NR 546 Week 7 Exam V3 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
7 Exam) | Chamberlain University
1. When prescribing stimulants for a child with ADHD, which of the following baseline
assessments is most critical according to clinical guidelines?
A. Thyroid stimulating hormone (TSH) levels
B. Serum creatinine and BUN
C. Liver function tests (LFTs)
D. Height, weight, and blood pressure
Correct Answer: D
Explanation: Clinical guidelines for pediatric ADHD require tracking growth parameters
and cardiovascular vitals throughout stimulant treatment. Stimulants have the potential to
cause growth suppression and increases in blood pressure or heart rate. Monitoring these
ensures the provider can adjust treatment if the patient deviates from their expected
growth curve.
2. Which of the following medications is FDA-approved for the treatment of irritability
associated with Autism Spectrum Disorder (ASD) in children and adolescents?
A. Risperidone
B. Methylphenidate
,C. Fluoxetine
D. Atomoxetine
Correct Answer: A
Explanation: Risperidone and Aripiprazole are the only two FDA-approved medications
for treating irritability in pediatric patients with ASD. These medications target symptoms
such as aggression, deliberate self-injury, and temper tantrums. Clinicians must monitor for
metabolic side effects, including weight gain and hyperprolactinemia, which are common
with these atypical antipsychotics.
3. An 80-year-old patient with dementia is experiencing significant agitation. Which class of
medication should be avoided if possible due to the Beers Criteria and increased risk of falls?
A. Benzodiazepines
B. Cholinesterase inhibitors
C. Selective Serotonin Reuptake Inhibitors (SSRIs)
D. NMDA receptor antagonists
Correct Answer: A
Explanation: Benzodiazepines are listed in the Beers Criteria as potentially inappropriate
for older adults due to an increased risk of cognitive impairment, delirium, and falls. In
elderly patients with dementia, these risks are even more pronounced and can lead to
paradoxical agitation. Alternative non-pharmacological interventions or safer psychotropic
classes should be explored first.
, 4. What is the primary mechanism of action of Atomoxetine (Strattera) in the treatment of
ADHD?
A. Dopamine reuptake inhibition
B. Alpha-2 adrenergic agonism
C. Selective norepinephrine reuptake inhibition
D. Serotonin receptor antagonism
Correct Answer: C
Explanation: Atomoxetine is a non-stimulant medication that works by selectively
inhibiting the presynaptic norepinephrine transporter. This increases the availability of
norepinephrine in the prefrontal cortex, which improves attention and impulse control.
Unlike stimulants, it has a lower potential for abuse and is often used when substance use
disorders are a concern.
5. A 72-year-old patient is prescribed Donepezil (Aricept) for Alzheimer’s disease. Which side
effect is a common concern that the PMHNP should educate the family about?
A. Gastrointestinal upset and bradycardia
B. Hypertension
C. Hyperglycemia
D. Dry mouth and urinary retention
Correct Answer: A
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
7 Exam) | Chamberlain University
1. When prescribing stimulants for a child with ADHD, which of the following baseline
assessments is most critical according to clinical guidelines?
A. Thyroid stimulating hormone (TSH) levels
B. Serum creatinine and BUN
C. Liver function tests (LFTs)
D. Height, weight, and blood pressure
Correct Answer: D
Explanation: Clinical guidelines for pediatric ADHD require tracking growth parameters
and cardiovascular vitals throughout stimulant treatment. Stimulants have the potential to
cause growth suppression and increases in blood pressure or heart rate. Monitoring these
ensures the provider can adjust treatment if the patient deviates from their expected
growth curve.
2. Which of the following medications is FDA-approved for the treatment of irritability
associated with Autism Spectrum Disorder (ASD) in children and adolescents?
A. Risperidone
B. Methylphenidate
,C. Fluoxetine
D. Atomoxetine
Correct Answer: A
Explanation: Risperidone and Aripiprazole are the only two FDA-approved medications
for treating irritability in pediatric patients with ASD. These medications target symptoms
such as aggression, deliberate self-injury, and temper tantrums. Clinicians must monitor for
metabolic side effects, including weight gain and hyperprolactinemia, which are common
with these atypical antipsychotics.
3. An 80-year-old patient with dementia is experiencing significant agitation. Which class of
medication should be avoided if possible due to the Beers Criteria and increased risk of falls?
A. Benzodiazepines
B. Cholinesterase inhibitors
C. Selective Serotonin Reuptake Inhibitors (SSRIs)
D. NMDA receptor antagonists
Correct Answer: A
Explanation: Benzodiazepines are listed in the Beers Criteria as potentially inappropriate
for older adults due to an increased risk of cognitive impairment, delirium, and falls. In
elderly patients with dementia, these risks are even more pronounced and can lead to
paradoxical agitation. Alternative non-pharmacological interventions or safer psychotropic
classes should be explored first.
, 4. What is the primary mechanism of action of Atomoxetine (Strattera) in the treatment of
ADHD?
A. Dopamine reuptake inhibition
B. Alpha-2 adrenergic agonism
C. Selective norepinephrine reuptake inhibition
D. Serotonin receptor antagonism
Correct Answer: C
Explanation: Atomoxetine is a non-stimulant medication that works by selectively
inhibiting the presynaptic norepinephrine transporter. This increases the availability of
norepinephrine in the prefrontal cortex, which improves attention and impulse control.
Unlike stimulants, it has a lower potential for abuse and is often used when substance use
disorders are a concern.
5. A 72-year-old patient is prescribed Donepezil (Aricept) for Alzheimer’s disease. Which side
effect is a common concern that the PMHNP should educate the family about?
A. Gastrointestinal upset and bradycardia
B. Hypertension
C. Hyperglycemia
D. Dry mouth and urinary retention
Correct Answer: A
