NSG552 PSYCHOPHARMACOLOGY
ADVANCED PRACTICE EXAM
QUESTIONS AND ANSWERS
1. Which neurotransmitter is primarily implicated in the reward system of the brain and is a
major target in treating substance use disorders?
A. GABA
B. Acetylcholine
C. Dopamine
D. Serotonin
Answer: C
Conceptual Explanation: Dopamine is the primary neurotransmitter involved in the
reward and pleasure centers of the brain, specifically the mesolimbic pathway.
2. A patient taking Clozapine presents with a fever, sore throat, and mouth sores. What is the
most urgent laboratory test to order?
A. Liver function tests
B. Complete Blood Count (CBC) with differential
,C. Serum Clozapine level
D. Fasten blood glucose
Answer: B
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A CBC
with differential is required to monitor the Absolute Neutrophil Count (ANC).
3. Which antidepressant is most likely to cause a hypertensive crisis when taken with foods
high in tyramine?
A. Phenelzine
B. Sertraline
C. Venlafaxine
D. Bupropion
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Inhibition of MAO-A in the gut prevents
the breakdown of tyramine, leading to excessive norepinephrine release and hypertensive
crisis.
4. What is the mechanism of action for typical (first-generation) antipsychotics that leads to
extrapyramidal symptoms (EPS)?
A. 5-HT2A receptor antagonism
B. D2 receptor antagonism in the mesolimbic pathway
, C. Alpha-1 adrenergic blockade
D. D2 receptor antagonism in the nigrostriatal pathway
Answer: D
Conceptual Explanation: While D2 blockade in the mesolimbic pathway reduces
psychosis, blockade in the nigrostriatal pathway causes movement disorders known as
EPS.
5. A patient on Lithium therapy presents with coarse tremors, ataxia, and confusion. The
serum level is 2.2 mEq/L. What is the priority intervention?
A. Advise the patient to drink more water
B. Administer a dose of Propranolol for the tremors
C. Hold the dose and prepare for hemodialysis or intensive hydration
D. Repeat the lab draw in 24 hours
Answer: C
Conceptual Explanation: Lithium levels above 2.0 mEq/L indicate severe toxicity,
characterized by neurologic symptoms. Hemodialysis is often necessary for levels this high
or symptomatic patients.
6. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Fluoxetine
ADVANCED PRACTICE EXAM
QUESTIONS AND ANSWERS
1. Which neurotransmitter is primarily implicated in the reward system of the brain and is a
major target in treating substance use disorders?
A. GABA
B. Acetylcholine
C. Dopamine
D. Serotonin
Answer: C
Conceptual Explanation: Dopamine is the primary neurotransmitter involved in the
reward and pleasure centers of the brain, specifically the mesolimbic pathway.
2. A patient taking Clozapine presents with a fever, sore throat, and mouth sores. What is the
most urgent laboratory test to order?
A. Liver function tests
B. Complete Blood Count (CBC) with differential
,C. Serum Clozapine level
D. Fasten blood glucose
Answer: B
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A CBC
with differential is required to monitor the Absolute Neutrophil Count (ANC).
3. Which antidepressant is most likely to cause a hypertensive crisis when taken with foods
high in tyramine?
A. Phenelzine
B. Sertraline
C. Venlafaxine
D. Bupropion
Answer: A
Conceptual Explanation: Phenelzine is an MAOI. Inhibition of MAO-A in the gut prevents
the breakdown of tyramine, leading to excessive norepinephrine release and hypertensive
crisis.
4. What is the mechanism of action for typical (first-generation) antipsychotics that leads to
extrapyramidal symptoms (EPS)?
A. 5-HT2A receptor antagonism
B. D2 receptor antagonism in the mesolimbic pathway
, C. Alpha-1 adrenergic blockade
D. D2 receptor antagonism in the nigrostriatal pathway
Answer: D
Conceptual Explanation: While D2 blockade in the mesolimbic pathway reduces
psychosis, blockade in the nigrostriatal pathway causes movement disorders known as
EPS.
5. A patient on Lithium therapy presents with coarse tremors, ataxia, and confusion. The
serum level is 2.2 mEq/L. What is the priority intervention?
A. Advise the patient to drink more water
B. Administer a dose of Propranolol for the tremors
C. Hold the dose and prepare for hemodialysis or intensive hydration
D. Repeat the lab draw in 24 hours
Answer: C
Conceptual Explanation: Lithium levels above 2.0 mEq/L indicate severe toxicity,
characterized by neurologic symptoms. Hemodialysis is often necessary for levels this high
or symptomatic patients.
6. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Fluoxetine
