NURS 5334 ADVANCED
PHARMACOLOGY - EXAM 3
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. A patient taking an SSRI for depression presents with hyperthermia, muscle rigidity, and
rapid fluctuations in vital signs after starting a new OTC supplement. Which supplement is the
most likely culprit?
A. Ginkgo biloba
B. Echinacea
C. Saw palmetto
D. St. John’s Wort
Answer: D
Conceptual Explanation: St. John’s Wort has serotonergic properties and can precipitate
Serotonin Syndrome when combined with SSRIs, characterized by autonomic instability,
hyperthermia, and neuromuscular excitability.
2. When initiating Lithium therapy for a patient with bipolar disorder, which laboratory
baseline is most critical to evaluate due to the drug’s primary route of excretion?
A. Serum Creatinine and GFR
,B. Serum Aminotransferases (ALT/AST)
C. Complete Blood Count (CBC)
D. Glycated Hemoglobin (A1C)
Answer: A
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys. Renal
impairment can lead to toxic accumulation, making baseline and periodic renal function
testing essential.
3. A patient on Clozapine therapy presents for a routine check-up. Which absolute neutrophil
count (ANC) value would necessitate immediate discontinuation of the drug and hematology
consultation?
A. 2500/mm3
B. 900/mm3
C. 1800/mm3
D. 3200/mm3
Answer: B
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. An
ANC below 1000/mm3 (severe neutropenia) requires immediate cessation of the drug.
, 4. A patient is switched from a high-potency typical antipsychotic to an atypical antipsychotic.
What is the primary reason for this transition in clinical practice regarding side effect profiles?
A. To reduce the risk of metabolic syndrome
B. To reduce the risk of extrapyramidal symptoms (EPS)
C. To eliminate the risk of Neuroleptic Malignant Syndrome
D. To avoid sedation
Answer: B
Conceptual Explanation: Atypical (second-generation) antipsychotics have a lower
affinity for D2 receptors in the nigrostriatal pathway, significantly reducing the incidence of
EPS compared to high-potency typical agents like Haloperidol.
5. Which mechanism best explains why Levodopa is administered in combination with
Carbidopa for Parkinson’s disease?
A. Carbidopa crosses the blood-brain barrier to inhibit dopamine reuptake
B. Carbidopa increases the gastric absorption of Levodopa
C. Carbidopa acts as a dopamine agonist in the striatum
D. Carbidopa inhibits peripheral decarboxylation of Levodopa
Answer: D
Conceptual Explanation: Carbidopa inhibits the enzyme DOPA decarboxylase in the
periphery, preventing the conversion of Levodopa to dopamine before it crosses the blood-
PHARMACOLOGY - EXAM 3
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. A patient taking an SSRI for depression presents with hyperthermia, muscle rigidity, and
rapid fluctuations in vital signs after starting a new OTC supplement. Which supplement is the
most likely culprit?
A. Ginkgo biloba
B. Echinacea
C. Saw palmetto
D. St. John’s Wort
Answer: D
Conceptual Explanation: St. John’s Wort has serotonergic properties and can precipitate
Serotonin Syndrome when combined with SSRIs, characterized by autonomic instability,
hyperthermia, and neuromuscular excitability.
2. When initiating Lithium therapy for a patient with bipolar disorder, which laboratory
baseline is most critical to evaluate due to the drug’s primary route of excretion?
A. Serum Creatinine and GFR
,B. Serum Aminotransferases (ALT/AST)
C. Complete Blood Count (CBC)
D. Glycated Hemoglobin (A1C)
Answer: A
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys. Renal
impairment can lead to toxic accumulation, making baseline and periodic renal function
testing essential.
3. A patient on Clozapine therapy presents for a routine check-up. Which absolute neutrophil
count (ANC) value would necessitate immediate discontinuation of the drug and hematology
consultation?
A. 2500/mm3
B. 900/mm3
C. 1800/mm3
D. 3200/mm3
Answer: B
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. An
ANC below 1000/mm3 (severe neutropenia) requires immediate cessation of the drug.
, 4. A patient is switched from a high-potency typical antipsychotic to an atypical antipsychotic.
What is the primary reason for this transition in clinical practice regarding side effect profiles?
A. To reduce the risk of metabolic syndrome
B. To reduce the risk of extrapyramidal symptoms (EPS)
C. To eliminate the risk of Neuroleptic Malignant Syndrome
D. To avoid sedation
Answer: B
Conceptual Explanation: Atypical (second-generation) antipsychotics have a lower
affinity for D2 receptors in the nigrostriatal pathway, significantly reducing the incidence of
EPS compared to high-potency typical agents like Haloperidol.
5. Which mechanism best explains why Levodopa is administered in combination with
Carbidopa for Parkinson’s disease?
A. Carbidopa crosses the blood-brain barrier to inhibit dopamine reuptake
B. Carbidopa increases the gastric absorption of Levodopa
C. Carbidopa acts as a dopamine agonist in the striatum
D. Carbidopa inhibits peripheral decarboxylation of Levodopa
Answer: D
Conceptual Explanation: Carbidopa inhibits the enzyme DOPA decarboxylase in the
periphery, preventing the conversion of Levodopa to dopamine before it crosses the blood-
