NR 546 FINAL EXAM PREP – ADVANCED
PSYCHOPHARMACOLOGY FOR THE
PMHNP QUESTIONS AND ANSWERS
(LATEST), (A+ GUARANTEE). JUST
RELEASED
1. A patient who smokes one pack of cigarettes per day is prescribed Clozapine. The PMHNP
knows that the polycyclic aromatic hydrocarbons in cigarette smoke induce which enzyme?
A. CYP1A2
B. CYP3A4
C. CYP2D6
D. CYP2C19
Answer: A
Conceptual Explanation: Cigarette smoke induces CYP1A2. If a patient stops smoking,
clozapine levels can rise significantly because the enzyme induction is removed, leading to
potential toxicity.
2. When prescribing Lithium, which of the following lab values is most critical to monitor due
to the drug’s narrow therapeutic index and primary route of excretion?
A. Serum Creatinine and GFR
,B. Liver Function Tests (LFTs)
C. Amylase and Lipase
D. Complete Blood Count (CBC) with differential
Answer: A
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys. Impaired
renal function (monitored via Serum Creatinine/GFR) can lead to lithium toxicity.
3. A 24-year-old female patient is being started on Lamotrigine for Bipolar II disorder. Which
titration schedule or side effect is the most significant clinical concern?
A. Rapid titration to 200mg to achieve efficacy quickly
B. Weight gain and metabolic syndrome
C. The risk of Stevens-Johnson Syndrome (SJS) if titrated too fast
D. Induction of CYP3A4 leading to oral contraceptive failure
Answer: C
Conceptual Explanation: Lamotrigine must be titrated slowly to minimize the risk of a
life-threatening rash, specifically Stevens-Johnson Syndrome (SJS).
4. A patient presenting with autonomic instability, hyperreflexia, and clonus after switching
from an SSRI to an MAOI without a sufficient washout period is likely experiencing:
A. Neuroleptic Malignant Syndrome (NMS)
B. Anticholinergic Toxicity
, C. Serotonin Syndrome
D. Hypertensive Crisis
Answer: C
Conceptual Explanation: Serotonin syndrome is characterized by the triad of mental
status changes, autonomic hyperactivity, and neuromuscular abnormalities (like clonus
and hyperreflexia).
5. Which mood stabilizer is most strongly associated with the potential for polycystic ovary
syndrome (PCOS) and weight gain in young female patients?
A. Lithium
B. Valproate (Depakote)
C. Lamotrigine
D. Topiramate
Answer: B
Conceptual Explanation: Valproate is associated with weight gain, hyperinsulinemia, and
an increased risk of PCOS in women.
6. Which of the following describes the mechanism of action of Buspirone?
A. 5-HT1A partial agonist
B. GABA-A positive allosteric modulator
C. D2 receptor antagonist
PSYCHOPHARMACOLOGY FOR THE
PMHNP QUESTIONS AND ANSWERS
(LATEST), (A+ GUARANTEE). JUST
RELEASED
1. A patient who smokes one pack of cigarettes per day is prescribed Clozapine. The PMHNP
knows that the polycyclic aromatic hydrocarbons in cigarette smoke induce which enzyme?
A. CYP1A2
B. CYP3A4
C. CYP2D6
D. CYP2C19
Answer: A
Conceptual Explanation: Cigarette smoke induces CYP1A2. If a patient stops smoking,
clozapine levels can rise significantly because the enzyme induction is removed, leading to
potential toxicity.
2. When prescribing Lithium, which of the following lab values is most critical to monitor due
to the drug’s narrow therapeutic index and primary route of excretion?
A. Serum Creatinine and GFR
,B. Liver Function Tests (LFTs)
C. Amylase and Lipase
D. Complete Blood Count (CBC) with differential
Answer: A
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys. Impaired
renal function (monitored via Serum Creatinine/GFR) can lead to lithium toxicity.
3. A 24-year-old female patient is being started on Lamotrigine for Bipolar II disorder. Which
titration schedule or side effect is the most significant clinical concern?
A. Rapid titration to 200mg to achieve efficacy quickly
B. Weight gain and metabolic syndrome
C. The risk of Stevens-Johnson Syndrome (SJS) if titrated too fast
D. Induction of CYP3A4 leading to oral contraceptive failure
Answer: C
Conceptual Explanation: Lamotrigine must be titrated slowly to minimize the risk of a
life-threatening rash, specifically Stevens-Johnson Syndrome (SJS).
4. A patient presenting with autonomic instability, hyperreflexia, and clonus after switching
from an SSRI to an MAOI without a sufficient washout period is likely experiencing:
A. Neuroleptic Malignant Syndrome (NMS)
B. Anticholinergic Toxicity
, C. Serotonin Syndrome
D. Hypertensive Crisis
Answer: C
Conceptual Explanation: Serotonin syndrome is characterized by the triad of mental
status changes, autonomic hyperactivity, and neuromuscular abnormalities (like clonus
and hyperreflexia).
5. Which mood stabilizer is most strongly associated with the potential for polycystic ovary
syndrome (PCOS) and weight gain in young female patients?
A. Lithium
B. Valproate (Depakote)
C. Lamotrigine
D. Topiramate
Answer: B
Conceptual Explanation: Valproate is associated with weight gain, hyperinsulinemia, and
an increased risk of PCOS in women.
6. Which of the following describes the mechanism of action of Buspirone?
A. 5-HT1A partial agonist
B. GABA-A positive allosteric modulator
C. D2 receptor antagonist
