DEPARTMENT OF PSYCHIATRIC AND MENTAL
HEALTH NURSING
NUR 373 PSYCHOPHARMACOLOGY FINAL EXAMINATION PRACTICE
QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS LATEST
2026-2027 UPDATE
Instructions: Answer all sixty (60) practice questions. Select the single best option for each
multiple-choice question. Highlighted options indicate correct answers along with verified solutions
and comprehensive rationales.
1. A patient taking clozapine for treatment-resistant schizophrenia must have routine
absolute neutrophil count (ANC) monitoring. Which ANC value requires immediate
discontinuation of clozapine and medical intervention for severe neutropenia?
A) ANC of 1,800/mm³
B) ANC of 1,200/mm³
C) ANC of less than 500/mm³
D) ANC of 2,200/mm³
Rationale: An ANC under 500/mm³ indicates severe neutropenia (agranulocytosis), requiring immediate
clozapine discontinuation to prevent life-threatening infection.
2. A patient started on haloperidol 2 days ago develops acute muscle spasms of the neck
turning the head sideways (torticollis) and upward eye deviation. What medication
should be administered immediately?
A) Benztropine IV or IM
B) Oral risperidone
C) Lorazepam PO
D) Propranolol PO
Rationale: Benztropine is an anticholinergic agent that rapidly reverses acute dystonic reactions caused by first-
generation antipsychotics.
3. Which mood stabilizer requires baseline and ongoing laboratory monitoring of thyroid
function (TSH) and renal function (BUN and serum creatinine)?
A) Valproic acid
B) Lithium carbonate
C) Lamotrigine
D) Carbamazepine
, Rationale: Long-term lithium therapy can induce hypothyroidism and renal impairment, requiring routine
monitoring of thyroid and kidney markers.
4. A patient taking lithium carbonate presents with coarse hand tremors, persistent
diarrhea, vomiting, muscle weakness, and ataxia. Serum lithium concentration is 2.1
mEq/L. How should the nurse interpret these findings?
A) Expected therapeutic response
B) Mild benign side effects
C) Acute lithium toxicity requiring drug hold and medical evaluation
D) Early signs of neuroleptic malignant syndrome
Rationale: Lithium levels above 1.5 mEq/L produce toxic signs such as coarse tremors, GI distress, and ataxia,
necessitating immediate medication cessation.
5. A patient prescribed lamotrigine for bipolar depression should be educated to report
which symptom immediately due to the risk of a life-threatening skin rash?
A) Any new skin rash or mucosal lesions (Stevens-Johnson syndrome)
B) Mild dry mouth
C) Transient drowsiness
D) Slight appetite loss
Rationale: Lamotrigine carries a black box warning for severe cutaneous adverse reactions, including Stevens-
Johnson syndrome, starting with a rash.
6. What is the primary mechanism of action of Selective Serotonin Reuptake Inhibitors
(SSRIs) such as sertraline and fluoxetine?
A) Direct stimulation of dopamine D2 receptors
B) Inhibition of the presynaptic serotonin reuptake transporter (SERT)
C) Blockade of central histamine H1 receptors
D) Irreversible inhibition of monoamine oxidase enzymes
Rationale: SSRIs selectively block the presynaptic reuptake pump, increasing serotonin concentration in the
synaptic cleft.
7. A patient taking phenelzine (an MAOI) presents to the emergency department with a
severe occipital headache, palpitations, neck stiffness, and a blood pressure of 210/120
mmHg after consuming aged cheese and red wine. What reaction is occurring?
A) Hypertensive crisis due to tyramine interaction
B) Serotonin syndrome
C) Neuroleptic malignant syndrome
D) Extrapyramidal symptom explosion
Rationale: MAOIs block intestinal tyramine breakdown; consuming tyramine-rich foods triggers massive
norepinephrine release and hypertensive crisis.
HEALTH NURSING
NUR 373 PSYCHOPHARMACOLOGY FINAL EXAMINATION PRACTICE
QUESTIONS AND ANSWERS WITH VERIFIED SOLUTIONS LATEST
2026-2027 UPDATE
Instructions: Answer all sixty (60) practice questions. Select the single best option for each
multiple-choice question. Highlighted options indicate correct answers along with verified solutions
and comprehensive rationales.
1. A patient taking clozapine for treatment-resistant schizophrenia must have routine
absolute neutrophil count (ANC) monitoring. Which ANC value requires immediate
discontinuation of clozapine and medical intervention for severe neutropenia?
A) ANC of 1,800/mm³
B) ANC of 1,200/mm³
C) ANC of less than 500/mm³
D) ANC of 2,200/mm³
Rationale: An ANC under 500/mm³ indicates severe neutropenia (agranulocytosis), requiring immediate
clozapine discontinuation to prevent life-threatening infection.
2. A patient started on haloperidol 2 days ago develops acute muscle spasms of the neck
turning the head sideways (torticollis) and upward eye deviation. What medication
should be administered immediately?
A) Benztropine IV or IM
B) Oral risperidone
C) Lorazepam PO
D) Propranolol PO
Rationale: Benztropine is an anticholinergic agent that rapidly reverses acute dystonic reactions caused by first-
generation antipsychotics.
3. Which mood stabilizer requires baseline and ongoing laboratory monitoring of thyroid
function (TSH) and renal function (BUN and serum creatinine)?
A) Valproic acid
B) Lithium carbonate
C) Lamotrigine
D) Carbamazepine
, Rationale: Long-term lithium therapy can induce hypothyroidism and renal impairment, requiring routine
monitoring of thyroid and kidney markers.
4. A patient taking lithium carbonate presents with coarse hand tremors, persistent
diarrhea, vomiting, muscle weakness, and ataxia. Serum lithium concentration is 2.1
mEq/L. How should the nurse interpret these findings?
A) Expected therapeutic response
B) Mild benign side effects
C) Acute lithium toxicity requiring drug hold and medical evaluation
D) Early signs of neuroleptic malignant syndrome
Rationale: Lithium levels above 1.5 mEq/L produce toxic signs such as coarse tremors, GI distress, and ataxia,
necessitating immediate medication cessation.
5. A patient prescribed lamotrigine for bipolar depression should be educated to report
which symptom immediately due to the risk of a life-threatening skin rash?
A) Any new skin rash or mucosal lesions (Stevens-Johnson syndrome)
B) Mild dry mouth
C) Transient drowsiness
D) Slight appetite loss
Rationale: Lamotrigine carries a black box warning for severe cutaneous adverse reactions, including Stevens-
Johnson syndrome, starting with a rash.
6. What is the primary mechanism of action of Selective Serotonin Reuptake Inhibitors
(SSRIs) such as sertraline and fluoxetine?
A) Direct stimulation of dopamine D2 receptors
B) Inhibition of the presynaptic serotonin reuptake transporter (SERT)
C) Blockade of central histamine H1 receptors
D) Irreversible inhibition of monoamine oxidase enzymes
Rationale: SSRIs selectively block the presynaptic reuptake pump, increasing serotonin concentration in the
synaptic cleft.
7. A patient taking phenelzine (an MAOI) presents to the emergency department with a
severe occipital headache, palpitations, neck stiffness, and a blood pressure of 210/120
mmHg after consuming aged cheese and red wine. What reaction is occurring?
A) Hypertensive crisis due to tyramine interaction
B) Serotonin syndrome
C) Neuroleptic malignant syndrome
D) Extrapyramidal symptom explosion
Rationale: MAOIs block intestinal tyramine breakdown; consuming tyramine-rich foods triggers massive
norepinephrine release and hypertensive crisis.
