NU 643 Exam 4 V2 | NU 643 Advanced
Psychopharmacology | Actual Q&A with Rationale
(NU643 Exam 4) | Regis University
1. When prescribing stimulants for the treatment of ADHD, what is the primary mechanism of
action for Methylphenidate?
A. It induces the release of dopamine from presynaptic storage vesicles.
B. It blocks the reuptake of norepinephrine and dopamine via the transporter proteins.
C. It acts as a potent agonist at the alpha-2 adrenergic receptors.
D. It primarily inhibits monoamine oxidase type B in the synaptic cleft.
Correct Answer: B
Explanation: Methylphenidate works by blocking the dopamine transporter (DAT) and
norepinephrine transporter (NET) which increases the concentration of these
neurotransmitters in the synapse. Unlike amphetamines, it does not significantly promote
the release of dopamine from the vesicles. This increased synaptic availability helps
improve attention and executive function in patients with ADHD.
2. Which medication is classified as a non-stimulant and works as a selective norepinephrine
reuptake inhibitor (SNRI) for ADHD?
A. Guanfacine
B. Atomoxetine
,C. Lisdexamfetamine
D. Clonidine
Correct Answer: B
Explanation: Atomoxetine (Strattera) is the first non-stimulant approved by the FDA for
the treatment of ADHD and acts selectively on norepinephrine reuptake. It is particularly
useful for patients with a history of substance abuse or those who experience significant
side effects from stimulants. Clinical effects typically take 2 to 4 weeks to become apparent
unlike the immediate impact of stimulants.
3. What is the black box warning associated with the use of antipsychotics in elderly patients
with dementia-related psychosis?
A. Increased risk of hepatotoxicity
B. Increased risk of agranulocytosis
C. Increased risk of permanent tardive dyskinesia within the first month
D. Increased risk of death, primarily from cardiovascular or infectious causes
Correct Answer: D
Explanation: The FDA requires a black box warning for all antipsychotics regarding their
use in dementia-related psychosis in the elderly due to an increased mortality rate. The
causes are often cardiovascular (such as heart failure or sudden death) or infectious (like
pneumonia). Prescribers must weigh the benefits against these serious risks and document
the rationale clearly.
, 4. In the treatment of Alzheimer’s disease, what is the mechanism of action of Memantine?
A. NMDA receptor antagonism
B. Acetylcholinesterase inhibition
C. Serotonin receptor agonism
D. Dopamine D2 receptor blockade
Correct Answer: A
Explanation: Memantine acts as an uncompetitive, moderate-affinity NMDA receptor
antagonist that regulates glutamate activity. By blocking excessive glutamate stimulation, it
prevents neurotoxicity that can lead to further neuronal death in Alzheimer’s patients. It is
often used for moderate to severe stages of the disease, sometimes in combination with
cholinesterase inhibitors.
5. Which medication used for Alcohol Use Disorder (AUD) acts by causing a highly unpleasant
physical reaction when alcohol is consumed?
A. Acamprosate
B. Naltrexone
C. Topiramate
D. Disulfiram
Correct Answer: D
Psychopharmacology | Actual Q&A with Rationale
(NU643 Exam 4) | Regis University
1. When prescribing stimulants for the treatment of ADHD, what is the primary mechanism of
action for Methylphenidate?
A. It induces the release of dopamine from presynaptic storage vesicles.
B. It blocks the reuptake of norepinephrine and dopamine via the transporter proteins.
C. It acts as a potent agonist at the alpha-2 adrenergic receptors.
D. It primarily inhibits monoamine oxidase type B in the synaptic cleft.
Correct Answer: B
Explanation: Methylphenidate works by blocking the dopamine transporter (DAT) and
norepinephrine transporter (NET) which increases the concentration of these
neurotransmitters in the synapse. Unlike amphetamines, it does not significantly promote
the release of dopamine from the vesicles. This increased synaptic availability helps
improve attention and executive function in patients with ADHD.
2. Which medication is classified as a non-stimulant and works as a selective norepinephrine
reuptake inhibitor (SNRI) for ADHD?
A. Guanfacine
B. Atomoxetine
,C. Lisdexamfetamine
D. Clonidine
Correct Answer: B
Explanation: Atomoxetine (Strattera) is the first non-stimulant approved by the FDA for
the treatment of ADHD and acts selectively on norepinephrine reuptake. It is particularly
useful for patients with a history of substance abuse or those who experience significant
side effects from stimulants. Clinical effects typically take 2 to 4 weeks to become apparent
unlike the immediate impact of stimulants.
3. What is the black box warning associated with the use of antipsychotics in elderly patients
with dementia-related psychosis?
A. Increased risk of hepatotoxicity
B. Increased risk of agranulocytosis
C. Increased risk of permanent tardive dyskinesia within the first month
D. Increased risk of death, primarily from cardiovascular or infectious causes
Correct Answer: D
Explanation: The FDA requires a black box warning for all antipsychotics regarding their
use in dementia-related psychosis in the elderly due to an increased mortality rate. The
causes are often cardiovascular (such as heart failure or sudden death) or infectious (like
pneumonia). Prescribers must weigh the benefits against these serious risks and document
the rationale clearly.
, 4. In the treatment of Alzheimer’s disease, what is the mechanism of action of Memantine?
A. NMDA receptor antagonism
B. Acetylcholinesterase inhibition
C. Serotonin receptor agonism
D. Dopamine D2 receptor blockade
Correct Answer: A
Explanation: Memantine acts as an uncompetitive, moderate-affinity NMDA receptor
antagonist that regulates glutamate activity. By blocking excessive glutamate stimulation, it
prevents neurotoxicity that can lead to further neuronal death in Alzheimer’s patients. It is
often used for moderate to severe stages of the disease, sometimes in combination with
cholinesterase inhibitors.
5. Which medication used for Alcohol Use Disorder (AUD) acts by causing a highly unpleasant
physical reaction when alcohol is consumed?
A. Acamprosate
B. Naltrexone
C. Topiramate
D. Disulfiram
Correct Answer: D
