NR 546 Exam 2 V1 | NR 546 Advanced
Psychopharmacology | Chamberlain | Q&A
with Rationale (Chamberlain NR546 Exam
2)
1. A patient is prescribed Lithium for the maintenance treatment of Bipolar I Disorder. Which
of the following serum lithium levels is considered within the standard therapeutic range for
maintenance?
A. 0.2 - 0.5 mEq/L
B. 2.5 - 3.0 mEq/L
C. 1.5 - 2.0 mEq/L
D. 0.6 - 1.2 mEq/L
Answer: D
Rationale: The standard therapeutic range for lithium maintenance is generally 0.6 to 1.2
mEq/L. Levels below this range may be ineffective for preventing relapse, while levels
above 1.5 mEq/L increase the risk of toxicity. Routine monitoring of serum levels is
essential to ensure safety and efficacy in patients with Bipolar Disorder.
,2. When initiating Lamotrigine therapy, the provider must educate the patient about the risk
of a serious dermatological reaction. What is the most significant risk associated with rapid
titration of Lamotrigine?
A. Alopecia areata
B. Stevens-Johnson Syndrome (SJS)
C. Psoriasis exacerbation
D. Severe contact dermatitis
Answer: B
Rationale: Stevens-Johnson Syndrome (SJS) is a rare but life-threatening skin reaction
associated with Lamotrigine use. To minimize this risk, the medication must be titrated
slowly according to a specific schedule. Patients must be instructed to stop the medication
and seek immediate medical attention if any rash or mucosal involvement occurs.
3. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders like bulimia?
A. Bupropion
B. Venlafaxine
C. Sertraline
D. Mirtazapine
Answer: A
,Rationale: Bupropion is known to lower the seizure threshold, making it contraindicated
in individuals with known seizure disorders. Additionally, patients with eating disorders
such as bulimia or anorexia nervosa have an increased risk of electrolyte imbalances, which
further predisposes them to seizures while taking this medication. Alternative
antidepressants should be selected for these high-risk populations.
4. A patient taking a Monoamine Oxidase Inhibitor (MAOI) must adhere to a low-tyramine
diet. What is the primary risk if a patient on an MAOI consumes foods high in tyramine?
A. Serotonin Syndrome
B. Hypoglycemic episode
C. Hypertensive Crisis
D. Acute Renal Failure
Answer: C
Rationale: MAOIs inhibit the breakdown of tyramine, a substance found in aged cheeses,
cured meats, and fermented products. Excessive tyramine leads to a massive release of
norepinephrine, which can cause a rapid and dangerous increase in blood pressure known
as a hypertensive crisis. This condition is a medical emergency and requires immediate
intervention.
5. Valproic acid (Depakote) requires regular laboratory monitoring. Which of the following
sets of labs are most critical for a patient on long-term Valproate therapy?
A. Complete Blood Count (CBC) and Liver Function Tests (LFTs)
, B. Renal function and Serum Electrolytes
C. Thyroid Stimulating Hormone (TSH) and Vitamin B12
D. Urine drug screen and Blood Glucose
Answer: A
Rationale: Valproic acid is associated with risks of hepatotoxicity and thrombocytopenia.
Therefore, baseline and periodic monitoring of Liver Function Tests (LFTs) and a Complete
Blood Count (CBC) with platelets is required. Monitoring helps identify early signs of liver
dysfunction or blood dyscrasias that necessitate medication adjustment or discontinuation.
6. A 28-year-old female patient with Bipolar Disorder is planning to become pregnant. Which
mood stabilizer is most strongly associated with Ebstein’s anomaly in the fetus?
A. Valproate
B. Carbamazepine
C. Lamotrigine
D. Lithium
Answer: D
Rationale: Lithium exposure during the first trimester of pregnancy is linked to Ebstein’s
anomaly, a rare congenital heart defect involving the tricuspid valve. While the absolute
risk is lower than previously thought, it remains a significant consideration in
Psychopharmacology | Chamberlain | Q&A
with Rationale (Chamberlain NR546 Exam
2)
1. A patient is prescribed Lithium for the maintenance treatment of Bipolar I Disorder. Which
of the following serum lithium levels is considered within the standard therapeutic range for
maintenance?
A. 0.2 - 0.5 mEq/L
B. 2.5 - 3.0 mEq/L
C. 1.5 - 2.0 mEq/L
D. 0.6 - 1.2 mEq/L
Answer: D
Rationale: The standard therapeutic range for lithium maintenance is generally 0.6 to 1.2
mEq/L. Levels below this range may be ineffective for preventing relapse, while levels
above 1.5 mEq/L increase the risk of toxicity. Routine monitoring of serum levels is
essential to ensure safety and efficacy in patients with Bipolar Disorder.
,2. When initiating Lamotrigine therapy, the provider must educate the patient about the risk
of a serious dermatological reaction. What is the most significant risk associated with rapid
titration of Lamotrigine?
A. Alopecia areata
B. Stevens-Johnson Syndrome (SJS)
C. Psoriasis exacerbation
D. Severe contact dermatitis
Answer: B
Rationale: Stevens-Johnson Syndrome (SJS) is a rare but life-threatening skin reaction
associated with Lamotrigine use. To minimize this risk, the medication must be titrated
slowly according to a specific schedule. Patients must be instructed to stop the medication
and seek immediate medical attention if any rash or mucosal involvement occurs.
3. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders like bulimia?
A. Bupropion
B. Venlafaxine
C. Sertraline
D. Mirtazapine
Answer: A
,Rationale: Bupropion is known to lower the seizure threshold, making it contraindicated
in individuals with known seizure disorders. Additionally, patients with eating disorders
such as bulimia or anorexia nervosa have an increased risk of electrolyte imbalances, which
further predisposes them to seizures while taking this medication. Alternative
antidepressants should be selected for these high-risk populations.
4. A patient taking a Monoamine Oxidase Inhibitor (MAOI) must adhere to a low-tyramine
diet. What is the primary risk if a patient on an MAOI consumes foods high in tyramine?
A. Serotonin Syndrome
B. Hypoglycemic episode
C. Hypertensive Crisis
D. Acute Renal Failure
Answer: C
Rationale: MAOIs inhibit the breakdown of tyramine, a substance found in aged cheeses,
cured meats, and fermented products. Excessive tyramine leads to a massive release of
norepinephrine, which can cause a rapid and dangerous increase in blood pressure known
as a hypertensive crisis. This condition is a medical emergency and requires immediate
intervention.
5. Valproic acid (Depakote) requires regular laboratory monitoring. Which of the following
sets of labs are most critical for a patient on long-term Valproate therapy?
A. Complete Blood Count (CBC) and Liver Function Tests (LFTs)
, B. Renal function and Serum Electrolytes
C. Thyroid Stimulating Hormone (TSH) and Vitamin B12
D. Urine drug screen and Blood Glucose
Answer: A
Rationale: Valproic acid is associated with risks of hepatotoxicity and thrombocytopenia.
Therefore, baseline and periodic monitoring of Liver Function Tests (LFTs) and a Complete
Blood Count (CBC) with platelets is required. Monitoring helps identify early signs of liver
dysfunction or blood dyscrasias that necessitate medication adjustment or discontinuation.
6. A 28-year-old female patient with Bipolar Disorder is planning to become pregnant. Which
mood stabilizer is most strongly associated with Ebstein’s anomaly in the fetus?
A. Valproate
B. Carbamazepine
C. Lamotrigine
D. Lithium
Answer: D
Rationale: Lithium exposure during the first trimester of pregnancy is linked to Ebstein’s
anomaly, a rare congenital heart defect involving the tricuspid valve. While the absolute
risk is lower than previously thought, it remains a significant consideration in
