NSG 552 Exam 2 V1 | NSG 552
Psychopharmacology | Actual Q&A with Rationale
(NSG 552 Exam 2) | Wilkes
1. Which antidepressant is most likely to cause a significant increase in blood pressure at
higher doses due to its norepinephrine reuptake inhibition?
A. Venlafaxine
B. Escitalopram
C. Mirtazapine
D. Sertraline
Correct Answer: A
Explanation: Venlafaxine is a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) that
exhibits dose-dependent effects. At lower doses, it primarily affects serotonin, but at doses
above 150 mg, it significantly increases norepinephrine activity. This increase in
norepinephrine can lead to sustained elevations in diastolic blood pressure, necessitating
regular monitoring.
2. A patient taking Lithium presents with coarse tremors, ataxia, and confusion. What is the
most likely interpretation of these findings?
A. Therapeutic side effects
B. Serotonin Syndrome
,C. Extrapyramidal Symptoms
D. Lithium Toxicity
Correct Answer: D
Explanation: Lithium has a narrow therapeutic index, typically between 0.6 and 1.2
mEq/L. Signs of toxicity include neurological symptoms such as ataxia, confusion, and
coarse tremors, which differ from the fine tremors seen at therapeutic levels. Immediate
medical intervention and serum level checks are required to prevent permanent renal or
neurological damage.
3. Which of the following medications is contraindicated in patients with a history of seizure
disorders or eating disorders?
A. Duloxetine
B. Fluoxetine
C. Bupropion
D. Trazodone
Correct Answer: C
Explanation: Bupropion works by inhibiting the reuptake of norepinephrine and
dopamine, which can lower the seizure threshold. It is specifically contraindicated in
patients with bulimia or anorexia nervosa due to an increased incidence of seizures in
these populations. Clinicians must screen for these conditions before initiating treatment to
ensure patient safety.
, 4. When switching a patient from a Selective Serotonin Reuptake Inhibitor (SSRI) to a
Monoamine Oxidase Inhibitor (MAOI), what is the mandatory washout period for most
SSRIs?
A. 24 hours
B. 7 days
C. 5 weeks
D. 14 days
Correct Answer: D
Explanation: A washout period is necessary to prevent the development of Serotonin
Syndrome, a potentially fatal condition. For most SSRIs, a 14-day period allows the drug to
clear the system before starting an MAOI. However, Fluoxetine requires a longer 5-week
washout due to its exceptionally long half-life.
5. Which antipsychotic medication requires frequent blood monitoring of Absolute
Neutrophil Count (ANC) due to the risk of agranulocytosis?
A. Clozapine
B. Risperidone
C. Olanzapine
D. Quetiapine
Correct Answer: A
Psychopharmacology | Actual Q&A with Rationale
(NSG 552 Exam 2) | Wilkes
1. Which antidepressant is most likely to cause a significant increase in blood pressure at
higher doses due to its norepinephrine reuptake inhibition?
A. Venlafaxine
B. Escitalopram
C. Mirtazapine
D. Sertraline
Correct Answer: A
Explanation: Venlafaxine is a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) that
exhibits dose-dependent effects. At lower doses, it primarily affects serotonin, but at doses
above 150 mg, it significantly increases norepinephrine activity. This increase in
norepinephrine can lead to sustained elevations in diastolic blood pressure, necessitating
regular monitoring.
2. A patient taking Lithium presents with coarse tremors, ataxia, and confusion. What is the
most likely interpretation of these findings?
A. Therapeutic side effects
B. Serotonin Syndrome
,C. Extrapyramidal Symptoms
D. Lithium Toxicity
Correct Answer: D
Explanation: Lithium has a narrow therapeutic index, typically between 0.6 and 1.2
mEq/L. Signs of toxicity include neurological symptoms such as ataxia, confusion, and
coarse tremors, which differ from the fine tremors seen at therapeutic levels. Immediate
medical intervention and serum level checks are required to prevent permanent renal or
neurological damage.
3. Which of the following medications is contraindicated in patients with a history of seizure
disorders or eating disorders?
A. Duloxetine
B. Fluoxetine
C. Bupropion
D. Trazodone
Correct Answer: C
Explanation: Bupropion works by inhibiting the reuptake of norepinephrine and
dopamine, which can lower the seizure threshold. It is specifically contraindicated in
patients with bulimia or anorexia nervosa due to an increased incidence of seizures in
these populations. Clinicians must screen for these conditions before initiating treatment to
ensure patient safety.
, 4. When switching a patient from a Selective Serotonin Reuptake Inhibitor (SSRI) to a
Monoamine Oxidase Inhibitor (MAOI), what is the mandatory washout period for most
SSRIs?
A. 24 hours
B. 7 days
C. 5 weeks
D. 14 days
Correct Answer: D
Explanation: A washout period is necessary to prevent the development of Serotonin
Syndrome, a potentially fatal condition. For most SSRIs, a 14-day period allows the drug to
clear the system before starting an MAOI. However, Fluoxetine requires a longer 5-week
washout due to its exceptionally long half-life.
5. Which antipsychotic medication requires frequent blood monitoring of Absolute
Neutrophil Count (ANC) due to the risk of agranulocytosis?
A. Clozapine
B. Risperidone
C. Olanzapine
D. Quetiapine
Correct Answer: A
