NR 546 Week 8 Exam V1 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
8 Exam) | Chamberlain University
1. A 10-year-old male is diagnosed with ADHD, predominantly inattentive type. Which of the
following is the primary mechanism of action for Methylphenidate in treating this condition?
A. It enhances the release of serotonin in the prefrontal cortex.
B. It acts as a selective alpha-2A adrenergic receptor agonist.
C. It inhibits the reuptake of dopamine and norepinephrine by blocking transporters.
D. It irreversibly binds to monoamine oxidase enzymes.
Correct Answer: C
Explanation: Methylphenidate functions by blocking the reuptake of dopamine (DAT) and
norepinephrine (NET), thereby increasing their concentrations in the synaptic cleft. This
action specifically targets the prefrontal cortex to improve focus and attention. Unlike
amphetamines, it does not significantly promote the release of stored catecholamines from
vesicles.
2. A patient is prescribed Atomoxetine (Strattera) for ADHD. Which laboratory or clinical
assessment is most critical for the PMHNP to monitor periodically?
A. White blood cell count for agranulocytosis.
B. Serum potassium levels.
,C. Liver function tests and signs of jaundice.
D. Thyroid stimulating hormone.
Correct Answer: C
Explanation: Atomoxetine is associated with a rare but serious risk of severe liver injury.
The PMHNP must educate the patient to report signs such as dark urine or yellowing of the
skin immediately. Routine monitoring of liver enzymes is recommended if clinical signs of
hepatic dysfunction appear during treatment.
3. Which of the following medications is a non-stimulant selective alpha-2A adrenergic
agonist used in the treatment of ADHD?
A. Guanfacine ER
B. Modafinil
C. Lisdexamfetamine
D. Armodafinil
Correct Answer: A
Explanation: Guanfacine extended-release (Intuniv) is a selective alpha-2A adrenergic
receptor agonist. It works by strengthening the signal transmission in the prefrontal cortex
to improve executive function. It is often used as an adjunct to stimulants or as a
monotherapy for patients who cannot tolerate stimulants.
, 4. An 82-year-old patient with moderate Alzheimer’s dementia is currently taking Donepezil.
The family notes a decline in cognition. Which medication could be added to provide a
synergistic neuroprotective effect?
A. Rivastigmine
B. Galantamine
C. Memantine
D. Lorazepam
Correct Answer: C
Explanation: Memantine is an NMDA receptor antagonist that regulates glutamate activity,
which is often overstimulated in Alzheimer’s disease. Combining a cholinesterase inhibitor
like Donepezil with Memantine targets two different pathways of the disease. This
combination is FDA-approved for moderate to severe stages of dementia to help slow the
rate of clinical decline.
5. A PMHNP is treating a patient with Alcohol Use Disorder. The patient wants a medication
that will reduce the ‘pleasurable’ effects or cravings associated with drinking. Which is the
best choice?
A. Disulfiram
B. Naltrexone
C. Acamprosate
D. Chlordiazepoxide
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
8 Exam) | Chamberlain University
1. A 10-year-old male is diagnosed with ADHD, predominantly inattentive type. Which of the
following is the primary mechanism of action for Methylphenidate in treating this condition?
A. It enhances the release of serotonin in the prefrontal cortex.
B. It acts as a selective alpha-2A adrenergic receptor agonist.
C. It inhibits the reuptake of dopamine and norepinephrine by blocking transporters.
D. It irreversibly binds to monoamine oxidase enzymes.
Correct Answer: C
Explanation: Methylphenidate functions by blocking the reuptake of dopamine (DAT) and
norepinephrine (NET), thereby increasing their concentrations in the synaptic cleft. This
action specifically targets the prefrontal cortex to improve focus and attention. Unlike
amphetamines, it does not significantly promote the release of stored catecholamines from
vesicles.
2. A patient is prescribed Atomoxetine (Strattera) for ADHD. Which laboratory or clinical
assessment is most critical for the PMHNP to monitor periodically?
A. White blood cell count for agranulocytosis.
B. Serum potassium levels.
,C. Liver function tests and signs of jaundice.
D. Thyroid stimulating hormone.
Correct Answer: C
Explanation: Atomoxetine is associated with a rare but serious risk of severe liver injury.
The PMHNP must educate the patient to report signs such as dark urine or yellowing of the
skin immediately. Routine monitoring of liver enzymes is recommended if clinical signs of
hepatic dysfunction appear during treatment.
3. Which of the following medications is a non-stimulant selective alpha-2A adrenergic
agonist used in the treatment of ADHD?
A. Guanfacine ER
B. Modafinil
C. Lisdexamfetamine
D. Armodafinil
Correct Answer: A
Explanation: Guanfacine extended-release (Intuniv) is a selective alpha-2A adrenergic
receptor agonist. It works by strengthening the signal transmission in the prefrontal cortex
to improve executive function. It is often used as an adjunct to stimulants or as a
monotherapy for patients who cannot tolerate stimulants.
, 4. An 82-year-old patient with moderate Alzheimer’s dementia is currently taking Donepezil.
The family notes a decline in cognition. Which medication could be added to provide a
synergistic neuroprotective effect?
A. Rivastigmine
B. Galantamine
C. Memantine
D. Lorazepam
Correct Answer: C
Explanation: Memantine is an NMDA receptor antagonist that regulates glutamate activity,
which is often overstimulated in Alzheimer’s disease. Combining a cholinesterase inhibitor
like Donepezil with Memantine targets two different pathways of the disease. This
combination is FDA-approved for moderate to severe stages of dementia to help slow the
rate of clinical decline.
5. A PMHNP is treating a patient with Alcohol Use Disorder. The patient wants a medication
that will reduce the ‘pleasurable’ effects or cravings associated with drinking. Which is the
best choice?
A. Disulfiram
B. Naltrexone
C. Acamprosate
D. Chlordiazepoxide
