NR 546 Week 10 Exam V2 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
10 Exam) | Chamberlain University
1. A 10-year-old patient with ADHD is prescribed Methylphenidate (Ritalin). Which
mechanism best describes how this medication improves attention and focus?
A. It inhibits the enzyme monoamine oxidase in the synaptic cleft.
B. It acts as a selective alpha-2A adrenergic receptor agonist.
C. It increases the release of dopamine from presynaptic vesicles.
D. It blocks the reuptake of dopamine and norepinephrine by inhibiting transporters.
Correct Answer: D
Explanation: Methylphenidate primarily acts as a blocker of the dopamine transporter
(DAT) and norepinephrine transporter (NET). By inhibiting these transporters, it increases
the concentration of these neurotransmitters in the synaptic cleft. This enhancement of
catecholamine signaling in the prefrontal cortex is thought to improve the executive
functions associated with ADHD.
2. A patient with Alcohol Use Disorder is prescribed Naltrexone. What is the primary
mechanism of action for this medication in treating alcohol dependence?
A. It acts as a competitive antagonist at the mu-opioid receptor.
B. It creates a physical sensitivity to alcohol by inhibiting acetaldehyde dehydrogenase.
,C. It modulates glutamate and GABA neurotransmission to reduce withdrawal symptoms.
D. It increases dopamine release in the reward pathway to substitute for alcohol.
Correct Answer: A
Explanation: Naltrexone is a long-acting opioid antagonist that blocks the mu-opioid
receptors. By blocking these receptors, it reduces the reinforcing effects and the ‘pleasure’
associated with alcohol consumption. This helps to reduce the frequency and severity of
relapses by diminishing the craving for alcohol.
3. Which FDA-approved medication for ADHD is a non-stimulant and functions as a selective
norepinephrine reuptake inhibitor (SNRI)?
A. Lisdexamfetamine (Vyvanse)
B. Guanfacine (Intuniv)
C. Clonidine (Kapvay)
D. Atomoxetine (Strattera)
Correct Answer: D
Explanation: Atomoxetine is a non-stimulant medication specifically designed to inhibit
the reuptake of norepinephrine. Unlike stimulants, it does not have a high potential for
abuse because it does not significantly increase dopamine in the nucleus accumbens. It is
often a first-line choice for patients with a history of substance use disorder or those who
cannot tolerate stimulant side effects.
,4. A patient is seeking treatment for Binge Eating Disorder (BED). Which medication is FDA-
approved for the treatment of moderate to severe BED?
A. Phentermine
B. Fluoxetine (Prozac)
C. Topiramate (Topamax)
D. Lisdexamfetamine (Vyvanse)
Correct Answer: D
Explanation: Lisdexamfetamine, a stimulant primarily used for ADHD, was the first
medication to receive FDA approval for moderate to severe Binge Eating Disorder. The
mechanism is thought to involve the modulation of dopamine and norepinephrine, which
helps control impulse and reward seeking behavior. Other medications like Fluoxetine are
FDA approved for Bulimia Nervosa, but not specifically for BED.
5. When prescribing stimulants for a pediatric patient with ADHD, which of the following is a
critical monitoring parameter according to the Black Box Warning?
A. Hepatic enzyme levels
B. Serum glucose levels
C. Visual acuity and intraocular pressure
D. Cardiovascular risk and potential for sudden death
Correct Answer: D
, Explanation: Stimulants carry a Black Box Warning regarding their potential for serious
cardiovascular adverse events, including sudden death in patients with pre-existing heart
abnormalities. Providers must screen for cardiac history and monitor blood pressure and
heart rate during treatment. Additionally, they carry a warning for the potential for abuse
and dependence.
6. A patient with a long history of heavy alcohol use presents with tremors, agitation, and
elevated vital signs. Which class of medication is the first-line treatment for managing acute
alcohol withdrawal?
A. Antipsychotics
B. Benzodiazepines
C. Beta-blockers
D. Anticonvulsants
Correct Answer: B
Explanation: Benzodiazepines such as Lorazepam or Diazepam are the gold standard for
treating acute alcohol withdrawal syndrome. They work by enhancing GABAergic activity,
which counteracts the CNS hyperexcitability caused by alcohol cessation. Proper dosing
prevents complications such as seizures and delirium tremens.
7. Guanfacine ER (Intuniv) is used in the treatment of ADHD. How does its mechanism of
action differ from that of stimulants?
A. It increases the release of serotonin in the synapse.
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
10 Exam) | Chamberlain University
1. A 10-year-old patient with ADHD is prescribed Methylphenidate (Ritalin). Which
mechanism best describes how this medication improves attention and focus?
A. It inhibits the enzyme monoamine oxidase in the synaptic cleft.
B. It acts as a selective alpha-2A adrenergic receptor agonist.
C. It increases the release of dopamine from presynaptic vesicles.
D. It blocks the reuptake of dopamine and norepinephrine by inhibiting transporters.
Correct Answer: D
Explanation: Methylphenidate primarily acts as a blocker of the dopamine transporter
(DAT) and norepinephrine transporter (NET). By inhibiting these transporters, it increases
the concentration of these neurotransmitters in the synaptic cleft. This enhancement of
catecholamine signaling in the prefrontal cortex is thought to improve the executive
functions associated with ADHD.
2. A patient with Alcohol Use Disorder is prescribed Naltrexone. What is the primary
mechanism of action for this medication in treating alcohol dependence?
A. It acts as a competitive antagonist at the mu-opioid receptor.
B. It creates a physical sensitivity to alcohol by inhibiting acetaldehyde dehydrogenase.
,C. It modulates glutamate and GABA neurotransmission to reduce withdrawal symptoms.
D. It increases dopamine release in the reward pathway to substitute for alcohol.
Correct Answer: A
Explanation: Naltrexone is a long-acting opioid antagonist that blocks the mu-opioid
receptors. By blocking these receptors, it reduces the reinforcing effects and the ‘pleasure’
associated with alcohol consumption. This helps to reduce the frequency and severity of
relapses by diminishing the craving for alcohol.
3. Which FDA-approved medication for ADHD is a non-stimulant and functions as a selective
norepinephrine reuptake inhibitor (SNRI)?
A. Lisdexamfetamine (Vyvanse)
B. Guanfacine (Intuniv)
C. Clonidine (Kapvay)
D. Atomoxetine (Strattera)
Correct Answer: D
Explanation: Atomoxetine is a non-stimulant medication specifically designed to inhibit
the reuptake of norepinephrine. Unlike stimulants, it does not have a high potential for
abuse because it does not significantly increase dopamine in the nucleus accumbens. It is
often a first-line choice for patients with a history of substance use disorder or those who
cannot tolerate stimulant side effects.
,4. A patient is seeking treatment for Binge Eating Disorder (BED). Which medication is FDA-
approved for the treatment of moderate to severe BED?
A. Phentermine
B. Fluoxetine (Prozac)
C. Topiramate (Topamax)
D. Lisdexamfetamine (Vyvanse)
Correct Answer: D
Explanation: Lisdexamfetamine, a stimulant primarily used for ADHD, was the first
medication to receive FDA approval for moderate to severe Binge Eating Disorder. The
mechanism is thought to involve the modulation of dopamine and norepinephrine, which
helps control impulse and reward seeking behavior. Other medications like Fluoxetine are
FDA approved for Bulimia Nervosa, but not specifically for BED.
5. When prescribing stimulants for a pediatric patient with ADHD, which of the following is a
critical monitoring parameter according to the Black Box Warning?
A. Hepatic enzyme levels
B. Serum glucose levels
C. Visual acuity and intraocular pressure
D. Cardiovascular risk and potential for sudden death
Correct Answer: D
, Explanation: Stimulants carry a Black Box Warning regarding their potential for serious
cardiovascular adverse events, including sudden death in patients with pre-existing heart
abnormalities. Providers must screen for cardiac history and monitor blood pressure and
heart rate during treatment. Additionally, they carry a warning for the potential for abuse
and dependence.
6. A patient with a long history of heavy alcohol use presents with tremors, agitation, and
elevated vital signs. Which class of medication is the first-line treatment for managing acute
alcohol withdrawal?
A. Antipsychotics
B. Benzodiazepines
C. Beta-blockers
D. Anticonvulsants
Correct Answer: B
Explanation: Benzodiazepines such as Lorazepam or Diazepam are the gold standard for
treating acute alcohol withdrawal syndrome. They work by enhancing GABAergic activity,
which counteracts the CNS hyperexcitability caused by alcohol cessation. Proper dosing
prevents complications such as seizures and delirium tremens.
7. Guanfacine ER (Intuniv) is used in the treatment of ADHD. How does its mechanism of
action differ from that of stimulants?
A. It increases the release of serotonin in the synapse.
