism of action describes the medication Donepezil (Aricept)?
A. NMDA receptor antagonist
,B. Reversible acetylcholinesterase inhibitor
C. Dopamine agonist
D. Selective serotonin reuptake inhibitor
Answer: B
Rationale: Donepezil works by inhibiting the enzyme acetylcholinesterase, which is
responsible for breaking down acetylcholine in the synaptic cleft. By preventing this
breakdown, the medication increases the concentration of acetylcholine available for nerve
impulse transmission. This mechanism aims to improve cognitive function or slow the rate
of decline in patients with Alzheimer’s disease.
3. When prescribing stimulants for ADHD in a pediatric patient, which baseline assessment is
mandatory to monitor for potential side effects?
A. Serum creatinine and BUN
B. Height, weight, and blood pressure
C. Liver function tests
D. Electroencephalogram (EEG)
Answer: B
Rationale: Stimulants are known to potentially suppress growth and increase
cardiovascular load in pediatric populations. Monitoring height and weight at every visit
ensures that the child is maintaining an appropriate growth trajectory. Blood pressure and
,heart rate monitoring are also essential to detect any stimulant-induced hypertension or
tachycardia early.
4. Which medication used in the treatment of Alcohol Use Disorder acts as an irreversible
inhibitor of aldehyde dehydrogenase?
A. Naltrexone
B. Disulfiram
C. Acamprosate
D. Topiramate
Answer: B
Rationale: Disulfiram works by blocking the enzyme aldehyde dehydrogenase, leading to
the accumulation of acetaldehyde if alcohol is consumed. This accumulation results in a
highly unpleasant ‘disulfiram reaction’ involving flushing, nausea, and palpitations. It
serves as a psychological deterrent rather than a physiological craving reducer.
5. A pregnant patient in her second trimester requires treatment for moderate depression.
Which of the following SSRIs is generally avoided due to a higher risk of cardiovascular
malformations in the fetus?
A. Sertraline
B. Fluoxetine
C. Paroxetine
, D. Citalopram
Answer: C
Rationale: Paroxetine (Paxil) has been associated with a slightly increased risk of fetal
cardiac malformations, particularly ventricular septal defects, when taken during the first
trimester. Most clinical guidelines suggest avoiding paroxetine in women planning
pregnancy or those who are pregnant. Sertraline is often preferred in pregnancy and
lactation due to its safety profile and low infant exposure.
6. Which medication is FDA-approved for the treatment of irritability associated with Autism
Spectrum Disorder (ASD) in children and adolescents?
A. Risperidone
B. Lithium
C. Buspirone
D. Venlafaxine
Answer: A
Rationale: Risperidone and Aripiprazole are currently the only two medications FDA-
approved for treating irritability, aggression, and self-injurious behaviors in children with
ASD. These atypical antipsychotics help manage behavioral symptoms but do not treat the
core social deficits of autism. Close monitoring for metabolic side effects and
extrapyramidal symptoms is required when using these agents in pediatric patients.
