NR 546 Week 6 Exam V1 | NR 546
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 6
Exam) | Chamberlain University
1. A 28-year-old female patient diagnosed with Bipolar I disorder is being started on Lithium.
Which of the following baseline laboratory tests is most critical before initiating therapy?
A. Serum creatinine and BUN
B. Liver function tests (LFTs)
C. Platelet count
D. Serum amylase
Answer: A
Rationale: Lithium is excreted almost exclusively by the kidneys, making baseline renal
function assessment essential. Impaired renal clearance can lead to rapid lithium toxicity
even at standard doses. Providers must monitor BUN and creatinine levels periodically
throughout treatment to ensure patient safety.
2. When educating a patient about Lithium therapy, the PMHNP should instruct the patient to
avoid which of the following medications due to the risk of increasing Lithium levels?
A. Acetaminophen
,B. Aspirin
C. Ibuprofen
D. Gabapentin
Answer: C
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen can decrease
renal blood flow and reduce the clearance of Lithium. This interaction significantly
increases the risk of Lithium toxicity. Patients should be advised to use acetaminophen for
pain relief as it does not typically interact with Lithium levels.
3. A patient taking Valproic acid (Depakote) for Bipolar disorder presents with severe
abdominal pain, nausea, and vomiting. Which potential adverse effect should the PMHNP
investigate first?
A. Stevens-Johnson Syndrome
B. Agranulocytosis
C. Pancreatitis
D. Nephrogenic diabetes insipidus
Answer: C
Rationale: Valproic acid carries a black box warning for life-threatening pancreatitis,
which can occur shortly after initiation or after years of therapy. Symptoms include severe
, abdominal pain radiating to the back, nausea, and vomiting. Immediate laboratory
evaluation of serum amylase and lipase levels is required if this condition is suspected.
4. What is the narrow therapeutic serum range for Lithium when used for the maintenance
treatment of Bipolar Disorder?
A. 0.4 to 0.8 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.0 to 1.5 mEq/L
D. 1.5 to 2.0 mEq/L
Answer: B
Rationale: The therapeutic range for Lithium is narrow, generally cited between 0.6 and
1.2 mEq/L for maintenance therapy. Levels above 1.5 mEq/L are considered toxic and
require immediate intervention. Regular blood draws are necessary to ensure the patient
remains within this narrow window to balance efficacy and safety.
5. A PMHNP is starting a patient on Lamotrigine (Lamictal). What is the primary reason for the
slow titration schedule of this medication?
A. To prevent gastrointestinal upset
B. To allow the patient to adjust to sedation
C. To minimize the risk of weight gain
D. To reduce the risk of Stevens-Johnson Syndrome
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 6
Exam) | Chamberlain University
1. A 28-year-old female patient diagnosed with Bipolar I disorder is being started on Lithium.
Which of the following baseline laboratory tests is most critical before initiating therapy?
A. Serum creatinine and BUN
B. Liver function tests (LFTs)
C. Platelet count
D. Serum amylase
Answer: A
Rationale: Lithium is excreted almost exclusively by the kidneys, making baseline renal
function assessment essential. Impaired renal clearance can lead to rapid lithium toxicity
even at standard doses. Providers must monitor BUN and creatinine levels periodically
throughout treatment to ensure patient safety.
2. When educating a patient about Lithium therapy, the PMHNP should instruct the patient to
avoid which of the following medications due to the risk of increasing Lithium levels?
A. Acetaminophen
,B. Aspirin
C. Ibuprofen
D. Gabapentin
Answer: C
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen can decrease
renal blood flow and reduce the clearance of Lithium. This interaction significantly
increases the risk of Lithium toxicity. Patients should be advised to use acetaminophen for
pain relief as it does not typically interact with Lithium levels.
3. A patient taking Valproic acid (Depakote) for Bipolar disorder presents with severe
abdominal pain, nausea, and vomiting. Which potential adverse effect should the PMHNP
investigate first?
A. Stevens-Johnson Syndrome
B. Agranulocytosis
C. Pancreatitis
D. Nephrogenic diabetes insipidus
Answer: C
Rationale: Valproic acid carries a black box warning for life-threatening pancreatitis,
which can occur shortly after initiation or after years of therapy. Symptoms include severe
, abdominal pain radiating to the back, nausea, and vomiting. Immediate laboratory
evaluation of serum amylase and lipase levels is required if this condition is suspected.
4. What is the narrow therapeutic serum range for Lithium when used for the maintenance
treatment of Bipolar Disorder?
A. 0.4 to 0.8 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.0 to 1.5 mEq/L
D. 1.5 to 2.0 mEq/L
Answer: B
Rationale: The therapeutic range for Lithium is narrow, generally cited between 0.6 and
1.2 mEq/L for maintenance therapy. Levels above 1.5 mEq/L are considered toxic and
require immediate intervention. Regular blood draws are necessary to ensure the patient
remains within this narrow window to balance efficacy and safety.
5. A PMHNP is starting a patient on Lamotrigine (Lamictal). What is the primary reason for the
slow titration schedule of this medication?
A. To prevent gastrointestinal upset
B. To allow the patient to adjust to sedation
C. To minimize the risk of weight gain
D. To reduce the risk of Stevens-Johnson Syndrome
