NSG 552 WILKES
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. A patient with treatment-resistant depression is prescribed an MAOI. Which mechanism
explains the hypertensive crisis risk when consuming tyramine?
A. Tyramine acts as a direct agonist on alpha-1 receptors.
B. MAOIs cause tyramine to convert directly into epinephrine.
C. Tyramine prevents the reuptake of serotonin in the synaptic cleft.
D. MAOIs inhibit the breakdown of tyramine, leading to excessive norepinephrine release.
Answer: D
Conceptual Explanation: MAOIs inhibit Monoamine Oxidase in the gut; when tyramine is
not degraded, it enters the systemic circulation and displaces norepinephrine from storage
vesicles, leading to a hypertensive crisis.
2. Which dopaminergic pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Nigrostriatal pathway
,B. Mesolimbic pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: Hyperactivity of dopamine in the mesolimbic pathway is linked
to positive symptoms, whereas hypoactivity in the mesocortical pathway is linked to
negative and cognitive symptoms.
3. How many half-lives are generally required for a drug to reach steady-state plasma
concentrations?
A. 1 to 2
B. 7 to 8
C. 4 to 5
D. 10 to 12
Answer: C
Conceptual Explanation: It takes approximately 4 to 5 half-lives for a drug’s rate of
administration to equal its rate of elimination, achieving steady state.
4. A patient taking Clozapine must have regular blood draws. What is the primary
hematologic risk being monitored?
A. Thrombocytopenia
, B. Severe Neutropenia (Agranulocytosis)
C. Aplastic anemia
D. Polycythemia vera
Answer: B
Conceptual Explanation: Clozapine carries a Black Box Warning for severe neutropenia
(absolute neutrophil count < 500/µL), necessitating regular monitoring via the REMS
program.
5. Which of the following describes the mechanism of action of Buspirone?
A. 5-HT1A partial agonist
B. GABA-A positive allosteric modulator
C. Selective norepinephrine reuptake inhibitor
D. NMDA receptor antagonist
Answer: A
Conceptual Explanation: Buspirone is a 5-HT1A partial agonist used for Generalized
Anxiety Disorder. It lacks the sedative and addictive properties of benzodiazepines.
6. When prescribing Lithium, which laboratory tests are essential for baseline and ongoing
monitoring?
A. AST, ALT, and Bilirubin
B. Complete Blood Count only
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. A patient with treatment-resistant depression is prescribed an MAOI. Which mechanism
explains the hypertensive crisis risk when consuming tyramine?
A. Tyramine acts as a direct agonist on alpha-1 receptors.
B. MAOIs cause tyramine to convert directly into epinephrine.
C. Tyramine prevents the reuptake of serotonin in the synaptic cleft.
D. MAOIs inhibit the breakdown of tyramine, leading to excessive norepinephrine release.
Answer: D
Conceptual Explanation: MAOIs inhibit Monoamine Oxidase in the gut; when tyramine is
not degraded, it enters the systemic circulation and displaces norepinephrine from storage
vesicles, leading to a hypertensive crisis.
2. Which dopaminergic pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Nigrostriatal pathway
,B. Mesolimbic pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: Hyperactivity of dopamine in the mesolimbic pathway is linked
to positive symptoms, whereas hypoactivity in the mesocortical pathway is linked to
negative and cognitive symptoms.
3. How many half-lives are generally required for a drug to reach steady-state plasma
concentrations?
A. 1 to 2
B. 7 to 8
C. 4 to 5
D. 10 to 12
Answer: C
Conceptual Explanation: It takes approximately 4 to 5 half-lives for a drug’s rate of
administration to equal its rate of elimination, achieving steady state.
4. A patient taking Clozapine must have regular blood draws. What is the primary
hematologic risk being monitored?
A. Thrombocytopenia
, B. Severe Neutropenia (Agranulocytosis)
C. Aplastic anemia
D. Polycythemia vera
Answer: B
Conceptual Explanation: Clozapine carries a Black Box Warning for severe neutropenia
(absolute neutrophil count < 500/µL), necessitating regular monitoring via the REMS
program.
5. Which of the following describes the mechanism of action of Buspirone?
A. 5-HT1A partial agonist
B. GABA-A positive allosteric modulator
C. Selective norepinephrine reuptake inhibitor
D. NMDA receptor antagonist
Answer: A
Conceptual Explanation: Buspirone is a 5-HT1A partial agonist used for Generalized
Anxiety Disorder. It lacks the sedative and addictive properties of benzodiazepines.
6. When prescribing Lithium, which laboratory tests are essential for baseline and ongoing
monitoring?
A. AST, ALT, and Bilirubin
B. Complete Blood Count only
