NR 546 Week 1 Exam V1 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
1 Exam) | Chamberlain University
1. A patient who smokes one pack of cigarettes per day is prescribed olanzapine. If the
patient suddenly stops smoking, what is the most likely pharmacological outcome?
A. Olanzapine levels will decrease due to reduced enzyme activity.
B. Olanzapine will become highly protein-bound and inactive.
C. There will be no change in olanzapine metabolism.
D. Olanzapine levels will increase, potentially leading to toxicity.
Correct Answer: D
Explanation: Cigarette smoke contains polycyclic aromatic hydrocarbons that act as
potent inducers of the CYP1A2 enzyme. When a patient stops smoking, the induction of this
enzyme ceases, leading to a slower metabolism of CYP1A2 substrates like olanzapine.
Consequently, the serum levels of olanzapine rise, which requires careful monitoring for
increased adverse effects or toxicity.
2. Which of the following best describes the function of a partial agonist at a
neurotransmitter receptor?
A. It fully activates the receptor to its maximum potential.
B. It blocks the receptor completely, preventing any signal transduction.
,C. It acts as an antagonist in the presence of a full agonist and as an agonist in the absence
of one.
D. It activates the receptor to a sub-maximal level regardless of concentration.
Correct Answer: C
Explanation: A partial agonist has intrinsic activity that is lower than that of a full agonist
but higher than that of an antagonist. In the presence of a full agonist, it competes for the
receptor and lowers the overall response, effectively acting as an antagonist. In a low-signal
environment, it provides a stabilizing level of activation, which is often referred to as a
‘dimmer switch’ effect in psychopharmacology.
3. In the process of signal transduction, what is the role of a ‘second messenger’?
A. To carry the signal from the cell surface to the internal machinery of the cell.
B. To transport the neurotransmitter across the synaptic cleft.
C. To degrade the primary neurotransmitter in the synapse.
D. To act as a voltage-gated ion channel.
Correct Answer: A
Explanation: Second messengers are intracellular signaling molecules released by the cell
in response to exposure to extracellular signaling molecules—the first messengers.
Examples include cyclic AMP (cAMP) and calcium ions, which initiate a cascade of
downstream events such as protein kinase activation. This process eventually leads to
changes in gene expression and cellular function over time.
, 4. The enzyme responsible for the rate-limiting step in the synthesis of dopamine is:
A. Dopa decarboxylase
B. Monoamine oxidase
C. Dopamine beta-hydroxylase
D. Tyrosine hydroxylase
Correct Answer: D
Explanation: Tyrosine hydroxylase is the enzyme that converts the amino acid tyrosine
into L-DOPA. This step is considered the rate-limiting step because it is the slowest part of
the biosynthetic pathway and determines the overall rate of dopamine production.
Understanding this pathway is crucial for managing conditions like Parkinson’s disease and
schizophrenia where dopamine levels are imbalanced.
5. Which cytochrome P450 enzyme is most commonly involved in the metabolism of
antidepressants and is highly polymorphic?
A. CYP1A2
B. CYP3A4
C. CYP2C19
D. CYP2D6
Correct Answer: D
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
1 Exam) | Chamberlain University
1. A patient who smokes one pack of cigarettes per day is prescribed olanzapine. If the
patient suddenly stops smoking, what is the most likely pharmacological outcome?
A. Olanzapine levels will decrease due to reduced enzyme activity.
B. Olanzapine will become highly protein-bound and inactive.
C. There will be no change in olanzapine metabolism.
D. Olanzapine levels will increase, potentially leading to toxicity.
Correct Answer: D
Explanation: Cigarette smoke contains polycyclic aromatic hydrocarbons that act as
potent inducers of the CYP1A2 enzyme. When a patient stops smoking, the induction of this
enzyme ceases, leading to a slower metabolism of CYP1A2 substrates like olanzapine.
Consequently, the serum levels of olanzapine rise, which requires careful monitoring for
increased adverse effects or toxicity.
2. Which of the following best describes the function of a partial agonist at a
neurotransmitter receptor?
A. It fully activates the receptor to its maximum potential.
B. It blocks the receptor completely, preventing any signal transduction.
,C. It acts as an antagonist in the presence of a full agonist and as an agonist in the absence
of one.
D. It activates the receptor to a sub-maximal level regardless of concentration.
Correct Answer: C
Explanation: A partial agonist has intrinsic activity that is lower than that of a full agonist
but higher than that of an antagonist. In the presence of a full agonist, it competes for the
receptor and lowers the overall response, effectively acting as an antagonist. In a low-signal
environment, it provides a stabilizing level of activation, which is often referred to as a
‘dimmer switch’ effect in psychopharmacology.
3. In the process of signal transduction, what is the role of a ‘second messenger’?
A. To carry the signal from the cell surface to the internal machinery of the cell.
B. To transport the neurotransmitter across the synaptic cleft.
C. To degrade the primary neurotransmitter in the synapse.
D. To act as a voltage-gated ion channel.
Correct Answer: A
Explanation: Second messengers are intracellular signaling molecules released by the cell
in response to exposure to extracellular signaling molecules—the first messengers.
Examples include cyclic AMP (cAMP) and calcium ions, which initiate a cascade of
downstream events such as protein kinase activation. This process eventually leads to
changes in gene expression and cellular function over time.
, 4. The enzyme responsible for the rate-limiting step in the synthesis of dopamine is:
A. Dopa decarboxylase
B. Monoamine oxidase
C. Dopamine beta-hydroxylase
D. Tyrosine hydroxylase
Correct Answer: D
Explanation: Tyrosine hydroxylase is the enzyme that converts the amino acid tyrosine
into L-DOPA. This step is considered the rate-limiting step because it is the slowest part of
the biosynthetic pathway and determines the overall rate of dopamine production.
Understanding this pathway is crucial for managing conditions like Parkinson’s disease and
schizophrenia where dopamine levels are imbalanced.
5. Which cytochrome P450 enzyme is most commonly involved in the metabolism of
antidepressants and is highly polymorphic?
A. CYP1A2
B. CYP3A4
C. CYP2C19
D. CYP2D6
Correct Answer: D
