NR 546 Week 5 Exam V2 | NR 546
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 5
Exam) | Chamberlain University
1. Which Selective Serotonin Reuptake Inhibitor (SSRI) is characterized by an exceptionally
long half-life, making it less likely to cause discontinuation syndrome?
A. Paroxetine
B. Fluoxetine
C. Sertraline
D. Fluvoxamine
Answer: B
Rationale: Fluoxetine has a very long half-life, lasting approximately 2 to 3 days for the
parent drug and even longer for its active metabolite, norfluoxetine. This long duration of
action allows for a natural tapering effect when the medication is stopped. Consequently,
patients are much less likely to experience withdrawal symptoms compared to those on
shorter-acting SSRIs like paroxetine.
2. A patient taking Phenelzine (Nardil) must adhere to a low-tyramine diet to prevent which
life-threatening condition?
A. Serotonin Syndrome
,B. Neuroleptic Malignant Syndrome
C. Hypertensive Crisis
D. Agranulocytosis
Answer: C
Rationale: Phenelzine is a non-selective Monoamine Oxidase Inhibitor (MAOI) that inhibits
the breakdown of dietary tyramine. Excessive tyramine levels can trigger a massive release
of norepinephrine, leading to severe vasoconstriction. This clinical event is known as a
hypertensive crisis and is characterized by a rapid, dangerous spike in blood pressure and
potential occipital headache.
3. When switching a patient from Fluoxetine to an MAOI, how long must the clinician wait to
ensure a proper ‘washout’ period?
A. 2 weeks
B. 5 weeks
C. 7 days
D. 10 days
Answer: B
Rationale: Due to the long half-life of fluoxetine and its active metabolite norfluoxetine, a
5-week washout period is required before starting an MAOI. For most other SSRIs, a 2-
week washout is sufficient to prevent the risk of serotonin syndrome. Failing to wait the
, full 5 weeks can lead to fatal serotonergic toxicity due to the overlapping effects of the
medications.
4. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders?
A. Bupropion
B. Mirtazapine
C. Venlafaxine
D. Amitriptyline
Answer: A
Rationale: Bupropion is known to lower the seizure threshold, particularly in high doses
or in vulnerable populations. It is specifically contraindicated in patients with bulimia or
anorexia nervosa due to an increased risk of seizures associated with electrolyte
imbalances. PMHNPs must carefully screen for these conditions before prescribing this
norepinephrine-dopamine reuptake inhibitor (NDRI).
5. A patient on Lithium for Bipolar Disorder presents with a fine hand tremor, polyuria, and
mild thirst. What is the most appropriate interpretation of these findings?
A. Expected side effects at therapeutic levels
B. Early signs of Lithium toxicity
C. Symptoms of water intoxication
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 5
Exam) | Chamberlain University
1. Which Selective Serotonin Reuptake Inhibitor (SSRI) is characterized by an exceptionally
long half-life, making it less likely to cause discontinuation syndrome?
A. Paroxetine
B. Fluoxetine
C. Sertraline
D. Fluvoxamine
Answer: B
Rationale: Fluoxetine has a very long half-life, lasting approximately 2 to 3 days for the
parent drug and even longer for its active metabolite, norfluoxetine. This long duration of
action allows for a natural tapering effect when the medication is stopped. Consequently,
patients are much less likely to experience withdrawal symptoms compared to those on
shorter-acting SSRIs like paroxetine.
2. A patient taking Phenelzine (Nardil) must adhere to a low-tyramine diet to prevent which
life-threatening condition?
A. Serotonin Syndrome
,B. Neuroleptic Malignant Syndrome
C. Hypertensive Crisis
D. Agranulocytosis
Answer: C
Rationale: Phenelzine is a non-selective Monoamine Oxidase Inhibitor (MAOI) that inhibits
the breakdown of dietary tyramine. Excessive tyramine levels can trigger a massive release
of norepinephrine, leading to severe vasoconstriction. This clinical event is known as a
hypertensive crisis and is characterized by a rapid, dangerous spike in blood pressure and
potential occipital headache.
3. When switching a patient from Fluoxetine to an MAOI, how long must the clinician wait to
ensure a proper ‘washout’ period?
A. 2 weeks
B. 5 weeks
C. 7 days
D. 10 days
Answer: B
Rationale: Due to the long half-life of fluoxetine and its active metabolite norfluoxetine, a
5-week washout period is required before starting an MAOI. For most other SSRIs, a 2-
week washout is sufficient to prevent the risk of serotonin syndrome. Failing to wait the
, full 5 weeks can lead to fatal serotonergic toxicity due to the overlapping effects of the
medications.
4. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders?
A. Bupropion
B. Mirtazapine
C. Venlafaxine
D. Amitriptyline
Answer: A
Rationale: Bupropion is known to lower the seizure threshold, particularly in high doses
or in vulnerable populations. It is specifically contraindicated in patients with bulimia or
anorexia nervosa due to an increased risk of seizures associated with electrolyte
imbalances. PMHNPs must carefully screen for these conditions before prescribing this
norepinephrine-dopamine reuptake inhibitor (NDRI).
5. A patient on Lithium for Bipolar Disorder presents with a fine hand tremor, polyuria, and
mild thirst. What is the most appropriate interpretation of these findings?
A. Expected side effects at therapeutic levels
B. Early signs of Lithium toxicity
C. Symptoms of water intoxication
