NSG 552
EXAM 3
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 3 Comprehensive Study Guide
,Table of Contents
NSG 552 Exam 3........................................................... 2
NSG 552 Exam 3 Study Guide .................................... 63
NSG 552 Exam 3
SECTION 1: SUBSTANCE USE DISORDERS
Question 1
A 34-year-old male is brought to the emergency department by EMS. His
girlfriend reports finding him unresponsive in the bathroom with a syringe
nearby. On examination, he has pinpoint pupils, respiratory rate of 6
breaths/minute, and blood pressure of 88/52 mmHg. Which medication
should be administered first?
• A. Naloxone (Narcan)
• B. Methadone
• C. Buprenorphine (Suboxone)
• D. Naltrexone
Correct Answer: A. Naloxone (Narcan)
Rationale: The patient presents with the classic triad of opioid intoxication:
miosis (pinpoint pupils), respiratory depression (RR 6), and hypotension
(88/52). Naloxone is a potent opioid antagonist and the treatment of choice for
acute opioid overdose. It rapidly reverses respiratory depression. Methadone
and buprenorphine are maintenance medications, not emergency treatments.
Naltrexone is an antagonist used after detoxification and would not be
appropriate in an acute overdose.
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Question 2 [SELECT ALL THAT APPLY]
A nurse is assessing a patient suspected of opioid intoxication. Which findings
are consistent with this diagnosis? Select all that apply.
• A. Miosis (pinpoint pupils)
• B. Respiratory depression
• C. Tachycardia
• D. Hypotension
• E. Bradycardia
• F. Hypertension
Correct Answer: A, B, D, E
Rationale: Opioid intoxication presents with miosis (pinpoint pupils),
respiratory depression, bradycardia, hypotension, and unconsciousness.
Tachycardia and hypertension are NOT features of opioid intoxication; these
are more consistent with stimulant intoxication (e.g., cocaine). The classic
presentation is the triad of pinpoint pupils, respiratory depression, and
decreased level of consciousness.
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Question 3
A 28-year-old female presents to the clinic 24 hours after her last heroin use.
She reports severe anxiety, lacrimation (excessive tearing), muscle aches,
diarrhea, and abdominal cramps. Her vital signs show mild tachycardia and
hypertension. Which medication is most appropriate for managing her
symptoms?
• A. Naloxone
• B. Methadone
• C. Naltrexone
• D. Disulfiram
Correct Answer: B. Methadone
, Rationale: This patient is experiencing opioid withdrawal, characterized by
anxiety, lacrimation, muscle aches, diarrhea, and abdominal cramps.
Methadone is a long-acting full mu opioid agonist used for opioid use disorder
maintenance. It decreases cravings and withdrawal symptoms. Naloxone is for
overdose, not withdrawal. Naltrexone is an antagonist used after detoxification
and would precipitate withdrawal if given now. Disulfiram is for alcohol use
disorder.
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Question 4
A nurse practitioner is initiating buprenorphine (Suboxone) therapy for a
patient with opioid use disorder. The patient last used heroin 8 hours ago.
What is the most important consideration before starting buprenorphine?
• A. The patient must be in moderate withdrawal before starting
• B. Buprenorphine can be started immediately regardless of withdrawal
status
• C. The patient should receive a loading dose of methadone first
• D. Naloxone must be administered prior to buprenorphine
Correct Answer: A. The patient must be in moderate withdrawal before
starting
Rationale: Buprenorphine is a partial mu opioid agonist. Starting it too soon
after a full opioid agonist (like heroin) can precipitate withdrawal because it
displaces opioids from the mu receptors. The patient should be in moderate
withdrawal (typically 12-24 hours after short-acting opioids) before initiating
buprenorphine. This is a critical clinical pearl for safe buprenorphine initiation.
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Question 5 [SELECT ALL THAT APPLY]
A patient has been prescribed methadone for opioid use disorder
maintenance. Which monitoring parameters are essential? Select all that
apply.
• A. QTc interval on ECG
EXAM 3
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 3 Comprehensive Study Guide
,Table of Contents
NSG 552 Exam 3........................................................... 2
NSG 552 Exam 3 Study Guide .................................... 63
NSG 552 Exam 3
SECTION 1: SUBSTANCE USE DISORDERS
Question 1
A 34-year-old male is brought to the emergency department by EMS. His
girlfriend reports finding him unresponsive in the bathroom with a syringe
nearby. On examination, he has pinpoint pupils, respiratory rate of 6
breaths/minute, and blood pressure of 88/52 mmHg. Which medication
should be administered first?
• A. Naloxone (Narcan)
• B. Methadone
• C. Buprenorphine (Suboxone)
• D. Naltrexone
Correct Answer: A. Naloxone (Narcan)
Rationale: The patient presents with the classic triad of opioid intoxication:
miosis (pinpoint pupils), respiratory depression (RR 6), and hypotension
(88/52). Naloxone is a potent opioid antagonist and the treatment of choice for
acute opioid overdose. It rapidly reverses respiratory depression. Methadone
and buprenorphine are maintenance medications, not emergency treatments.
Naltrexone is an antagonist used after detoxification and would not be
appropriate in an acute overdose.
,──────────────────────────────────────────────────
──────────────────────────────
Question 2 [SELECT ALL THAT APPLY]
A nurse is assessing a patient suspected of opioid intoxication. Which findings
are consistent with this diagnosis? Select all that apply.
• A. Miosis (pinpoint pupils)
• B. Respiratory depression
• C. Tachycardia
• D. Hypotension
• E. Bradycardia
• F. Hypertension
Correct Answer: A, B, D, E
Rationale: Opioid intoxication presents with miosis (pinpoint pupils),
respiratory depression, bradycardia, hypotension, and unconsciousness.
Tachycardia and hypertension are NOT features of opioid intoxication; these
are more consistent with stimulant intoxication (e.g., cocaine). The classic
presentation is the triad of pinpoint pupils, respiratory depression, and
decreased level of consciousness.
──────────────────────────────────────────────────
──────────────────────────────
Question 3
A 28-year-old female presents to the clinic 24 hours after her last heroin use.
She reports severe anxiety, lacrimation (excessive tearing), muscle aches,
diarrhea, and abdominal cramps. Her vital signs show mild tachycardia and
hypertension. Which medication is most appropriate for managing her
symptoms?
• A. Naloxone
• B. Methadone
• C. Naltrexone
• D. Disulfiram
Correct Answer: B. Methadone
, Rationale: This patient is experiencing opioid withdrawal, characterized by
anxiety, lacrimation, muscle aches, diarrhea, and abdominal cramps.
Methadone is a long-acting full mu opioid agonist used for opioid use disorder
maintenance. It decreases cravings and withdrawal symptoms. Naloxone is for
overdose, not withdrawal. Naltrexone is an antagonist used after detoxification
and would precipitate withdrawal if given now. Disulfiram is for alcohol use
disorder.
──────────────────────────────────────────────────
──────────────────────────────
Question 4
A nurse practitioner is initiating buprenorphine (Suboxone) therapy for a
patient with opioid use disorder. The patient last used heroin 8 hours ago.
What is the most important consideration before starting buprenorphine?
• A. The patient must be in moderate withdrawal before starting
• B. Buprenorphine can be started immediately regardless of withdrawal
status
• C. The patient should receive a loading dose of methadone first
• D. Naloxone must be administered prior to buprenorphine
Correct Answer: A. The patient must be in moderate withdrawal before
starting
Rationale: Buprenorphine is a partial mu opioid agonist. Starting it too soon
after a full opioid agonist (like heroin) can precipitate withdrawal because it
displaces opioids from the mu receptors. The patient should be in moderate
withdrawal (typically 12-24 hours after short-acting opioids) before initiating
buprenorphine. This is a critical clinical pearl for safe buprenorphine initiation.
──────────────────────────────────────────────────
──────────────────────────────
Question 5 [SELECT ALL THAT APPLY]
A patient has been prescribed methadone for opioid use disorder
maintenance. Which monitoring parameters are essential? Select all that
apply.
• A. QTc interval on ECG
