NSG 552 WILKES
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient is prescribed a medication that acts as an inverse agonist at the GABA-A receptor.
What is the expected physiological result?
A. Increased chloride channel opening frequency
B. Closure of the chloride channel and opposite effect of GABA
C. Enhanced binding of GABA to the receptor
D. No change in receptor activity unless GABA is present
Answer: B
Conceptual Explanation: An inverse agonist binds to a receptor and produces the
opposite pharmacological effect of an agonist, in this case, closing the chloride channel
rather than opening it.
2. Which dopamine pathway is primarily associated with the development of negative
symptoms and cognitive impairment in schizophrenia?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Answer: D
Conceptual Explanation: Hypofunction of the mesocortical dopamine pathway is linked to
negative symptoms and cognitive deficits in schizophrenia.
3. A patient stable on Clozapine starts smoking one pack of cigarettes per day. What change
in Clozapine levels is most likely to occur?
A. Levels will increase significantly
B. Levels will remain unchanged
C. Levels will decrease significantly
D. Levels will fluctuate based on nicotine patches
Answer: C
Conceptual Explanation: Polycyclic aromatic hydrocarbons in cigarette smoke induce the
CYP1A2 enzyme, which metabolizes Clozapine, leading to decreased serum levels.
4. Which of the following medication combinations carries the highest risk for causing a
hypertensive crisis?
A. Fluoxetine and Lithium
B. Sertraline and Alprazolam
, C. Phenelzine and Pseudoephedrine
D. Amitriptyline and Valproate
Answer: C
Conceptual Explanation: Phenelzine is an MAOI; combined with sympathomimetics like
pseudoephedrine, it can cause massive norepinephrine release and a hypertensive crisis.
5. A patient taking Lithium for Bipolar I Disorder is started on a Thiazide diuretic for
hypertension. What is the most likely outcome?
A. Decreased Lithium levels due to increased excretion
B. Increased Lithium levels due to decreased renal clearance
C. Hyperkalemia leading to Lithium toxicity
D. Reduced efficacy of the Thiazide diuretic
Answer: B
Conceptual Explanation: Thiazide diuretics cause sodium depletion, which leads the
proximal tubule to reabsorb both sodium and lithium, increasing lithium serum levels.
6. Which antidepressant is uniquely known for its mechanism as an Alpha-2 antagonist,
increasing both serotonin and norepinephrine?
A. Venlafaxine
B. Bupropion
C. Mirtazapine
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient is prescribed a medication that acts as an inverse agonist at the GABA-A receptor.
What is the expected physiological result?
A. Increased chloride channel opening frequency
B. Closure of the chloride channel and opposite effect of GABA
C. Enhanced binding of GABA to the receptor
D. No change in receptor activity unless GABA is present
Answer: B
Conceptual Explanation: An inverse agonist binds to a receptor and produces the
opposite pharmacological effect of an agonist, in this case, closing the chloride channel
rather than opening it.
2. Which dopamine pathway is primarily associated with the development of negative
symptoms and cognitive impairment in schizophrenia?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Answer: D
Conceptual Explanation: Hypofunction of the mesocortical dopamine pathway is linked to
negative symptoms and cognitive deficits in schizophrenia.
3. A patient stable on Clozapine starts smoking one pack of cigarettes per day. What change
in Clozapine levels is most likely to occur?
A. Levels will increase significantly
B. Levels will remain unchanged
C. Levels will decrease significantly
D. Levels will fluctuate based on nicotine patches
Answer: C
Conceptual Explanation: Polycyclic aromatic hydrocarbons in cigarette smoke induce the
CYP1A2 enzyme, which metabolizes Clozapine, leading to decreased serum levels.
4. Which of the following medication combinations carries the highest risk for causing a
hypertensive crisis?
A. Fluoxetine and Lithium
B. Sertraline and Alprazolam
, C. Phenelzine and Pseudoephedrine
D. Amitriptyline and Valproate
Answer: C
Conceptual Explanation: Phenelzine is an MAOI; combined with sympathomimetics like
pseudoephedrine, it can cause massive norepinephrine release and a hypertensive crisis.
5. A patient taking Lithium for Bipolar I Disorder is started on a Thiazide diuretic for
hypertension. What is the most likely outcome?
A. Decreased Lithium levels due to increased excretion
B. Increased Lithium levels due to decreased renal clearance
C. Hyperkalemia leading to Lithium toxicity
D. Reduced efficacy of the Thiazide diuretic
Answer: B
Conceptual Explanation: Thiazide diuretics cause sodium depletion, which leads the
proximal tubule to reabsorb both sodium and lithium, increasing lithium serum levels.
6. Which antidepressant is uniquely known for its mechanism as an Alpha-2 antagonist,
increasing both serotonin and norepinephrine?
A. Venlafaxine
B. Bupropion
C. Mirtazapine
