NR 546 PSYCHOPHARMACOLOGY
FINAL EXAM PREP QUESTIONS AND
VERIFIED ANSWERS |GRADE A+| JUST
RELEASED CHAMBERLAIN COLLEGE
OF NURSING
1. A patient with Treatment-Resistant Depression (TRD) is prescribed Esketamine. Which
mechanism of action distinguishes this medication from traditional monoamine
antidepressants?
A. Partial agonism of the D2 receptor
B. Selective inhibition of serotonin reuptake
C. Non-competitive NMDA receptor antagonism
D. Inhibition of Monoamine Oxidase B
Answer: C
Conceptual Explanation: Esketamine acts as a non-competitive NMDA receptor
antagonist, impacting glutamate transmission, unlike traditional antidepressants that
target serotonin, norepinephrine, or dopamine.
,2. Which side effect of Second-Generation Antipsychotics (SGAs) is primarily mediated by H1
and 5HT2C receptor antagonism?
A. Weight gain and sedation
B. Extrapyramidal symptoms
C. Galactorrhea
D. Prolonged QTc interval
Answer: A
Conceptual Explanation: Antagonism of histamine (H1) and serotonin (5HT2C) receptors
is strongly associated with metabolic side effects, including significant weight gain and
sedation, common in agents like Clozapine and Olanzapine.
3. A 28-year-old female patient started on Lamotrigine for Bipolar II disorder. She calls the
clinic reporting a new rash on her chest. What is the priority action?
A. Immediately discontinue the medication and seek emergency evaluation
B. Reduce the dose by half and schedule an appointment
C. Apply topical hydrocortisone and monitor for 24 hours
D. Take an antihistamine to rule out a minor allergic reaction
Answer: A
, Conceptual Explanation: Due to the risk of Stevens-Johnson Syndrome (SJS), any new
rash during Lamotrigine titration must be treated as a medical emergency requiring
immediate discontinuation.
4. According to the Stahl’s Essential Psychopharmacology, which pathway is associated with
the negative symptoms of schizophrenia when dopamine levels are low?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: Dopamine deficiency in the mesocortical pathway is
hypothesized to lead to cognitive and negative symptoms of schizophrenia.
5. Which antidepressant is considered the best choice for a patient concerned about sexual
dysfunction and weight gain?
A. Paroxetine
B. Amitriptyline
C. Bupropion
D. Mirtazapine
Answer: C
FINAL EXAM PREP QUESTIONS AND
VERIFIED ANSWERS |GRADE A+| JUST
RELEASED CHAMBERLAIN COLLEGE
OF NURSING
1. A patient with Treatment-Resistant Depression (TRD) is prescribed Esketamine. Which
mechanism of action distinguishes this medication from traditional monoamine
antidepressants?
A. Partial agonism of the D2 receptor
B. Selective inhibition of serotonin reuptake
C. Non-competitive NMDA receptor antagonism
D. Inhibition of Monoamine Oxidase B
Answer: C
Conceptual Explanation: Esketamine acts as a non-competitive NMDA receptor
antagonist, impacting glutamate transmission, unlike traditional antidepressants that
target serotonin, norepinephrine, or dopamine.
,2. Which side effect of Second-Generation Antipsychotics (SGAs) is primarily mediated by H1
and 5HT2C receptor antagonism?
A. Weight gain and sedation
B. Extrapyramidal symptoms
C. Galactorrhea
D. Prolonged QTc interval
Answer: A
Conceptual Explanation: Antagonism of histamine (H1) and serotonin (5HT2C) receptors
is strongly associated with metabolic side effects, including significant weight gain and
sedation, common in agents like Clozapine and Olanzapine.
3. A 28-year-old female patient started on Lamotrigine for Bipolar II disorder. She calls the
clinic reporting a new rash on her chest. What is the priority action?
A. Immediately discontinue the medication and seek emergency evaluation
B. Reduce the dose by half and schedule an appointment
C. Apply topical hydrocortisone and monitor for 24 hours
D. Take an antihistamine to rule out a minor allergic reaction
Answer: A
, Conceptual Explanation: Due to the risk of Stevens-Johnson Syndrome (SJS), any new
rash during Lamotrigine titration must be treated as a medical emergency requiring
immediate discontinuation.
4. According to the Stahl’s Essential Psychopharmacology, which pathway is associated with
the negative symptoms of schizophrenia when dopamine levels are low?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: Dopamine deficiency in the mesocortical pathway is
hypothesized to lead to cognitive and negative symptoms of schizophrenia.
5. Which antidepressant is considered the best choice for a patient concerned about sexual
dysfunction and weight gain?
A. Paroxetine
B. Amitriptyline
C. Bupropion
D. Mirtazapine
Answer: C
