NR 546 Exam 3 V1 | NR 546 Advanced
Psychopharmacology | Chamberlain | Q&A
with Rationale (Chamberlain NR546 Exam
3)
1. A 10-year-old male is diagnosed with ADHD, predominantly inattentive type. Which of the
following is the primary mechanism of action for Methylphenidate (Ritalin) in treating this
condition?
A. It promotes the release of dopamine from the presynaptic storage vesicles into the
synapse.
B. It acts as a potent agonist at the Alpha-2A adrenergic receptors in the prefrontal cortex.
C. It blocks the reuptake of both norepinephrine and dopamine by inhibiting their
respective transporters.
D. It inhibits the monoamine oxidase enzyme, preventing the breakdown of
catecholamines.
Answer: C
Rationale: Methylphenidate works primarily by blocking the reuptake of dopamine and
norepinephrine, which increases the concentration of these neurotransmitters in the
synaptic cleft. Unlike amphetamines, it does not typically promote the release of dopamine
from storage vesicles. This increased synaptic availability helps to improve focus and
reduce impulsivity in children with ADHD.
,2. A 78-year-old patient with Alzheimer’s disease is being started on Donepezil (Aricept).
What is the most appropriate education regarding the timing and side effects of this
medication?
A. Take the medication at bedtime to minimize GI upset and monitor for bradycardia.
B. Take the medication in the morning to prevent insomnia and expect weight gain.
C. The medication should be taken on an empty stomach to increase absorption rates.
D. Stop the medication immediately if the patient experiences any vivid dreams.
Answer: A
Rationale: Donepezil is typically administered at bedtime to help mitigate the common
side effects of nausea and gastrointestinal distress. Because it increases cholinergic activity,
it can lead to bradycardia or syncope, making cardiac monitoring important in the elderly.
Providers should also warn caregivers about the potential for vivid dreams and increased
gastric acid secretion.
3. Which medication is FDA-approved for the treatment of moderate-to-severe Alzheimer’s
disease and acts as an NMDA receptor antagonist?
A. Rivastigmine
B. Galantamine
C. Memantine
D. Aducanumab
,Answer: C
Rationale: Memantine (Namenda) is an NMDA receptor antagonist that regulates the
activity of glutamate in the brain. Glutamate overstimulation is thought to contribute to the
neurodegeneration seen in Alzheimer’s disease. By blocking excessive NMDA receptor
activation, Memantine helps protect neurons from excitotoxicity.
4. A patient with Alcohol Use Disorder is prescribed Disulfiram (Antabuse). Which of the
following statements by the patient indicates a need for further teaching?
A. I can start taking this medication as soon as I finish my last drink.
B. I must avoid all forms of alcohol, including those found in mouthwash and cough syrup.
C. If I drink alcohol while on this, I might experience severe vomiting and a rapid heartbeat.
D. I need to wait at least 12 hours after my last drink before taking the first dose.
Answer: A
Rationale: Disulfiram should never be administered until the patient has abstained from
alcohol for at least 12 hours. Taking it while alcohol is still in the system will trigger a
highly unpleasant and potentially dangerous reaction. Education must include the risk of
hidden alcohol in household products and the duration of the drug’s effect, which can last
up to two weeks after the last dose.
5. Which of the following medications is a first-line treatment for opioid withdrawal
symptoms and is a non-opioid, alpha-2 adrenergic agonist?
A. Methadone
, B. Lofexidine
C. Buprenorphine
D. Naltrexone
Answer: B
Rationale: Lofexidine (Lucemyra) is an alpha-2 adrenergic agonist specifically FDA-
approved for the mitigation of opioid withdrawal symptoms. It works by reducing the
sympathetic nervous system’s ‘fight or flight’ response that occurs during withdrawal.
Unlike methadone or buprenorphine, it is not an opioid and does not carry a risk of
addiction or respiratory depression.
6. When treating a pregnant patient with a history of Opioid Use Disorder (OUD), which
treatment approach is generally recommended as the standard of care?
A. Abrupt discontinuation of all opioids to protect the fetus from addiction.
B. Opioid Agonist Therapy (OAT) with Methadone or Buprenorphine mono-product.
C. Wait until the second trimester to start Naltrexone maintenance.
D. Detoxification using high-dose benzodiazepines.
Answer: B
Rationale: Opioid Agonist Therapy (OAT) with Methadone or Buprenorphine is the gold
standard for pregnant women with OUD to prevent withdrawal and fetal distress. Abrupt
withdrawal is associated with high rates of relapse and potential fetal demise. The
Psychopharmacology | Chamberlain | Q&A
with Rationale (Chamberlain NR546 Exam
3)
1. A 10-year-old male is diagnosed with ADHD, predominantly inattentive type. Which of the
following is the primary mechanism of action for Methylphenidate (Ritalin) in treating this
condition?
A. It promotes the release of dopamine from the presynaptic storage vesicles into the
synapse.
B. It acts as a potent agonist at the Alpha-2A adrenergic receptors in the prefrontal cortex.
C. It blocks the reuptake of both norepinephrine and dopamine by inhibiting their
respective transporters.
D. It inhibits the monoamine oxidase enzyme, preventing the breakdown of
catecholamines.
Answer: C
Rationale: Methylphenidate works primarily by blocking the reuptake of dopamine and
norepinephrine, which increases the concentration of these neurotransmitters in the
synaptic cleft. Unlike amphetamines, it does not typically promote the release of dopamine
from storage vesicles. This increased synaptic availability helps to improve focus and
reduce impulsivity in children with ADHD.
,2. A 78-year-old patient with Alzheimer’s disease is being started on Donepezil (Aricept).
What is the most appropriate education regarding the timing and side effects of this
medication?
A. Take the medication at bedtime to minimize GI upset and monitor for bradycardia.
B. Take the medication in the morning to prevent insomnia and expect weight gain.
C. The medication should be taken on an empty stomach to increase absorption rates.
D. Stop the medication immediately if the patient experiences any vivid dreams.
Answer: A
Rationale: Donepezil is typically administered at bedtime to help mitigate the common
side effects of nausea and gastrointestinal distress. Because it increases cholinergic activity,
it can lead to bradycardia or syncope, making cardiac monitoring important in the elderly.
Providers should also warn caregivers about the potential for vivid dreams and increased
gastric acid secretion.
3. Which medication is FDA-approved for the treatment of moderate-to-severe Alzheimer’s
disease and acts as an NMDA receptor antagonist?
A. Rivastigmine
B. Galantamine
C. Memantine
D. Aducanumab
,Answer: C
Rationale: Memantine (Namenda) is an NMDA receptor antagonist that regulates the
activity of glutamate in the brain. Glutamate overstimulation is thought to contribute to the
neurodegeneration seen in Alzheimer’s disease. By blocking excessive NMDA receptor
activation, Memantine helps protect neurons from excitotoxicity.
4. A patient with Alcohol Use Disorder is prescribed Disulfiram (Antabuse). Which of the
following statements by the patient indicates a need for further teaching?
A. I can start taking this medication as soon as I finish my last drink.
B. I must avoid all forms of alcohol, including those found in mouthwash and cough syrup.
C. If I drink alcohol while on this, I might experience severe vomiting and a rapid heartbeat.
D. I need to wait at least 12 hours after my last drink before taking the first dose.
Answer: A
Rationale: Disulfiram should never be administered until the patient has abstained from
alcohol for at least 12 hours. Taking it while alcohol is still in the system will trigger a
highly unpleasant and potentially dangerous reaction. Education must include the risk of
hidden alcohol in household products and the duration of the drug’s effect, which can last
up to two weeks after the last dose.
5. Which of the following medications is a first-line treatment for opioid withdrawal
symptoms and is a non-opioid, alpha-2 adrenergic agonist?
A. Methadone
, B. Lofexidine
C. Buprenorphine
D. Naltrexone
Answer: B
Rationale: Lofexidine (Lucemyra) is an alpha-2 adrenergic agonist specifically FDA-
approved for the mitigation of opioid withdrawal symptoms. It works by reducing the
sympathetic nervous system’s ‘fight or flight’ response that occurs during withdrawal.
Unlike methadone or buprenorphine, it is not an opioid and does not carry a risk of
addiction or respiratory depression.
6. When treating a pregnant patient with a history of Opioid Use Disorder (OUD), which
treatment approach is generally recommended as the standard of care?
A. Abrupt discontinuation of all opioids to protect the fetus from addiction.
B. Opioid Agonist Therapy (OAT) with Methadone or Buprenorphine mono-product.
C. Wait until the second trimester to start Naltrexone maintenance.
D. Detoxification using high-dose benzodiazepines.
Answer: B
Rationale: Opioid Agonist Therapy (OAT) with Methadone or Buprenorphine is the gold
standard for pregnant women with OUD to prevent withdrawal and fetal distress. Abrupt
withdrawal is associated with high rates of relapse and potential fetal demise. The
