NSG 552
EXAM 1
Psychopharmacology
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
➢100 Exam Questions w/ Answers
➢Expert Rationales included.
➢Exam 1 Comprehensive Study Guide
,Table of Contents
NSG 552 Exam 1...............................................................2
NSG 552 Exam 1 Study Guide ................................. 55
NSG 552 Exam 1
Question 1 (SINGLE BEST ANSWER)
A 24-year-old male with schizophrenia is prescribed haloperidol 10 mg IM for
acute agitation. Which medication should be co-administered to reduce the
risk of severe extrapyramidal symptoms (EPS)?
• A. Propranolol
• B. Benztropine
• C. Amantadine
• D. Clonazepam
Correct Answer: B. Benztropine
Rationale: IM haloperidol should be administered with an anticholinergic agent such
as benztropine or diphenhydramine to reduce the risk of severe EPS, particularly acute
dystonia.
,Question 2 (SINGLE BEST ANSWER)
A patient presents with involuntary movements of the facial muscles, tongue
protrusion, and lip smacking after 5 years of antipsychotic therapy. Which
condition is most likely?
• A. Acute dystonia
• B. Akathisia
• C. Tardive dyskinesia
• D. Neuroleptic malignant syndrome
Correct Answer: C. Tardive dyskinesia
Rationale: Tardive dyskinesia (TD) is characterized by involuntary movements of the
facial muscles, tongue, and limbs. It is a neurotoxic side effect of long-term
antipsychotic use targeting dopamine receptors.
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Question 3 (SELECT ALL THAT APPLY)
A patient on clozapine presents with fever, sore throat, and malaise. The
PMHNP suspects agranulocytosis. Select all that apply regarding clozapine
monitoring:
• A. Monitor WBC and ANC weekly for the first 6 months
• B. Discontinue clozapine if ANC falls below 1,500/mm³
• C. Agranulocytosis occurs in approximately 1% of patients
• D. Sialorrhea occurs in 30-80% of patients and is managed with glycopyrrolate
• E. Clozapine is first-line for all patients with schizophrenia
Correct Answer: A, B, C, D
Rationale: Clozapine requires WBC/ANC monitoring due to agranulocytosis risk
(1%). It is discontinued if ANC <1,500. Sialorrhea is common (30-80%) and managed
with glycopyrrolate. Clozapine is reserved for treatment-resistant schizophrenia, not
first-line.
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Question 4 (SINGLE BEST ANSWER)
A 35-year-old female on risperidone reports galactorrhea and amenorrhea.
Which pathway is primarily responsible for this adverse effect?
• A. Mesolimbic pathway
• B. Mesocortical pathway
• C. Nigrostriatal pathway
• D. Tuberoinfundibular pathway
Correct Answer: D. Tuberoinfundibular pathway
Rationale: D2 blockade in the tuberoinfundibular pathway results in
hyperprolactinemia, causing galactorrhea, amenorrhea, gynecomastia, and decreased
libido. Risperidone is particularly associated with this effect.
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─────────────────────────
Question 5 (SINGLE BEST ANSWER)
A patient with bipolar disorder has a lithium level of 2.1 mEq/L. Which clinical
manifestation is most concerning?
• A. Coarse tremor and ataxia
• B. Seizures and coma
• C. Nausea and diarrhea
• D. Polyuria and polydipsia
Correct Answer: B. Seizures and coma
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L). Levels >2.0
mEq/L are potentially lethal and manifest with seizures, coma, and death. Early signs
include nausea, vomiting, and coarse tremors.
EXAM 1
Psychopharmacology
Actual Questions with Verified Answers
Wilkes University
Pass the Exam with Confidence
What You Will Get:
➢100 Exam Questions w/ Answers
➢Expert Rationales included.
➢Exam 1 Comprehensive Study Guide
,Table of Contents
NSG 552 Exam 1...............................................................2
NSG 552 Exam 1 Study Guide ................................. 55
NSG 552 Exam 1
Question 1 (SINGLE BEST ANSWER)
A 24-year-old male with schizophrenia is prescribed haloperidol 10 mg IM for
acute agitation. Which medication should be co-administered to reduce the
risk of severe extrapyramidal symptoms (EPS)?
• A. Propranolol
• B. Benztropine
• C. Amantadine
• D. Clonazepam
Correct Answer: B. Benztropine
Rationale: IM haloperidol should be administered with an anticholinergic agent such
as benztropine or diphenhydramine to reduce the risk of severe EPS, particularly acute
dystonia.
,Question 2 (SINGLE BEST ANSWER)
A patient presents with involuntary movements of the facial muscles, tongue
protrusion, and lip smacking after 5 years of antipsychotic therapy. Which
condition is most likely?
• A. Acute dystonia
• B. Akathisia
• C. Tardive dyskinesia
• D. Neuroleptic malignant syndrome
Correct Answer: C. Tardive dyskinesia
Rationale: Tardive dyskinesia (TD) is characterized by involuntary movements of the
facial muscles, tongue, and limbs. It is a neurotoxic side effect of long-term
antipsychotic use targeting dopamine receptors.
───────────────────────────────────────────────────────
─────────────────────────
Question 3 (SELECT ALL THAT APPLY)
A patient on clozapine presents with fever, sore throat, and malaise. The
PMHNP suspects agranulocytosis. Select all that apply regarding clozapine
monitoring:
• A. Monitor WBC and ANC weekly for the first 6 months
• B. Discontinue clozapine if ANC falls below 1,500/mm³
• C. Agranulocytosis occurs in approximately 1% of patients
• D. Sialorrhea occurs in 30-80% of patients and is managed with glycopyrrolate
• E. Clozapine is first-line for all patients with schizophrenia
Correct Answer: A, B, C, D
Rationale: Clozapine requires WBC/ANC monitoring due to agranulocytosis risk
(1%). It is discontinued if ANC <1,500. Sialorrhea is common (30-80%) and managed
with glycopyrrolate. Clozapine is reserved for treatment-resistant schizophrenia, not
first-line.
, ───────────────────────────────────────────────────────
─────────────────────────
Question 4 (SINGLE BEST ANSWER)
A 35-year-old female on risperidone reports galactorrhea and amenorrhea.
Which pathway is primarily responsible for this adverse effect?
• A. Mesolimbic pathway
• B. Mesocortical pathway
• C. Nigrostriatal pathway
• D. Tuberoinfundibular pathway
Correct Answer: D. Tuberoinfundibular pathway
Rationale: D2 blockade in the tuberoinfundibular pathway results in
hyperprolactinemia, causing galactorrhea, amenorrhea, gynecomastia, and decreased
libido. Risperidone is particularly associated with this effect.
───────────────────────────────────────────────────────
─────────────────────────
Question 5 (SINGLE BEST ANSWER)
A patient with bipolar disorder has a lithium level of 2.1 mEq/L. Which clinical
manifestation is most concerning?
• A. Coarse tremor and ataxia
• B. Seizures and coma
• C. Nausea and diarrhea
• D. Polyuria and polydipsia
Correct Answer: B. Seizures and coma
Rationale: Lithium has a narrow therapeutic index (0.6-1.2 mEq/L). Levels >2.0
mEq/L are potentially lethal and manifest with seizures, coma, and death. Early signs
include nausea, vomiting, and coarse tremors.
