,NSG 552 Psychopharmacology Exam 3 Actual 2026/2027 –
Complete Exam-Style Questions | 100% Verified – Pass
Guaranteed – A+ Graded
SECTION 1: SUBSTANCE USE DISORDERS
Alcohol Use Disorder
Question 1
A patient with alcohol use disorder is admitted and is 12 hours since his last drink.
He is tremulous, diaphoretic, and reports nausea. His CIWA-Ar score is 14. Which
is the most appropriate pharmacologic intervention?
A. Haloperidol 5 mg IM now for agitation
B. Chlordiazepoxide 50 mg PO now only
C. Lorazepam 2 mg IV push now and repeat CIWA-Ar in 1 hour
D. Thiamine 100 mg IV now and repeat in 6 hours
Correct Answer: C. Lorazepam 2 mg IV push now and repeat CIWA-Ar in 1 hour
Rationale: A CIWA-Ar score of 14 indicates moderate withdrawal.
Benzodiazepines are first-line treatment for alcohol withdrawal. Lorazepam is
preferred in hospitalized patients due to its shorter half-life and lack of active
metabolites. Symptom-triggered therapy with repeat CIWA-Ar assessment is the
standard of care. Haloperidol does not treat withdrawal and can lower seizure
threshold. Thiamine prevents Wernicke's encephalopathy but does not treat
withdrawal symptoms.
Question 2
Which medication for alcohol use disorder is most appropriate for a patient with
significant hepatic dysfunction?
A. Disulfiram
B. Naltrexone
,C. Acamprosate
D. Chlordiazepoxide
Correct Answer: C. Acamprosate
Rationale: Acamprosate is cleared renally, making it the preferred option for
patients with hepatic dysfunction. Naltrexone carries a hepatotoxicity warning.
Disulfiram is metabolized by the liver and can cause hepatotoxicity.
Chlordiazepoxide is metabolized hepatically and may accumulate in liver disease.
Question 3
A patient with alcohol use disorder is prescribed disulfiram. Which statement
indicates the patient understands the medication teaching?
A. "I can drink wine but not hard liquor."
B. "This medication will reduce my cravings for alcohol."
C. "Even small amounts of alcohol can cause severe nausea and vomiting."
D. "I need to take this medication only when I feel like drinking."
Correct Answer: C. "Even small amounts of alcohol can cause severe nausea and
vomiting."
Rationale: Disulfiram works via negative reinforcement—drinking produces
unpleasant effects including nausea, vomiting, flushing, and palpitations. This is
not a craving-reduction medication. Any alcohol, including that in mouthwash or
cooking, can trigger the reaction.
Question 4
A patient on disulfiram reports drinking a beer 2 hours ago and is now
experiencing severe flushing, nausea, vomiting, and palpitations. What is the
priority intervention?
A. Administer naloxone
B. Administer IV fluids and monitor vital signs
, C. Administer flumazenil
D. Administer activated charcoal
Correct Answer: B. Administer IV fluids and monitor vital signs
Rationale: The disulfiram-alcohol reaction can cause hypotension and
cardiovascular collapse. Supportive care with IV fluids and vital sign monitoring is
the priority. Naloxone is for opioid overdose. Flumazenil is for benzodiazepine
overdose. Activated charcoal is not effective after 2 hours.
Question 5
A patient is started on naltrexone for alcohol use disorder. What is the primary
mechanism of action?
A. Blocks alcohol metabolism
B. Reduces cravings by blocking opioid receptors
C. Increases GABA activity
D. Decreases glutamate activity
Correct Answer: B. Reduces cravings by blocking opioid receptors
Rationale: Naltrexone is an opioid receptor antagonist that reduces the rewarding
effects of alcohol and decreases cravings. Disulfiram blocks alcohol metabolism.
Acamprosate modulates glutamate and GABA.
Question 6
Which medication for alcohol use disorder requires the patient to be abstinent for
at least 4 hours before initiation?
A. Naltrexone
B. Acamprosate
C. Disulfiram
D. Gabapentin
Complete Exam-Style Questions | 100% Verified – Pass
Guaranteed – A+ Graded
SECTION 1: SUBSTANCE USE DISORDERS
Alcohol Use Disorder
Question 1
A patient with alcohol use disorder is admitted and is 12 hours since his last drink.
He is tremulous, diaphoretic, and reports nausea. His CIWA-Ar score is 14. Which
is the most appropriate pharmacologic intervention?
A. Haloperidol 5 mg IM now for agitation
B. Chlordiazepoxide 50 mg PO now only
C. Lorazepam 2 mg IV push now and repeat CIWA-Ar in 1 hour
D. Thiamine 100 mg IV now and repeat in 6 hours
Correct Answer: C. Lorazepam 2 mg IV push now and repeat CIWA-Ar in 1 hour
Rationale: A CIWA-Ar score of 14 indicates moderate withdrawal.
Benzodiazepines are first-line treatment for alcohol withdrawal. Lorazepam is
preferred in hospitalized patients due to its shorter half-life and lack of active
metabolites. Symptom-triggered therapy with repeat CIWA-Ar assessment is the
standard of care. Haloperidol does not treat withdrawal and can lower seizure
threshold. Thiamine prevents Wernicke's encephalopathy but does not treat
withdrawal symptoms.
Question 2
Which medication for alcohol use disorder is most appropriate for a patient with
significant hepatic dysfunction?
A. Disulfiram
B. Naltrexone
,C. Acamprosate
D. Chlordiazepoxide
Correct Answer: C. Acamprosate
Rationale: Acamprosate is cleared renally, making it the preferred option for
patients with hepatic dysfunction. Naltrexone carries a hepatotoxicity warning.
Disulfiram is metabolized by the liver and can cause hepatotoxicity.
Chlordiazepoxide is metabolized hepatically and may accumulate in liver disease.
Question 3
A patient with alcohol use disorder is prescribed disulfiram. Which statement
indicates the patient understands the medication teaching?
A. "I can drink wine but not hard liquor."
B. "This medication will reduce my cravings for alcohol."
C. "Even small amounts of alcohol can cause severe nausea and vomiting."
D. "I need to take this medication only when I feel like drinking."
Correct Answer: C. "Even small amounts of alcohol can cause severe nausea and
vomiting."
Rationale: Disulfiram works via negative reinforcement—drinking produces
unpleasant effects including nausea, vomiting, flushing, and palpitations. This is
not a craving-reduction medication. Any alcohol, including that in mouthwash or
cooking, can trigger the reaction.
Question 4
A patient on disulfiram reports drinking a beer 2 hours ago and is now
experiencing severe flushing, nausea, vomiting, and palpitations. What is the
priority intervention?
A. Administer naloxone
B. Administer IV fluids and monitor vital signs
, C. Administer flumazenil
D. Administer activated charcoal
Correct Answer: B. Administer IV fluids and monitor vital signs
Rationale: The disulfiram-alcohol reaction can cause hypotension and
cardiovascular collapse. Supportive care with IV fluids and vital sign monitoring is
the priority. Naloxone is for opioid overdose. Flumazenil is for benzodiazepine
overdose. Activated charcoal is not effective after 2 hours.
Question 5
A patient is started on naltrexone for alcohol use disorder. What is the primary
mechanism of action?
A. Blocks alcohol metabolism
B. Reduces cravings by blocking opioid receptors
C. Increases GABA activity
D. Decreases glutamate activity
Correct Answer: B. Reduces cravings by blocking opioid receptors
Rationale: Naltrexone is an opioid receptor antagonist that reduces the rewarding
effects of alcohol and decreases cravings. Disulfiram blocks alcohol metabolism.
Acamprosate modulates glutamate and GABA.
Question 6
Which medication for alcohol use disorder requires the patient to be abstinent for
at least 4 hours before initiation?
A. Naltrexone
B. Acamprosate
C. Disulfiram
D. Gabapentin
