NUR 546 FINAL EXAM – ADVANCED
PSYCHOPHARMACOLOGY FOR THE PMHNP |
QUESTIONS WITH VERIFIED ACCURATE ANSWERS |
2026 | CHAMBERLAIN
A patient taking an SSRI develops agitation, diaphoresis, hyperreflexia, tremor, and
clonus after a medication change. Which condition is most likely?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Tardive dyskinesia
✅ Correct Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome is characterized by altered mental status, autonomic
instability, hyperreflexia, tremor, and clonus.
2.
Which antidepressant is most associated with sexual dysfunction?
A. Bupropion
B. Mirtazapine
C. Sertraline
D. Vortioxetine
✅ Correct Answer: C. Sertraline
Rationale: SSRIs such as sertraline commonly cause decreased libido, delayed
orgasm, and erectile dysfunction.
3.
Which antidepressant is generally considered to have the lowest risk of sexual adverse
effects?
A. Paroxetine
B. Fluoxetine
C. Bupropion
D. Citalopram
✅ Correct Answer: C. Bupropion
,Rationale: Bupropion has relatively low rates of sexual dysfunction and may sometimes
improve SSRI-associated sexual adverse effects.
4.
A patient taking lithium reports severe diarrhea, vomiting, coarse tremor, and confusion.
What is the priority action?
A. Increase the lithium dose
B. Administer the next scheduled dose with food
C. Hold lithium and evaluate for toxicity
D. Add an SSRI
✅ Correct Answer: C. Hold lithium and evaluate for toxicity
Rationale: GI symptoms, coarse tremor, and confusion can indicate lithium toxicity and
require immediate evaluation.
5.
Which laboratory test is particularly important for a patient receiving lithium therapy?
A. Serum sodium and renal function
B. Hemoglobin A1c only
C. Serum amylase only
D. Troponin level
✅ Correct Answer: A. Serum sodium and renal function
Rationale: Lithium is primarily renally eliminated. Renal function and sodium balance
significantly affect lithium concentrations and toxicity risk.
6.
Which medication can significantly increase lithium concentrations and increase the risk
of toxicity?
A. Acetaminophen
B. Ibuprofen
C. Amoxicillin
D. Loratadine
✅ Correct Answer: B. Ibuprofen
Rationale: NSAIDs can reduce renal lithium clearance, increasing serum lithium
concentrations.
7.
Which adverse effect is particularly associated with clozapine?
, A. Agranulocytosis
B. Hyperthyroidism
C. Pulmonary fibrosis
D. Severe hypoglycemia
✅ Correct Answer: A. Agranulocytosis
Rationale: Clozapine can cause severe neutropenia/agranulocytosis, requiring
appropriate blood-count monitoring.
8.
A patient taking clozapine develops fever and sore throat. What should the PMHNP
consider first?
A. Expected mild adverse effects
B. Agranulocytosis or neutropenia
C. Tardive dyskinesia
D. Serotonin syndrome
✅ Correct Answer: B. Agranulocytosis or neutropenia
Rationale: Fever and sore throat can signal serious neutropenia and warrant prompt
evaluation.
9.
Which antipsychotic has a relatively high risk of metabolic adverse effects?
A. Ziprasidone
B. Aripiprazole
C. Olanzapine
D. Haloperidol
✅ Correct Answer: C. Olanzapine
Rationale: Olanzapine is associated with substantial weight gain and metabolic
abnormalities, including dyslipidemia and hyperglycemia.
10.
Which antipsychotic is considered relatively weight-neutral compared with many other
second-generation antipsychotics?
A. Olanzapine
B. Clozapine
C. Aripiprazole
D. Quetiapine
PSYCHOPHARMACOLOGY FOR THE PMHNP |
QUESTIONS WITH VERIFIED ACCURATE ANSWERS |
2026 | CHAMBERLAIN
A patient taking an SSRI develops agitation, diaphoresis, hyperreflexia, tremor, and
clonus after a medication change. Which condition is most likely?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Tardive dyskinesia
✅ Correct Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome is characterized by altered mental status, autonomic
instability, hyperreflexia, tremor, and clonus.
2.
Which antidepressant is most associated with sexual dysfunction?
A. Bupropion
B. Mirtazapine
C. Sertraline
D. Vortioxetine
✅ Correct Answer: C. Sertraline
Rationale: SSRIs such as sertraline commonly cause decreased libido, delayed
orgasm, and erectile dysfunction.
3.
Which antidepressant is generally considered to have the lowest risk of sexual adverse
effects?
A. Paroxetine
B. Fluoxetine
C. Bupropion
D. Citalopram
✅ Correct Answer: C. Bupropion
,Rationale: Bupropion has relatively low rates of sexual dysfunction and may sometimes
improve SSRI-associated sexual adverse effects.
4.
A patient taking lithium reports severe diarrhea, vomiting, coarse tremor, and confusion.
What is the priority action?
A. Increase the lithium dose
B. Administer the next scheduled dose with food
C. Hold lithium and evaluate for toxicity
D. Add an SSRI
✅ Correct Answer: C. Hold lithium and evaluate for toxicity
Rationale: GI symptoms, coarse tremor, and confusion can indicate lithium toxicity and
require immediate evaluation.
5.
Which laboratory test is particularly important for a patient receiving lithium therapy?
A. Serum sodium and renal function
B. Hemoglobin A1c only
C. Serum amylase only
D. Troponin level
✅ Correct Answer: A. Serum sodium and renal function
Rationale: Lithium is primarily renally eliminated. Renal function and sodium balance
significantly affect lithium concentrations and toxicity risk.
6.
Which medication can significantly increase lithium concentrations and increase the risk
of toxicity?
A. Acetaminophen
B. Ibuprofen
C. Amoxicillin
D. Loratadine
✅ Correct Answer: B. Ibuprofen
Rationale: NSAIDs can reduce renal lithium clearance, increasing serum lithium
concentrations.
7.
Which adverse effect is particularly associated with clozapine?
, A. Agranulocytosis
B. Hyperthyroidism
C. Pulmonary fibrosis
D. Severe hypoglycemia
✅ Correct Answer: A. Agranulocytosis
Rationale: Clozapine can cause severe neutropenia/agranulocytosis, requiring
appropriate blood-count monitoring.
8.
A patient taking clozapine develops fever and sore throat. What should the PMHNP
consider first?
A. Expected mild adverse effects
B. Agranulocytosis or neutropenia
C. Tardive dyskinesia
D. Serotonin syndrome
✅ Correct Answer: B. Agranulocytosis or neutropenia
Rationale: Fever and sore throat can signal serious neutropenia and warrant prompt
evaluation.
9.
Which antipsychotic has a relatively high risk of metabolic adverse effects?
A. Ziprasidone
B. Aripiprazole
C. Olanzapine
D. Haloperidol
✅ Correct Answer: C. Olanzapine
Rationale: Olanzapine is associated with substantial weight gain and metabolic
abnormalities, including dyslipidemia and hyperglycemia.
10.
Which antipsychotic is considered relatively weight-neutral compared with many other
second-generation antipsychotics?
A. Olanzapine
B. Clozapine
C. Aripiprazole
D. Quetiapine
