NSG 552 EXAM 3 – ADVANCED
PSYCHOPHARMACOLOGY PRACTICE
QUESTIONS AND ANSWERS
1. A patient is prescribed Mirtazapine for depression and insomnia. Which mechanism of
action explains its effect on sleep and appetite?
A. Antagonism of H1 histamine and 5-HT2C receptors
B. Selective inhibition of serotonin reuptake
C. Agonism of alpha-2 adrenergic receptors
D. Inhibition of monoamine oxidase A
Answer: A
Conceptual Explanation: Mirtazapine’s sedative properties and weight gain potential are
primarily due to its potent antagonism of H1 histamine receptors and 5-HT2C receptors.
2. Which of the following antidepressants is classified as a SPARI (Serotonin Partial Agonist
Reuptake Inhibitor)?
A. Vortioxetine
B. Duloxetine
,C. Vilazodone
D. Venlafaxine
Answer: C
Conceptual Explanation: Vilazodone acts as a serotonin reuptake inhibitor and a 5-HT1A
receptor partial agonist, qualifying it as a SPARI.
3. A patient taking Lithium presents with coarse tremors, ataxia, and confusion. What is the
most likely serum lithium level?
A. 0.6 - 0.8 mEq/L
B. 1.0 - 1.2 mEq/L
C. Above 1.5 - 2.0 mEq/L
D. 0.4 - 0.6 mEq/L
Answer: C
Conceptual Explanation: Serum levels above 1.5 mEq/L represent toxicity; coarse
tremors, ataxia, and confusion are classic signs of moderate to severe lithium toxicity.
4. Which antipsychotic requires mandatory blood monitoring of Absolute Neutrophil Count
(ANC) due to the risk of agranulocytosis?
A. Olanzapine
B. Clozapine
C. Risperidone
, D. Quetiapine
Answer: B
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis and
requires strict ANC monitoring through the REMS program.
5. In the treatment of ADHD, how does the mechanism of Atomoxetine differ from that of
Methylphenidate?
A. Atomoxetine increases dopamine in the nucleus accumbens, while Methylphenidate does
not.
B. Atomoxetine is a selective norepinephrine reuptake inhibitor, while Methylphenidate
blocks dopamine and norepinephrine transporters.
C. Atomoxetine is a controlled substance; Methylphenidate is not.
D. Methylphenidate acts exclusively on alpha-2 receptors.
Answer: B
Conceptual Explanation: Atomoxetine (Strattera) is a non-stimulant selective NRI,
whereas Methylphenidate increases synaptic levels of both DA and NE via transporter
blockade.
6. Which CYP450 enzyme is primarily responsible for the metabolism of many SSRIs and is
inhibited by fluoxetine and paroxetine?
A. CYP1A2
PSYCHOPHARMACOLOGY PRACTICE
QUESTIONS AND ANSWERS
1. A patient is prescribed Mirtazapine for depression and insomnia. Which mechanism of
action explains its effect on sleep and appetite?
A. Antagonism of H1 histamine and 5-HT2C receptors
B. Selective inhibition of serotonin reuptake
C. Agonism of alpha-2 adrenergic receptors
D. Inhibition of monoamine oxidase A
Answer: A
Conceptual Explanation: Mirtazapine’s sedative properties and weight gain potential are
primarily due to its potent antagonism of H1 histamine receptors and 5-HT2C receptors.
2. Which of the following antidepressants is classified as a SPARI (Serotonin Partial Agonist
Reuptake Inhibitor)?
A. Vortioxetine
B. Duloxetine
,C. Vilazodone
D. Venlafaxine
Answer: C
Conceptual Explanation: Vilazodone acts as a serotonin reuptake inhibitor and a 5-HT1A
receptor partial agonist, qualifying it as a SPARI.
3. A patient taking Lithium presents with coarse tremors, ataxia, and confusion. What is the
most likely serum lithium level?
A. 0.6 - 0.8 mEq/L
B. 1.0 - 1.2 mEq/L
C. Above 1.5 - 2.0 mEq/L
D. 0.4 - 0.6 mEq/L
Answer: C
Conceptual Explanation: Serum levels above 1.5 mEq/L represent toxicity; coarse
tremors, ataxia, and confusion are classic signs of moderate to severe lithium toxicity.
4. Which antipsychotic requires mandatory blood monitoring of Absolute Neutrophil Count
(ANC) due to the risk of agranulocytosis?
A. Olanzapine
B. Clozapine
C. Risperidone
, D. Quetiapine
Answer: B
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis and
requires strict ANC monitoring through the REMS program.
5. In the treatment of ADHD, how does the mechanism of Atomoxetine differ from that of
Methylphenidate?
A. Atomoxetine increases dopamine in the nucleus accumbens, while Methylphenidate does
not.
B. Atomoxetine is a selective norepinephrine reuptake inhibitor, while Methylphenidate
blocks dopamine and norepinephrine transporters.
C. Atomoxetine is a controlled substance; Methylphenidate is not.
D. Methylphenidate acts exclusively on alpha-2 receptors.
Answer: B
Conceptual Explanation: Atomoxetine (Strattera) is a non-stimulant selective NRI,
whereas Methylphenidate increases synaptic levels of both DA and NE via transporter
blockade.
6. Which CYP450 enzyme is primarily responsible for the metabolism of many SSRIs and is
inhibited by fluoxetine and paroxetine?
A. CYP1A2
