NSG 552 Final Exam V2 | NSG 552
Psychopharmacology | Actual Q&A with Rationale
(NSG 552 Final Exam) | Wilkes
1. A patient diagnosed with Bipolar I Disorder presents with a Lithium level of 1.8 mEq/L.
Which of the following symptoms would the provider most likely observe?
A. Mild thirst and polyuria
B. Increased appetite and weight gain
C. Coarse hand tremors and ataxia
D. Fine resting tremor
Correct Answer: C
Explanation: A lithium level of 1.8 mEq/L indicates moderate toxicity, which typically
manifests as neurological impairments like coarse tremors or ataxia. Levels below 1.2
mEq/L are generally considered therapeutic, while levels above 1.5 mEq/L require
immediate attention. The provider must assess the patient for worsening symptoms and
potentially discontinue the medication to prevent permanent damage.
2. Which mechanism of action is primarily responsible for the therapeutic effects of Selective
Serotonin Reuptake Inhibitors (SSRIs)?
A. Antagonism of the 5-HT2A receptor
B. Inhibition of the SERT protein to increase synaptic serotonin
,C. Blockade of the D2 dopamine receptor
D. Inhibition of Monoamine Oxidase
Correct Answer: B
Explanation: SSRIs work by binding to the serotonin transporter (SERT) and preventing
the reabsorption of serotonin into the presynaptic neuron. This action increases the
concentration of serotonin available in the synaptic cleft for binding to postsynaptic
receptors. Over time, this increase in serotonin leads to downstream neuroplastic changes
that alleviate depressive symptoms.
3. When prescribing Clozapine (Clozaril), the provider must monitor the Absolute Neutrophil
Count (ANC) to mitigate the risk of which condition?
A. Thrombocytopenia
B. Agranulocytosis
C. Hyperlipidemia
D. Nephrogenic Diabetes Insipidus
Correct Answer: B
Explanation: Clozapine is associated with a risk of severe neutropenia, also known as
agranulocytosis, which can be fatal. Consequently, the FDA requires strict monitoring of
ANC levels through a centralized REMS program. Patients must have regular blood work to
ensure their immune system is functioning adequately while taking this medication.
, 4. A patient taking Phenelzine (Nardil) should be educated to avoid aged cheeses and cured
meats to prevent which complication?
A. Hypertensive Crisis
B. Neuroleptic Malignant Syndrome
C. Serotonin Syndrome
D. Metabolic Syndrome
Correct Answer: A
Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that prevents the
breakdown of tyramine in the body. Consuming high-tyramine foods while on an MAOI can
lead to a sudden and dangerous rise in blood pressure, known as a hypertensive crisis. This
condition requires emergency medical treatment and careful dietary management by the
patient.
5. Which of the following is considered a hallmark symptom of Neuroleptic Malignant
Syndrome (NMS)?
A. Muscular ‘lead-pipe’ rigidity
B. Hypotension and bradycardia
C. Hyperreflexia and myoclonus
D. Maculopapular rash
Correct Answer: A
Psychopharmacology | Actual Q&A with Rationale
(NSG 552 Final Exam) | Wilkes
1. A patient diagnosed with Bipolar I Disorder presents with a Lithium level of 1.8 mEq/L.
Which of the following symptoms would the provider most likely observe?
A. Mild thirst and polyuria
B. Increased appetite and weight gain
C. Coarse hand tremors and ataxia
D. Fine resting tremor
Correct Answer: C
Explanation: A lithium level of 1.8 mEq/L indicates moderate toxicity, which typically
manifests as neurological impairments like coarse tremors or ataxia. Levels below 1.2
mEq/L are generally considered therapeutic, while levels above 1.5 mEq/L require
immediate attention. The provider must assess the patient for worsening symptoms and
potentially discontinue the medication to prevent permanent damage.
2. Which mechanism of action is primarily responsible for the therapeutic effects of Selective
Serotonin Reuptake Inhibitors (SSRIs)?
A. Antagonism of the 5-HT2A receptor
B. Inhibition of the SERT protein to increase synaptic serotonin
,C. Blockade of the D2 dopamine receptor
D. Inhibition of Monoamine Oxidase
Correct Answer: B
Explanation: SSRIs work by binding to the serotonin transporter (SERT) and preventing
the reabsorption of serotonin into the presynaptic neuron. This action increases the
concentration of serotonin available in the synaptic cleft for binding to postsynaptic
receptors. Over time, this increase in serotonin leads to downstream neuroplastic changes
that alleviate depressive symptoms.
3. When prescribing Clozapine (Clozaril), the provider must monitor the Absolute Neutrophil
Count (ANC) to mitigate the risk of which condition?
A. Thrombocytopenia
B. Agranulocytosis
C. Hyperlipidemia
D. Nephrogenic Diabetes Insipidus
Correct Answer: B
Explanation: Clozapine is associated with a risk of severe neutropenia, also known as
agranulocytosis, which can be fatal. Consequently, the FDA requires strict monitoring of
ANC levels through a centralized REMS program. Patients must have regular blood work to
ensure their immune system is functioning adequately while taking this medication.
, 4. A patient taking Phenelzine (Nardil) should be educated to avoid aged cheeses and cured
meats to prevent which complication?
A. Hypertensive Crisis
B. Neuroleptic Malignant Syndrome
C. Serotonin Syndrome
D. Metabolic Syndrome
Correct Answer: A
Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that prevents the
breakdown of tyramine in the body. Consuming high-tyramine foods while on an MAOI can
lead to a sudden and dangerous rise in blood pressure, known as a hypertensive crisis. This
condition requires emergency medical treatment and careful dietary management by the
patient.
5. Which of the following is considered a hallmark symptom of Neuroleptic Malignant
Syndrome (NMS)?
A. Muscular ‘lead-pipe’ rigidity
B. Hypotension and bradycardia
C. Hyperreflexia and myoclonus
D. Maculopapular rash
Correct Answer: A
