NR668 Week 4 Psychopharmacology Exam Study
Guide | 250 NCLEX-Style Q&A with Rationales |
Pharmacodynamics, Pharmacokinetics,
Antidepressants, Antipsychotics, Mood Stabilizers,
Anxiolytics, Stimulants | Black Box Warnings |
2024-2025
,1. Which pharmacodynamic term refers to the amount of drug
needed to produce a given effect?
A. Efficacy
B. Potency
C. Affinity
D. Bioavailability
Answer: B. Potency
Rationale: Potency is the amount of drug required to produce a
specific effect; efficacy is the maximal effect.
2. Which pharmacokinetic process reduces the bioavailability of
orally administered drugs before they reach systemic circulation?
A. Distribution
B. First-pass metabolism
C. Renal excretion
D. Protein binding
Answer: B. First-pass metabolism
Rationale: Drugs absorbed from the GI tract pass through the
portal vein to the liver, where metabolism can reduce the amount
reaching systemic circulation.
3. A drug that binds to a receptor and produces a submaximal
response is called a:
A. Full agonist
B. Antagonist
C. Partial agonist
D. Inverse agonist
Answer: C. Partial agonist
, Rationale: A partial agonist activates the receptor but cannot
produce a full maximal response.
4. Which combination places a patient at highest risk for serotonin
syndrome?
A. SSRI and MAOI
B. SSRI and acetaminophen
C. Lithium and a thiazide
D. Benzodiazepine and an opioid
Answer: A. SSRI and MAOI
Rationale: Combining serotonergic drugs such as an SSRI with an
MAOI can cause excessive serotonin activity and potentially fatal
serotonin syndrome.
5. Which black box warning applies to antipsychotics in elderly
patients with dementia-related psychosis?
A. Increased risk of death
B. Stevens-Johnson syndrome
C. Priapism
D. Serotonin syndrome
Answer: A. Increased risk of death
Rationale: Antipsychotics carry a black box warning for increased
mortality in elderly patients with dementia-related psychosis.
6. What is the usual therapeutic serum range for lithium?
A. 0.1–0.4 mEq/L
B. 0.6–1.2 mEq/L
C. 2.0–3.0 mEq/L
D. 5–10 mEq/L
Answer: B. 0.6–1.2 mEq/L
, Rationale: Lithium has a narrow therapeutic index, and levels
generally should be maintained around 0.6–1.2 mEq/L.
7. Which mood stabilizer requires slow titration because of the risk
of Stevens-Johnson syndrome?
A. Lithium
B. Valproate
C. Lamotrigine
D. Carbamazepine
Answer: C. Lamotrigine
Rationale: Lamotrigine can cause serious rash, including Stevens-
Johnson syndrome, so it must be titrated slowly.
8. Which drug combination creates the greatest risk of profound
respiratory depression?
A. Benzodiazepine and opioid
B. SSRI and NSAID
C. Lithium and SSRI
D. Buspirone and SSRI
Answer: A. Benzodiazepine and opioid
Rationale: Benzodiazepines and opioids have additive CNS
depressant effects and can cause respiratory depression, coma,
and death.
9. Which adverse effect should be monitored in a child taking a
stimulant for ADHD?
A. Increased growth velocity
B. Decreased appetite and weight loss
C. Bradycardia
D. Hypotension
Guide | 250 NCLEX-Style Q&A with Rationales |
Pharmacodynamics, Pharmacokinetics,
Antidepressants, Antipsychotics, Mood Stabilizers,
Anxiolytics, Stimulants | Black Box Warnings |
2024-2025
,1. Which pharmacodynamic term refers to the amount of drug
needed to produce a given effect?
A. Efficacy
B. Potency
C. Affinity
D. Bioavailability
Answer: B. Potency
Rationale: Potency is the amount of drug required to produce a
specific effect; efficacy is the maximal effect.
2. Which pharmacokinetic process reduces the bioavailability of
orally administered drugs before they reach systemic circulation?
A. Distribution
B. First-pass metabolism
C. Renal excretion
D. Protein binding
Answer: B. First-pass metabolism
Rationale: Drugs absorbed from the GI tract pass through the
portal vein to the liver, where metabolism can reduce the amount
reaching systemic circulation.
3. A drug that binds to a receptor and produces a submaximal
response is called a:
A. Full agonist
B. Antagonist
C. Partial agonist
D. Inverse agonist
Answer: C. Partial agonist
, Rationale: A partial agonist activates the receptor but cannot
produce a full maximal response.
4. Which combination places a patient at highest risk for serotonin
syndrome?
A. SSRI and MAOI
B. SSRI and acetaminophen
C. Lithium and a thiazide
D. Benzodiazepine and an opioid
Answer: A. SSRI and MAOI
Rationale: Combining serotonergic drugs such as an SSRI with an
MAOI can cause excessive serotonin activity and potentially fatal
serotonin syndrome.
5. Which black box warning applies to antipsychotics in elderly
patients with dementia-related psychosis?
A. Increased risk of death
B. Stevens-Johnson syndrome
C. Priapism
D. Serotonin syndrome
Answer: A. Increased risk of death
Rationale: Antipsychotics carry a black box warning for increased
mortality in elderly patients with dementia-related psychosis.
6. What is the usual therapeutic serum range for lithium?
A. 0.1–0.4 mEq/L
B. 0.6–1.2 mEq/L
C. 2.0–3.0 mEq/L
D. 5–10 mEq/L
Answer: B. 0.6–1.2 mEq/L
, Rationale: Lithium has a narrow therapeutic index, and levels
generally should be maintained around 0.6–1.2 mEq/L.
7. Which mood stabilizer requires slow titration because of the risk
of Stevens-Johnson syndrome?
A. Lithium
B. Valproate
C. Lamotrigine
D. Carbamazepine
Answer: C. Lamotrigine
Rationale: Lamotrigine can cause serious rash, including Stevens-
Johnson syndrome, so it must be titrated slowly.
8. Which drug combination creates the greatest risk of profound
respiratory depression?
A. Benzodiazepine and opioid
B. SSRI and NSAID
C. Lithium and SSRI
D. Buspirone and SSRI
Answer: A. Benzodiazepine and opioid
Rationale: Benzodiazepines and opioids have additive CNS
depressant effects and can cause respiratory depression, coma,
and death.
9. Which adverse effect should be monitored in a child taking a
stimulant for ADHD?
A. Increased growth velocity
B. Decreased appetite and weight loss
C. Bradycardia
D. Hypotension
