1
NSG 552 (Exams 1) Wilkes
Psychopharmacology | Advanced/Hard |
100% Pass Guaranteed | Graded A+
[1] A patient with major depressive disorder is prescribed fluoxetine. The patient is also taking
an over-the-counter herbal supplement. Which herbal supplement should the patient be
advised to avoid due to the risk of serotonin syndrome when combined with fluoxetine?
A. St. John's Wort
B. Omega-3 fatty acids
C. Vitamin D
D. Melatonin
Correct Answer: A
Explanation: St. John's Wort is a potent inducer of CYP3A4 and has serotonergic activity,
increasing the risk of serotonin syndrome when combined with SSRIs like fluoxetine .
[2] A patient is being initiated on clozapine for treatment-resistant schizophrenia. Which
monitoring parameter is mandatory for the duration of treatment?
,2
A. Complete blood count (CBC) with differential
B. Serum creatinine
C. Liver function tests
D. Electrocardiogram (ECG)
Correct Answer: A
Explanation: Mandatory monitoring of Absolute Neutrophil Count (ANC) through a CBC
with differential is required for clozapine therapy due to the risk of agranulocytosis .
[3] Which antipsychotic is most strongly associated with the greatest degree of weight gain and
metabolic side effects?
A. Aripiprazole
B. Ziprasidone
C. Olanzapine
D. Haloperidol
Correct Answer: C
Explanation: Olanzapine is associated with the highest risk of weight gain and metabolic
effects, including diabetes and dyslipidemia, among antipsychotics .
,3
[4] A patient on lithium therapy for bipolar disorder presents with coarse tremor, ataxia, and
confusion. What is the most likely diagnosis?
A. Lithium toxicity
B. Serotonin syndrome
C. Neuroleptic malignant syndrome
D. Parkinsonism
Correct Answer: A
Explanation: Symptoms of lithium toxicity include coarse tremor, ataxia, confusion, nausea,
vomiting, and diarrhea. A serum lithium level above 1.5 mEq/L is considered toxic .
[5] Which statement best describes the mechanism of action of lithium in bipolar disorder?
A. Directly antagonizes dopamine receptors in the prefrontal cortex
B. Modulates neurotransmitter release and signal transduction pathways
C. Potentiates GABA-mediated chloride influx
D. Blocks serotonin reuptake at the presynaptic terminal
Correct Answer: B
, 4
Explanation: Lithium modulates neurotransmitter release and signal transduction
cascades, including the inositol depletion hypothesis, affecting mood regulation .
[6] Among the following, which is the most appropriate first-line treatment for an acute manic
episode?
A. Lithium
B. Sertraline
C. Quetiapine
D. Valproate
Correct Answer: C
Explanation: Antipsychotics like quetiapine are recommended as first-line monotherapy for
acute mania, along with lithium and valproate .
[7] What is the primary mechanism of action of bupropion in treating depression?
A. Serotonin and norepinephrine reuptake inhibition
B. Dopamine and norepinephrine reuptake inhibition
C. Serotonin reuptake inhibition
NSG 552 (Exams 1) Wilkes
Psychopharmacology | Advanced/Hard |
100% Pass Guaranteed | Graded A+
[1] A patient with major depressive disorder is prescribed fluoxetine. The patient is also taking
an over-the-counter herbal supplement. Which herbal supplement should the patient be
advised to avoid due to the risk of serotonin syndrome when combined with fluoxetine?
A. St. John's Wort
B. Omega-3 fatty acids
C. Vitamin D
D. Melatonin
Correct Answer: A
Explanation: St. John's Wort is a potent inducer of CYP3A4 and has serotonergic activity,
increasing the risk of serotonin syndrome when combined with SSRIs like fluoxetine .
[2] A patient is being initiated on clozapine for treatment-resistant schizophrenia. Which
monitoring parameter is mandatory for the duration of treatment?
,2
A. Complete blood count (CBC) with differential
B. Serum creatinine
C. Liver function tests
D. Electrocardiogram (ECG)
Correct Answer: A
Explanation: Mandatory monitoring of Absolute Neutrophil Count (ANC) through a CBC
with differential is required for clozapine therapy due to the risk of agranulocytosis .
[3] Which antipsychotic is most strongly associated with the greatest degree of weight gain and
metabolic side effects?
A. Aripiprazole
B. Ziprasidone
C. Olanzapine
D. Haloperidol
Correct Answer: C
Explanation: Olanzapine is associated with the highest risk of weight gain and metabolic
effects, including diabetes and dyslipidemia, among antipsychotics .
,3
[4] A patient on lithium therapy for bipolar disorder presents with coarse tremor, ataxia, and
confusion. What is the most likely diagnosis?
A. Lithium toxicity
B. Serotonin syndrome
C. Neuroleptic malignant syndrome
D. Parkinsonism
Correct Answer: A
Explanation: Symptoms of lithium toxicity include coarse tremor, ataxia, confusion, nausea,
vomiting, and diarrhea. A serum lithium level above 1.5 mEq/L is considered toxic .
[5] Which statement best describes the mechanism of action of lithium in bipolar disorder?
A. Directly antagonizes dopamine receptors in the prefrontal cortex
B. Modulates neurotransmitter release and signal transduction pathways
C. Potentiates GABA-mediated chloride influx
D. Blocks serotonin reuptake at the presynaptic terminal
Correct Answer: B
, 4
Explanation: Lithium modulates neurotransmitter release and signal transduction
cascades, including the inositol depletion hypothesis, affecting mood regulation .
[6] Among the following, which is the most appropriate first-line treatment for an acute manic
episode?
A. Lithium
B. Sertraline
C. Quetiapine
D. Valproate
Correct Answer: C
Explanation: Antipsychotics like quetiapine are recommended as first-line monotherapy for
acute mania, along with lithium and valproate .
[7] What is the primary mechanism of action of bupropion in treating depression?
A. Serotonin and norepinephrine reuptake inhibition
B. Dopamine and norepinephrine reuptake inhibition
C. Serotonin reuptake inhibition
