NURS 6521 Final Exam | NURS 6521 Advanced
Pathophysiology II | Actual Q&A with Rationale
(NURS 6521 Final Exam) | Walden
Q1. A patient with Alzheimer’s disease is started on donepezil. What is the mechanism
of action?
A. Blocks NMDA receptors
B. Inhibits acetylcholinesterase
C. Increases dopamine release
D. Blocks serotonin reuptake
Correct answer: B
Rationale: Donepezil is a reversible acetylcholinesterase inhibitor that increases
acetylcholine levels in the synaptic cleft, temporarily improving cognitive function in
mild to moderate Alzheimer’s disease.
Q2. Which drug is first-line for status epilepticus?
A. Phenytoin
B. Lorazepam
C. Valproic acid
D. Gabapentin
Correct answer: B
Rationale: Lorazepam is a benzodiazepine that rapidly enhances GABA-A receptor
activity, making it the first-line agent to terminate seizure activity in status epilepticus.
Q3. A patient on an SSRI develops serotonin syndrome after adding a second
,serotonergic drug. Which symptom is hallmark?
A. Hypothermia and bradycardia
B. Hyperthermia, clonus, and agitation
C. Dry mouth and urinary retention
D. Sedation and hypotension
Correct answer: B
Rationale: Serotonin syndrome features hyperthermia, clonus, hyperreflexia, agitation,
and autonomic instability due to excessive serotonergic activity.
Q4. Which antipsychotic is most likely to cause extrapyramidal symptoms (EPS)?
A. Clozapine
B. Quetiapine
C. Haloperidol
D. Olanzapine
Correct answer: C
Rationale: Haloperidol is a first-generation antipsychotic with high D2 receptor affinity
in the striatum, leading to a high risk of EPS such as dystonia and parkinsonism.
Q5. A patient with bipolar disorder is started on lithium. Which requires regular
monitoring?
A. Liver function tests
B. Serum lithium levels, renal function, and thyroid function
C. Complete blood count only
D. Electrocardiogram only
, Correct answer: B
Rationale: Lithium has a narrow therapeutic index; toxicity can cause nausea, tremor,
ataxia, and seizures. Chronic use can impair renal function and cause hypothyroidism,
so regular monitoring of lithium levels, creatinine, and TSH is essential.
Q6. Which anticonvulsant is first-line for trigeminal neuralgia?
A. Phenytoin
B. Gabapentin
C. Carbamazepine
D. Valproic acid
Correct answer: C
Rationale: Carbamazepine stabilizes neuronal membranes by blocking sodium channels,
reducing pain paroxysms in trigeminal neuralgia.
Q7. Buspirone is used for generalized anxiety disorder. Which statement is correct?
A. It has rapid onset within 24 hours
B. It is a partial agonist at serotonin 5-HT1A receptors
C. It is contraindicated with SSRIs
D. It causes significant sedation and dependence
Correct answer: B
Rationale: Buspirone is a partial agonist at 5-HT1A receptors, with delayed onset (2–4
weeks) and no sedation or dependence, making it safe for chronic anxiety.
Q8. Which is a contraindication to clozapine?
A. History of hypertension
Pathophysiology II | Actual Q&A with Rationale
(NURS 6521 Final Exam) | Walden
Q1. A patient with Alzheimer’s disease is started on donepezil. What is the mechanism
of action?
A. Blocks NMDA receptors
B. Inhibits acetylcholinesterase
C. Increases dopamine release
D. Blocks serotonin reuptake
Correct answer: B
Rationale: Donepezil is a reversible acetylcholinesterase inhibitor that increases
acetylcholine levels in the synaptic cleft, temporarily improving cognitive function in
mild to moderate Alzheimer’s disease.
Q2. Which drug is first-line for status epilepticus?
A. Phenytoin
B. Lorazepam
C. Valproic acid
D. Gabapentin
Correct answer: B
Rationale: Lorazepam is a benzodiazepine that rapidly enhances GABA-A receptor
activity, making it the first-line agent to terminate seizure activity in status epilepticus.
Q3. A patient on an SSRI develops serotonin syndrome after adding a second
,serotonergic drug. Which symptom is hallmark?
A. Hypothermia and bradycardia
B. Hyperthermia, clonus, and agitation
C. Dry mouth and urinary retention
D. Sedation and hypotension
Correct answer: B
Rationale: Serotonin syndrome features hyperthermia, clonus, hyperreflexia, agitation,
and autonomic instability due to excessive serotonergic activity.
Q4. Which antipsychotic is most likely to cause extrapyramidal symptoms (EPS)?
A. Clozapine
B. Quetiapine
C. Haloperidol
D. Olanzapine
Correct answer: C
Rationale: Haloperidol is a first-generation antipsychotic with high D2 receptor affinity
in the striatum, leading to a high risk of EPS such as dystonia and parkinsonism.
Q5. A patient with bipolar disorder is started on lithium. Which requires regular
monitoring?
A. Liver function tests
B. Serum lithium levels, renal function, and thyroid function
C. Complete blood count only
D. Electrocardiogram only
, Correct answer: B
Rationale: Lithium has a narrow therapeutic index; toxicity can cause nausea, tremor,
ataxia, and seizures. Chronic use can impair renal function and cause hypothyroidism,
so regular monitoring of lithium levels, creatinine, and TSH is essential.
Q6. Which anticonvulsant is first-line for trigeminal neuralgia?
A. Phenytoin
B. Gabapentin
C. Carbamazepine
D. Valproic acid
Correct answer: C
Rationale: Carbamazepine stabilizes neuronal membranes by blocking sodium channels,
reducing pain paroxysms in trigeminal neuralgia.
Q7. Buspirone is used for generalized anxiety disorder. Which statement is correct?
A. It has rapid onset within 24 hours
B. It is a partial agonist at serotonin 5-HT1A receptors
C. It is contraindicated with SSRIs
D. It causes significant sedation and dependence
Correct answer: B
Rationale: Buspirone is a partial agonist at 5-HT1A receptors, with delayed onset (2–4
weeks) and no sedation or dependence, making it safe for chronic anxiety.
Q8. Which is a contraindication to clozapine?
A. History of hypertension
