NSG552 / NSG 552 EXAM 3 PSYCHOPHARMACOLOGY – QUESTIONS
AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
1. Neurobiology and Mechanisms of Action
2. Antidepressants (SSRIs, SNRIs, TCAs, MAOIs, Atypicals)
3. Antipsychotics (Typical and Atypical)
4. Mood Stabilizers and Anticonvulsants
5. Anxiolytics and Sedative-Hypnotics
6. Stimulants and ADHD Medications
7. Substance Use Disorder Pharmacotherapy
8. Geriatric and Pediatric Psychopharmacology
9. Adverse Effects, Drug Interactions, and Monitoring
10. Legal, Ethical, and Prescriptive Practice Standards
Introduction
This comprehensive examination is designed to assess advanced practice nursing knowledge in psychopharmacology,
focusing on the safe and effective use of psychotropic agents across the lifespan. The exam evaluates foundational
,neurobiology, pharmacokinetics, pharmacodynamics, clinical indications, contraindications, adverse effect profiles, drug
interactions, and evidence-based prescribing practices. Questions are structured as multiple-choice and clinical
scenario-based items to foster critical thinking and real-world clinical decision-making. Each question is accompanied
by a detailed rationale to reinforce learning and ensure deep understanding of key concepts. This assessment prepares
the clinician to manage complex psychiatric presentations while adhering to regulatory, ethical, and professional
practice standards.
SECTION ONE: QUESTIONS 1–100
1. A 45-year-old patient with major depressive disorder has been on fluoxetine 40 mg daily for 8 weeks with
partial response. The prescriber considers augmentation. Which agent is FDA-approved for augmentation of
SSRIs in treatment-resistant depression?
A. Lithium
B. Buspirone
C. Aripiprazole
D. Lamotrigine
🟢 C. Aripiprazole
🔴 Explanation: Aripiprazole is FDA-approved as an adjunctive treatment for major depressive disorder in patients
with inadequate response to antidepressant therapy. Lithium and buspirone are used off-label for augmentation,
while lamotrigine lacks robust evidence for this indication.
,2. A 28-year-old patient with bipolar I disorder is prescribed lamotrigine. What is the most critical patient
education point regarding this medication?
A. Monitor for weight gain and metabolic changes
B. Report any rash immediately, especially in the first 8 weeks
C. Avoid grapefruit juice consumption
D. Take with food to reduce gastrointestinal upset
🟢 B. Report any rash immediately, especially in the first 8 weeks
🔴 Explanation: Lamotrigine carries a black box warning for serious rashes, including Stevens-Johnson syndrome,
with highest risk in the first 8 weeks of treatment. Patients must be educated to report any rash promptly. Weight
gain is not a prominent side effect of lamotrigine, and grapefruit juice interaction is not significant.
3. Which neurotransmitter system is primarily implicated in the pathophysiology of schizophrenia?
A. Norepinephrine
B. Serotonin
C. Dopamine
D. Acetylcholine
🟢 C. Dopamine
🔴 Explanation: The dopamine hypothesis of schizophrenia posits that hyperdopaminergic activity in mesolimbic
pathways contributes to positive symptoms, while hypodopaminergic activity in prefrontal regions contributes to
, negative and cognitive symptoms. While other systems are involved, dopamine remains the primary focus.
4. A 70-year-old patient with generalized anxiety disorder and glaucoma is started on buspirone. Why is
buspirone preferred over benzodiazepines in this patient?
A. It has anxiolytic effects without muscle relaxation
B. It does not cause respiratory depression
C. It has no anticholinergic effects and does not increase intraocular pressure
D. It is more effective in geriatric patients
🟢 C. It has no anticholinergic effects and does not increase intraocular pressure
🔴 Explanation: Buspirone is a non-benzodiazepine anxiolytic that does not exhibit anticholinergic properties and
does not raise intraocular pressure, making it safer for patients with glaucoma. Benzodiazepines may have mild
anticholinergic effects and can worsen narrow-angle glaucoma.
5. A patient has been taking phenelzine for depression. Which dietary restriction is most critical to prevent
hypertensive crisis?
A. Avoiding caffeinated beverages
B. Limiting sodium intake
C. Avoiding tyramine-rich foods such as aged cheese and cured meats
D. Restricting fluid intake
AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains:
1. Neurobiology and Mechanisms of Action
2. Antidepressants (SSRIs, SNRIs, TCAs, MAOIs, Atypicals)
3. Antipsychotics (Typical and Atypical)
4. Mood Stabilizers and Anticonvulsants
5. Anxiolytics and Sedative-Hypnotics
6. Stimulants and ADHD Medications
7. Substance Use Disorder Pharmacotherapy
8. Geriatric and Pediatric Psychopharmacology
9. Adverse Effects, Drug Interactions, and Monitoring
10. Legal, Ethical, and Prescriptive Practice Standards
Introduction
This comprehensive examination is designed to assess advanced practice nursing knowledge in psychopharmacology,
focusing on the safe and effective use of psychotropic agents across the lifespan. The exam evaluates foundational
,neurobiology, pharmacokinetics, pharmacodynamics, clinical indications, contraindications, adverse effect profiles, drug
interactions, and evidence-based prescribing practices. Questions are structured as multiple-choice and clinical
scenario-based items to foster critical thinking and real-world clinical decision-making. Each question is accompanied
by a detailed rationale to reinforce learning and ensure deep understanding of key concepts. This assessment prepares
the clinician to manage complex psychiatric presentations while adhering to regulatory, ethical, and professional
practice standards.
SECTION ONE: QUESTIONS 1–100
1. A 45-year-old patient with major depressive disorder has been on fluoxetine 40 mg daily for 8 weeks with
partial response. The prescriber considers augmentation. Which agent is FDA-approved for augmentation of
SSRIs in treatment-resistant depression?
A. Lithium
B. Buspirone
C. Aripiprazole
D. Lamotrigine
🟢 C. Aripiprazole
🔴 Explanation: Aripiprazole is FDA-approved as an adjunctive treatment for major depressive disorder in patients
with inadequate response to antidepressant therapy. Lithium and buspirone are used off-label for augmentation,
while lamotrigine lacks robust evidence for this indication.
,2. A 28-year-old patient with bipolar I disorder is prescribed lamotrigine. What is the most critical patient
education point regarding this medication?
A. Monitor for weight gain and metabolic changes
B. Report any rash immediately, especially in the first 8 weeks
C. Avoid grapefruit juice consumption
D. Take with food to reduce gastrointestinal upset
🟢 B. Report any rash immediately, especially in the first 8 weeks
🔴 Explanation: Lamotrigine carries a black box warning for serious rashes, including Stevens-Johnson syndrome,
with highest risk in the first 8 weeks of treatment. Patients must be educated to report any rash promptly. Weight
gain is not a prominent side effect of lamotrigine, and grapefruit juice interaction is not significant.
3. Which neurotransmitter system is primarily implicated in the pathophysiology of schizophrenia?
A. Norepinephrine
B. Serotonin
C. Dopamine
D. Acetylcholine
🟢 C. Dopamine
🔴 Explanation: The dopamine hypothesis of schizophrenia posits that hyperdopaminergic activity in mesolimbic
pathways contributes to positive symptoms, while hypodopaminergic activity in prefrontal regions contributes to
, negative and cognitive symptoms. While other systems are involved, dopamine remains the primary focus.
4. A 70-year-old patient with generalized anxiety disorder and glaucoma is started on buspirone. Why is
buspirone preferred over benzodiazepines in this patient?
A. It has anxiolytic effects without muscle relaxation
B. It does not cause respiratory depression
C. It has no anticholinergic effects and does not increase intraocular pressure
D. It is more effective in geriatric patients
🟢 C. It has no anticholinergic effects and does not increase intraocular pressure
🔴 Explanation: Buspirone is a non-benzodiazepine anxiolytic that does not exhibit anticholinergic properties and
does not raise intraocular pressure, making it safer for patients with glaucoma. Benzodiazepines may have mild
anticholinergic effects and can worsen narrow-angle glaucoma.
5. A patient has been taking phenelzine for depression. Which dietary restriction is most critical to prevent
hypertensive crisis?
A. Avoiding caffeinated beverages
B. Limiting sodium intake
C. Avoiding tyramine-rich foods such as aged cheese and cured meats
D. Restricting fluid intake
