NSG552 FINAL EXAM 4 |
PSYCHOPHARMACOLOGY | WILKES
UNIVERSITY
1. A patient taking Clozapine presents with a fever, sore throat, and lethargy. Which lab value
is most critical to evaluate immediately?
A. Liver function tests
B. Absolute Neutrophil Count (ANC)
C. Serum Clozapine level
D. Fastest glucose
Answer: B
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
fever and sore throat are signs of potential infection due to low white blood cell counts,
requiring an immediate ANC check.
2. Which dopamine pathway is primarily responsible for the development of Extrapyramidal
Symptoms (EPS) when blocked by first-generation antipsychotics?
A. Mesolimbic pathway
B. Mesocortical pathway
,C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway leads to EPS and tardive dyskinesia.
3. A patient with Bipolar Disorder is prescribed Lithium. Which of the following conditions
would increase the risk of Lithium toxicity by decreasing renal clearance?
A. Hyponatremia
B. High sodium intake
C. Excessive fluid intake
D. Increased caffeine consumption
Answer: A
Conceptual Explanation: Lithium is handled by the kidneys similarly to sodium. When
sodium levels are low (hyponatremia), the kidneys conserve sodium and lithium, leading to
increased lithium levels and toxicity.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
bulimia?
A. Fluoxetine
B. Bupropion
, C. Venlafaxine
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances associated with eating disorders like bulimia or anorexia.
5. A patient is experiencing ‘brain shocks,’ irritability, and insomnia after stopping their
antidepressant abruptly. Which medication was most likely being used?
A. Fluoxetine
B. Paroxetine
C. Vortioxetine
D. Aripiprazole
Answer: B
Conceptual Explanation: Paroxetine has a short half-life and no active metabolites,
making it more prone to SSRI discontinuation syndrome compared to medications like
Fluoxetine.
6. What is the mechanism of action for the medication Buspirone?
A. GABA-A receptor agonist
B. 5-HT1A partial agonist
C. Norepinephrine reuptake inhibitor
PSYCHOPHARMACOLOGY | WILKES
UNIVERSITY
1. A patient taking Clozapine presents with a fever, sore throat, and lethargy. Which lab value
is most critical to evaluate immediately?
A. Liver function tests
B. Absolute Neutrophil Count (ANC)
C. Serum Clozapine level
D. Fastest glucose
Answer: B
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
fever and sore throat are signs of potential infection due to low white blood cell counts,
requiring an immediate ANC check.
2. Which dopamine pathway is primarily responsible for the development of Extrapyramidal
Symptoms (EPS) when blocked by first-generation antipsychotics?
A. Mesolimbic pathway
B. Mesocortical pathway
,C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway leads to EPS and tardive dyskinesia.
3. A patient with Bipolar Disorder is prescribed Lithium. Which of the following conditions
would increase the risk of Lithium toxicity by decreasing renal clearance?
A. Hyponatremia
B. High sodium intake
C. Excessive fluid intake
D. Increased caffeine consumption
Answer: A
Conceptual Explanation: Lithium is handled by the kidneys similarly to sodium. When
sodium levels are low (hyponatremia), the kidneys conserve sodium and lithium, leading to
increased lithium levels and toxicity.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
bulimia?
A. Fluoxetine
B. Bupropion
, C. Venlafaxine
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances associated with eating disorders like bulimia or anorexia.
5. A patient is experiencing ‘brain shocks,’ irritability, and insomnia after stopping their
antidepressant abruptly. Which medication was most likely being used?
A. Fluoxetine
B. Paroxetine
C. Vortioxetine
D. Aripiprazole
Answer: B
Conceptual Explanation: Paroxetine has a short half-life and no active metabolites,
making it more prone to SSRI discontinuation syndrome compared to medications like
Fluoxetine.
6. What is the mechanism of action for the medication Buspirone?
A. GABA-A receptor agonist
B. 5-HT1A partial agonist
C. Norepinephrine reuptake inhibitor
