NR 546 MIDTERM PRACTICE EXAM:
ADVANCED PSYCHOPHARMACOLOGY
QUESTIONS AND ANSWERS (LATEST),
(A+ GUARANTEE). JUST RELEASED
1. A patient is started on a medication that acts as a potent inhibitor of the CYP2D6 enzyme.
Which of the following medications would likely see a significant increase in plasma
concentration if co-administered?
A. Valproate
B. Gabapentin
C. Lithium
D. Risperidone
Answer: D
Conceptual Explanation: Risperidone is primarily metabolized by CYP2D6. Inhibiting this
enzyme leads to higher concentrations of the parent drug, potentially increasing side
effects.
2. Which dopaminergic pathway is primarily associated with the development of
Extrapyramidal Symptoms (EPS) when D2 receptors are blocked?
A. Mesocortical pathway
,B. Mesolimbic pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The Nigrostriatal pathway controls motor movements; blockade
of D2 receptors here results in EPS.
3. A 28-year-old female patient with Bipolar I disorder is prescribed Lamotrigine. What is the
most critical education point regarding the risk of Stevens-Johnson Syndrome (SJS)?
A. Maintain high salt intake to prevent toxicity.
B. Expect significant weight gain within the first month.
C. Do not take the medication with grapefruit juice.
D. Report any new rash or skin peeling immediately.
Answer: D
Conceptual Explanation: Lamotrigine carries a black box warning for SJS, a life-
threatening skin reaction; early detection of a rash is vital.
4. Regarding the mechanism of action of SSRIs, what is the immediate effect of inhibiting the
Serotonin Transporter (SERT)?
A. Immediate down-regulation of post-synaptic receptors.
B. Increased serotonin levels in the somatodendritic area of the neuron.
, C. Decreased firing of the raphe nucleus.
D. Immediate relief of depressive symptoms.
Answer: B
Conceptual Explanation: Initially, SERT inhibition increases 5HT in the somatodendritic
area. Therapeutic effects delayed until receptors down-regulate.
5. Which of the following describes the ‘agonist spectrum’ correctly regarding a partial
agonist?
A. It activates the receptor to the same extent as a full agonist.
B. It blocks the receptor entirely, preventing any signal transduction.
C. It activates the receptor to a submaximal level regardless of dosage.
D. It changes the receptor conformation to an inactive state.
Answer: C
Conceptual Explanation: Partial agonists act as ‘dimmer switches,’ providing less signal
than a full agonist but more than an antagonist.
6. A patient taking Lithium presents with coarse tremors, ataxia, and confusion. The Lithium
level is 2.2 mEq/L. What is the priority intervention?
A. Encourage increased fluid intake and retest in 24 hours.
B. Hold the dose and prepare for possible hemodialysis.
C. Switch the patient to Valproic Acid immediately.
ADVANCED PSYCHOPHARMACOLOGY
QUESTIONS AND ANSWERS (LATEST),
(A+ GUARANTEE). JUST RELEASED
1. A patient is started on a medication that acts as a potent inhibitor of the CYP2D6 enzyme.
Which of the following medications would likely see a significant increase in plasma
concentration if co-administered?
A. Valproate
B. Gabapentin
C. Lithium
D. Risperidone
Answer: D
Conceptual Explanation: Risperidone is primarily metabolized by CYP2D6. Inhibiting this
enzyme leads to higher concentrations of the parent drug, potentially increasing side
effects.
2. Which dopaminergic pathway is primarily associated with the development of
Extrapyramidal Symptoms (EPS) when D2 receptors are blocked?
A. Mesocortical pathway
,B. Mesolimbic pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The Nigrostriatal pathway controls motor movements; blockade
of D2 receptors here results in EPS.
3. A 28-year-old female patient with Bipolar I disorder is prescribed Lamotrigine. What is the
most critical education point regarding the risk of Stevens-Johnson Syndrome (SJS)?
A. Maintain high salt intake to prevent toxicity.
B. Expect significant weight gain within the first month.
C. Do not take the medication with grapefruit juice.
D. Report any new rash or skin peeling immediately.
Answer: D
Conceptual Explanation: Lamotrigine carries a black box warning for SJS, a life-
threatening skin reaction; early detection of a rash is vital.
4. Regarding the mechanism of action of SSRIs, what is the immediate effect of inhibiting the
Serotonin Transporter (SERT)?
A. Immediate down-regulation of post-synaptic receptors.
B. Increased serotonin levels in the somatodendritic area of the neuron.
, C. Decreased firing of the raphe nucleus.
D. Immediate relief of depressive symptoms.
Answer: B
Conceptual Explanation: Initially, SERT inhibition increases 5HT in the somatodendritic
area. Therapeutic effects delayed until receptors down-regulate.
5. Which of the following describes the ‘agonist spectrum’ correctly regarding a partial
agonist?
A. It activates the receptor to the same extent as a full agonist.
B. It blocks the receptor entirely, preventing any signal transduction.
C. It activates the receptor to a submaximal level regardless of dosage.
D. It changes the receptor conformation to an inactive state.
Answer: C
Conceptual Explanation: Partial agonists act as ‘dimmer switches,’ providing less signal
than a full agonist but more than an antagonist.
6. A patient taking Lithium presents with coarse tremors, ataxia, and confusion. The Lithium
level is 2.2 mEq/L. What is the priority intervention?
A. Encourage increased fluid intake and retest in 24 hours.
B. Hold the dose and prepare for possible hemodialysis.
C. Switch the patient to Valproic Acid immediately.
