NR 546 EXAM 3: ADVANCED
PSYCHOPHARMACOLOGY
COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS |GRADE A+| JUST
RELEASED CHAMBERLAIN COLLEGE
OF NURSING
1. A 32-year-old patient diagnosed with Bipolar I Disorder is being treated with Lithium.
Which of the following lab values would be most concerning regarding potential toxicity?
A. Lithium level of 0.8 mEq/L
B. Serum Sodium of 138 mEq/L
C. Lithium level of 1.6 mEq/L
D. Serum Creatinine of 0.9 mg/dL
Answer: C
Conceptual Explanation: A lithium level of 1.6 mEq/L is considered toxic. The therapeutic
range is typically 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L can cause significant side
effects and toxicity.
,2. Which mechanism of action distinguishes second-generation antipsychotics (SGAs) from
first-generation antipsychotics (FGAs)?
A. D2 receptor antagonism only
B. Muscarinic M1 receptor agonism
C. D2 receptor antagonism and 5HT2A receptor antagonism
D. GABA-A receptor modulation
Answer: C
Conceptual Explanation: SGAs are characterized by their ability to antagonize both
Dopamine-2 (D2) receptors and Serotonin-2A (5HT2A) receptors, which helps reduce EPS
and treat negative symptoms compared to FGAs.
3. A patient taking Clozapine presents for their mandatory blood work. Which Absolute
Neutrophil Count (ANC) result requires immediate discontinuation of the medication?
A. ANC 2,500/mm³
B. ANC 1,800/mm³
C. ANC 1,200/mm³
D. ANC 450/mm³
Answer: D
, Conceptual Explanation: An ANC below 500/mm³ (Severe Neutropenia) requires
immediate cessation of Clozapine due to the high risk of agranulocytosis and life-
threatening infection.
4. Which of the following medications is a partial agonist at the D2 receptor?
A. Haloperidol
B. Quetiapine
C. Aripiprazole
D. Olanzapine
Answer: C
Conceptual Explanation: Aripiprazole acts as a D2 partial agonist, meaning it stabilizes
dopamine activity by acting as an antagonist in high-dopamine environments and an
agonist in low-dopamine environments.
5. A patient is prescribed Lamotrigine for Bipolar II Disorder. The provider must educate the
patient on the risk of which life-threatening condition?
A. Agranulocytosis
B. Serotonin Syndrome
C. Neuroleptic Malignant Syndrome
D. Stevens-Johnson Syndrome (SJS)
Answer: D
PSYCHOPHARMACOLOGY
COMPREHENSIVE QUESTIONS AND
VERIFIED ANSWERS |GRADE A+| JUST
RELEASED CHAMBERLAIN COLLEGE
OF NURSING
1. A 32-year-old patient diagnosed with Bipolar I Disorder is being treated with Lithium.
Which of the following lab values would be most concerning regarding potential toxicity?
A. Lithium level of 0.8 mEq/L
B. Serum Sodium of 138 mEq/L
C. Lithium level of 1.6 mEq/L
D. Serum Creatinine of 0.9 mg/dL
Answer: C
Conceptual Explanation: A lithium level of 1.6 mEq/L is considered toxic. The therapeutic
range is typically 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L can cause significant side
effects and toxicity.
,2. Which mechanism of action distinguishes second-generation antipsychotics (SGAs) from
first-generation antipsychotics (FGAs)?
A. D2 receptor antagonism only
B. Muscarinic M1 receptor agonism
C. D2 receptor antagonism and 5HT2A receptor antagonism
D. GABA-A receptor modulation
Answer: C
Conceptual Explanation: SGAs are characterized by their ability to antagonize both
Dopamine-2 (D2) receptors and Serotonin-2A (5HT2A) receptors, which helps reduce EPS
and treat negative symptoms compared to FGAs.
3. A patient taking Clozapine presents for their mandatory blood work. Which Absolute
Neutrophil Count (ANC) result requires immediate discontinuation of the medication?
A. ANC 2,500/mm³
B. ANC 1,800/mm³
C. ANC 1,200/mm³
D. ANC 450/mm³
Answer: D
, Conceptual Explanation: An ANC below 500/mm³ (Severe Neutropenia) requires
immediate cessation of Clozapine due to the high risk of agranulocytosis and life-
threatening infection.
4. Which of the following medications is a partial agonist at the D2 receptor?
A. Haloperidol
B. Quetiapine
C. Aripiprazole
D. Olanzapine
Answer: C
Conceptual Explanation: Aripiprazole acts as a D2 partial agonist, meaning it stabilizes
dopamine activity by acting as an antagonist in high-dopamine environments and an
agonist in low-dopamine environments.
5. A patient is prescribed Lamotrigine for Bipolar II Disorder. The provider must educate the
patient on the risk of which life-threatening condition?
A. Agranulocytosis
B. Serotonin Syndrome
C. Neuroleptic Malignant Syndrome
D. Stevens-Johnson Syndrome (SJS)
Answer: D
