NU 643 Exam 4 V3 | NU 643 Advanced
Psychopharmacology | Actual Q&A with Rationale
(NU643 Exam 4) | Regis University
1. A 9-year-old male is diagnosed with ADHD, combined type. The provider is considering
starting a stimulant. Which of the following mechanisms best describes the primary action of
Methylphenidate?
A. It blocks the reuptake of norepinephrine and dopamine via the transporters (NET and
DAT).
B. It stimulates the release of dopamine from storage vesicles into the synapse.
C. It acts as a potent agonist at the Alpha-2A adrenergic receptor.
D. It inhibits Monoamine Oxidase Type B, increasing available synaptic dopamine.
Correct Answer: A
Explanation: Methylphenidate works primarily as a reuptake inhibitor for both dopamine
and norepinephrine. By blocking the transporters, it increases the synaptic concentration
of these neurotransmitters in the prefrontal cortex. This differs from amphetamines, which
also promote the release of neurotransmitters from presynaptic vesicles.
2. When treating an adult patient with Alcohol Use Disorder who has active liver disease
(elevated LFTs), which medication is preferred for the prevention of relapse?
A. Disulfiram
B. Naltrexone
,C. Topiramate
D. Acamprosate
Correct Answer: D
Explanation: Acamprosate is primarily excreted by the kidneys and does not undergo
significant hepatic metabolism. This makes it a safer choice compared to Naltrexone or
Disulfiram in patients with compromised liver function. The provider must ensure the
patient’s renal function is adequate before initiating therapy.
3. A patient is being treated for opioid overdose. The provider administers Naloxone. What is
the pharmacological mechanism of this rescue medication?
A. Partial agonism at the mu-opioid receptor.
B. Non-competitive inhibition of the kappa-opioid receptor.
C. Full competitive antagonism at the mu-opioid receptor.
D. Facilitation of GABAergic transmission to counter respiratory depression.
Correct Answer: C
Explanation: Naloxone has a very high affinity for the mu-opioid receptor, effectively
displacing opioids and reversing their effects. Because it is a competitive antagonist, it
provides immediate reversal of respiratory depression and sedation. Its duration of action
is relatively short, often requiring repeated doses.
, 4. Which of the following stimulants is a prodrug designed to reduce the potential for abuse
by requiring enzymatic conversion in red blood cells?
A. Vyvanse (Lisdexamfetamine)
B. Focalin XR (Dexmethylphenidate)
C. Concerta (Methylphenidate XR)
D. Adderall XR (Mixed Amphetamine Salts)
Correct Answer: A
Explanation: Lisdexamfetamine is a prodrug where D-amphetamine is linked to the amino
acid L-lysine. The active component is only released after the molecule is cleaved by
enzymes in the blood. This pharmacokinetic profile limits the ‘rush’ associated with
intranasal or intravenous administration, reducing abuse potential.
5. An adolescent patient with ADHD and a history of motor tics requires pharmacological
intervention. Which non-stimulant medication is FDA-approved for ADHD and less likely to
exacerbate tics?
A. Venlafaxine
B. Modafinil
C. Bupropion
D. Guanfacine ER
Correct Answer: D
Psychopharmacology | Actual Q&A with Rationale
(NU643 Exam 4) | Regis University
1. A 9-year-old male is diagnosed with ADHD, combined type. The provider is considering
starting a stimulant. Which of the following mechanisms best describes the primary action of
Methylphenidate?
A. It blocks the reuptake of norepinephrine and dopamine via the transporters (NET and
DAT).
B. It stimulates the release of dopamine from storage vesicles into the synapse.
C. It acts as a potent agonist at the Alpha-2A adrenergic receptor.
D. It inhibits Monoamine Oxidase Type B, increasing available synaptic dopamine.
Correct Answer: A
Explanation: Methylphenidate works primarily as a reuptake inhibitor for both dopamine
and norepinephrine. By blocking the transporters, it increases the synaptic concentration
of these neurotransmitters in the prefrontal cortex. This differs from amphetamines, which
also promote the release of neurotransmitters from presynaptic vesicles.
2. When treating an adult patient with Alcohol Use Disorder who has active liver disease
(elevated LFTs), which medication is preferred for the prevention of relapse?
A. Disulfiram
B. Naltrexone
,C. Topiramate
D. Acamprosate
Correct Answer: D
Explanation: Acamprosate is primarily excreted by the kidneys and does not undergo
significant hepatic metabolism. This makes it a safer choice compared to Naltrexone or
Disulfiram in patients with compromised liver function. The provider must ensure the
patient’s renal function is adequate before initiating therapy.
3. A patient is being treated for opioid overdose. The provider administers Naloxone. What is
the pharmacological mechanism of this rescue medication?
A. Partial agonism at the mu-opioid receptor.
B. Non-competitive inhibition of the kappa-opioid receptor.
C. Full competitive antagonism at the mu-opioid receptor.
D. Facilitation of GABAergic transmission to counter respiratory depression.
Correct Answer: C
Explanation: Naloxone has a very high affinity for the mu-opioid receptor, effectively
displacing opioids and reversing their effects. Because it is a competitive antagonist, it
provides immediate reversal of respiratory depression and sedation. Its duration of action
is relatively short, often requiring repeated doses.
, 4. Which of the following stimulants is a prodrug designed to reduce the potential for abuse
by requiring enzymatic conversion in red blood cells?
A. Vyvanse (Lisdexamfetamine)
B. Focalin XR (Dexmethylphenidate)
C. Concerta (Methylphenidate XR)
D. Adderall XR (Mixed Amphetamine Salts)
Correct Answer: A
Explanation: Lisdexamfetamine is a prodrug where D-amphetamine is linked to the amino
acid L-lysine. The active component is only released after the molecule is cleaved by
enzymes in the blood. This pharmacokinetic profile limits the ‘rush’ associated with
intranasal or intravenous administration, reducing abuse potential.
5. An adolescent patient with ADHD and a history of motor tics requires pharmacological
intervention. Which non-stimulant medication is FDA-approved for ADHD and less likely to
exacerbate tics?
A. Venlafaxine
B. Modafinil
C. Bupropion
D. Guanfacine ER
Correct Answer: D
