NSG 552 EXAM 2 – WILKES
PSYCHOPHARMACOLOGY QUESTIONS
WITH VERIFIED ANSWERS
1. A patient on Clozapine presents with an Absolute Neutrophil Count (ANC) of 900/mm³.
According to the Clozapine REMS program, what is the most appropriate clinical action?
A. Continue treatment but increase frequency of monitoring to daily
B. No action is needed as this is within the normal range for Clozapine therapy
C. Decrease the dose by 50% and repeat lab in 48 hours
D. Interrupt treatment, consult hematology, and monitor ANC daily until >1000/mm³
Answer: D
Conceptual Explanation: For general population patients, an ANC below 1000/mm³
requires treatment interruption and daily monitoring until the ANC stabilizes or rises
above 1000/mm³ due to the risk of agranulocytosis.
2. Which of the following antidepressants is most likely to cause a significant increase in
blood pressure at higher doses due to its potent norepinephrine reuptake inhibition?
A. Escitalopram
,B. Mirtazapine
C. Venlafaxine
D. Trazodone
Answer: C
Conceptual Explanation: Venlafaxine acts primarily as an SSRI at low doses but increases
norepinephrine reuptake inhibition at higher doses (usually >150mg), which can lead to
dose-dependent hypertension.
3. A 32-year-old female patient diagnosed with Bipolar I Disorder is planning to become
pregnant. Which mood stabilizer carries the highest risk for neural tube defects, such as spina
bifida?
A. Valproate
B. Lamotrigine
C. Lithium
D. Carbamazepine
Answer: A
Conceptual Explanation: Valproate (Depakote) is highly teratogenic, with a 1-10% risk of
neural tube defects if taken during the first trimester of pregnancy.
4. What is the mechanism of action of Atomoxetine (Strattera) in the treatment of ADHD?
A. Dopamine and Norepinephrine Reuptake Inhibitor
, B. Alpha-2 Adrenergic Agonist
C. Selective Norepinephrine Reuptake Inhibitor
D. NMDA Receptor Antagonist
Answer: C
Conceptual Explanation: Atomoxetine is a non-stimulant medication that works
specifically as a selective norepinephrine reuptake inhibitor (NRI).
5. A patient taking Phenelzine (an MAOI) presents to the emergency department with a
severe headache, palpitations, and a blood pressure of 210/120 mmHg. Which dietary
indiscretion most likely caused this?
A. Eating a turkey sandwich with white bread
B. Eating a bowl of white rice and steamed vegetables
C. Drinking a glass of orange juice
D. Consuming aged cheddar cheese and red wine
Answer: D
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Aged cheeses and red
wine are high in tyramine, which can trigger a hypertensive crisis when MAOIs are present.
6. Lithium toxicity is exacerbated by which of the following conditions or medications?
A. High sodium intake
B. Excessive hydration
PSYCHOPHARMACOLOGY QUESTIONS
WITH VERIFIED ANSWERS
1. A patient on Clozapine presents with an Absolute Neutrophil Count (ANC) of 900/mm³.
According to the Clozapine REMS program, what is the most appropriate clinical action?
A. Continue treatment but increase frequency of monitoring to daily
B. No action is needed as this is within the normal range for Clozapine therapy
C. Decrease the dose by 50% and repeat lab in 48 hours
D. Interrupt treatment, consult hematology, and monitor ANC daily until >1000/mm³
Answer: D
Conceptual Explanation: For general population patients, an ANC below 1000/mm³
requires treatment interruption and daily monitoring until the ANC stabilizes or rises
above 1000/mm³ due to the risk of agranulocytosis.
2. Which of the following antidepressants is most likely to cause a significant increase in
blood pressure at higher doses due to its potent norepinephrine reuptake inhibition?
A. Escitalopram
,B. Mirtazapine
C. Venlafaxine
D. Trazodone
Answer: C
Conceptual Explanation: Venlafaxine acts primarily as an SSRI at low doses but increases
norepinephrine reuptake inhibition at higher doses (usually >150mg), which can lead to
dose-dependent hypertension.
3. A 32-year-old female patient diagnosed with Bipolar I Disorder is planning to become
pregnant. Which mood stabilizer carries the highest risk for neural tube defects, such as spina
bifida?
A. Valproate
B. Lamotrigine
C. Lithium
D. Carbamazepine
Answer: A
Conceptual Explanation: Valproate (Depakote) is highly teratogenic, with a 1-10% risk of
neural tube defects if taken during the first trimester of pregnancy.
4. What is the mechanism of action of Atomoxetine (Strattera) in the treatment of ADHD?
A. Dopamine and Norepinephrine Reuptake Inhibitor
, B. Alpha-2 Adrenergic Agonist
C. Selective Norepinephrine Reuptake Inhibitor
D. NMDA Receptor Antagonist
Answer: C
Conceptual Explanation: Atomoxetine is a non-stimulant medication that works
specifically as a selective norepinephrine reuptake inhibitor (NRI).
5. A patient taking Phenelzine (an MAOI) presents to the emergency department with a
severe headache, palpitations, and a blood pressure of 210/120 mmHg. Which dietary
indiscretion most likely caused this?
A. Eating a turkey sandwich with white bread
B. Eating a bowl of white rice and steamed vegetables
C. Drinking a glass of orange juice
D. Consuming aged cheddar cheese and red wine
Answer: D
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Aged cheeses and red
wine are high in tyramine, which can trigger a hypertensive crisis when MAOIs are present.
6. Lithium toxicity is exacerbated by which of the following conditions or medications?
A. High sodium intake
B. Excessive hydration
