NR 546 Week 4 Exam V1 | NR 546
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 4
Exam) | Chamberlain University
1. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake Inhibitors
(SSRIs) to alleviate depressive symptoms?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Answer: A
Rationale: SSRIs function by inhibiting the reuptake of serotonin into the presynaptic
neuron, thereby increasing its availability in the synaptic cleft. This increased
concentration is thought to improve mood and emotional regulation over time. PMHNPs
must educate patients that therapeutic benefits typically take several weeks to manifest.
2. A patient taking lithium for bipolar disorder presents with coarse hand tremors, ataxia, and
confusion. What is the most appropriate initial action by the PMHNP?
A. Order a stat serum lithium level.
,B. Increase the lithium dose to manage symptoms.
C. Switch the patient to valproic acid immediately.
D. Administer a dose of benztropine.
Answer: A
Rationale: The presentation of coarse tremors and confusion strongly suggests lithium
toxicity, which requires immediate diagnostic confirmation via serum level testing. Toxic
levels are typically above 1.5 mEq/L and can be life-threatening if not addressed. The
PMHNP should also assess for dehydration or drug interactions that may have precipitated
the toxicity.
3. According to the REMS program, which laboratory value must be monitored for a patient
prescribed Clozapine?
A. Absolute Neutrophil Count (ANC)
B. Serum glucose
C. Liver function tests
D. Thyroid Stimulating Hormone (TSH)
Answer: A
Rationale: Clozapine carries a significant risk of agranulocytosis, a dangerous drop in
white blood cell counts. The ANC must be monitored weekly for the first six months of
, treatment to ensure patient safety. Failure to follow the REMS monitoring protocol
necessitates immediate discontinuation of the medication.
4. Which mechanism of action is responsible for the hypertensive crisis seen when MAOIs are
combined with tyramine-rich foods?
A. Excessive inhibition of Serotonin
B. Increased release of Norepinephrine
C. Blockade of Dopamine receptors
D. Activation of GABA receptors
Answer: B
Rationale: Monoamine oxidase inhibitors prevent the breakdown of tyramine in the gut.
When tyramine enters the bloodstream, it causes a massive release of stored
norepinephrine from sympathetic nerve endings. This results in severe vasoconstriction
and potentially fatal spikes in blood pressure.
5. A patient diagnosed with schizophrenia experiences acute dystonia shortly after starting
Haloperidol. Which medication should the PMHNP prescribe to treat this reaction?
A. Propranolol (Inderal)
B. Lorazepam (Ativan)
C. Benztropine (Cogentin)
D. Ziprasidone (Geodon)
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 4
Exam) | Chamberlain University
1. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake Inhibitors
(SSRIs) to alleviate depressive symptoms?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Answer: A
Rationale: SSRIs function by inhibiting the reuptake of serotonin into the presynaptic
neuron, thereby increasing its availability in the synaptic cleft. This increased
concentration is thought to improve mood and emotional regulation over time. PMHNPs
must educate patients that therapeutic benefits typically take several weeks to manifest.
2. A patient taking lithium for bipolar disorder presents with coarse hand tremors, ataxia, and
confusion. What is the most appropriate initial action by the PMHNP?
A. Order a stat serum lithium level.
,B. Increase the lithium dose to manage symptoms.
C. Switch the patient to valproic acid immediately.
D. Administer a dose of benztropine.
Answer: A
Rationale: The presentation of coarse tremors and confusion strongly suggests lithium
toxicity, which requires immediate diagnostic confirmation via serum level testing. Toxic
levels are typically above 1.5 mEq/L and can be life-threatening if not addressed. The
PMHNP should also assess for dehydration or drug interactions that may have precipitated
the toxicity.
3. According to the REMS program, which laboratory value must be monitored for a patient
prescribed Clozapine?
A. Absolute Neutrophil Count (ANC)
B. Serum glucose
C. Liver function tests
D. Thyroid Stimulating Hormone (TSH)
Answer: A
Rationale: Clozapine carries a significant risk of agranulocytosis, a dangerous drop in
white blood cell counts. The ANC must be monitored weekly for the first six months of
, treatment to ensure patient safety. Failure to follow the REMS monitoring protocol
necessitates immediate discontinuation of the medication.
4. Which mechanism of action is responsible for the hypertensive crisis seen when MAOIs are
combined with tyramine-rich foods?
A. Excessive inhibition of Serotonin
B. Increased release of Norepinephrine
C. Blockade of Dopamine receptors
D. Activation of GABA receptors
Answer: B
Rationale: Monoamine oxidase inhibitors prevent the breakdown of tyramine in the gut.
When tyramine enters the bloodstream, it causes a massive release of stored
norepinephrine from sympathetic nerve endings. This results in severe vasoconstriction
and potentially fatal spikes in blood pressure.
5. A patient diagnosed with schizophrenia experiences acute dystonia shortly after starting
Haloperidol. Which medication should the PMHNP prescribe to treat this reaction?
A. Propranolol (Inderal)
B. Lorazepam (Ativan)
C. Benztropine (Cogentin)
D. Ziprasidone (Geodon)
