NU 641 ADVANCED CLINICAL
PHARMACOLOGY EXAM 3 -
ADVANCED PSYCHOTROPIC AND
NEUROLOGICAL CARE QUESTIONS
AND ANSWERS AND EXPLANATIONS |
LATEST - REGIS
1. A patient initiated on Fluoxetine (Prozac) for Depression reports increased anxiety and
insomnia within the first week. What is the most appropriate pharmacological explanation?
A. Serotonin syndrome development
B. Initial activation effect common with SSRIs
C. Immediate downregulation of 5-HT1A receptors
D. Emergence of Bipolar I mania
Answer: B
Conceptual Explanation: SSRIs, particularly fluoxetine due to its long half-life, can cause
initial jitteriness, anxiety, and insomnia as the brain adjusts to increased serotonin levels.
This is often managed by starting with low doses.
2. Which antidepressant is contraindicated in a patient with a history of bulimia nervosa due
to an increased risk of seizures?
A. Sertraline
,B. Venlafaxine
C. Mirtazapine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion is contraindicated in patients with eating disorders
(bulimia or anorexia) because it significantly lowers the seizure threshold in these
populations.
3. A patient taking Phenelzine (Nardil) attends a party and consumes aged cheeses and red
wine. They present to the ER with a blood pressure of 210/120. Which substance caused this
interaction?
A. Tryptophan
B. Phenylalanine
C. Tyramine
D. Histamine
Answer: C
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Excess tyramine
leads to the release of norepinephrine, causing a hypertensive crisis.
, 4. When prescribing Lithium Carbonate, which of the following lab values is most critical to
monitor due to the drug’s narrow therapeutic index and excretion route?
A. Serum Albumin
B. Serum Creatinine
C. Liver Function Tests
D. Prothrombin Time
Answer: B
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys. Renal
impairment (monitored via creatinine/GFR) can lead to toxic accumulation.
5. A 25-year-old female started on Lamotrigine for Bipolar II disorder should be educated
extensively on which life-threatening adverse effect?
A. Stevens-Johnson Syndrome
B. Acute Angle Glaucoma
C. Agranulocytosis
D. Hepatotoxicity
Answer: A
Conceptual Explanation: Lamotrigine has a black-box warning for serious rashes,
including Stevens-Johnson Syndrome (SJS), necessitating a slow dose titration.
PHARMACOLOGY EXAM 3 -
ADVANCED PSYCHOTROPIC AND
NEUROLOGICAL CARE QUESTIONS
AND ANSWERS AND EXPLANATIONS |
LATEST - REGIS
1. A patient initiated on Fluoxetine (Prozac) for Depression reports increased anxiety and
insomnia within the first week. What is the most appropriate pharmacological explanation?
A. Serotonin syndrome development
B. Initial activation effect common with SSRIs
C. Immediate downregulation of 5-HT1A receptors
D. Emergence of Bipolar I mania
Answer: B
Conceptual Explanation: SSRIs, particularly fluoxetine due to its long half-life, can cause
initial jitteriness, anxiety, and insomnia as the brain adjusts to increased serotonin levels.
This is often managed by starting with low doses.
2. Which antidepressant is contraindicated in a patient with a history of bulimia nervosa due
to an increased risk of seizures?
A. Sertraline
,B. Venlafaxine
C. Mirtazapine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion is contraindicated in patients with eating disorders
(bulimia or anorexia) because it significantly lowers the seizure threshold in these
populations.
3. A patient taking Phenelzine (Nardil) attends a party and consumes aged cheeses and red
wine. They present to the ER with a blood pressure of 210/120. Which substance caused this
interaction?
A. Tryptophan
B. Phenylalanine
C. Tyramine
D. Histamine
Answer: C
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Excess tyramine
leads to the release of norepinephrine, causing a hypertensive crisis.
, 4. When prescribing Lithium Carbonate, which of the following lab values is most critical to
monitor due to the drug’s narrow therapeutic index and excretion route?
A. Serum Albumin
B. Serum Creatinine
C. Liver Function Tests
D. Prothrombin Time
Answer: B
Conceptual Explanation: Lithium is excreted almost entirely by the kidneys. Renal
impairment (monitored via creatinine/GFR) can lead to toxic accumulation.
5. A 25-year-old female started on Lamotrigine for Bipolar II disorder should be educated
extensively on which life-threatening adverse effect?
A. Stevens-Johnson Syndrome
B. Acute Angle Glaucoma
C. Agranulocytosis
D. Hepatotoxicity
Answer: A
Conceptual Explanation: Lamotrigine has a black-box warning for serious rashes,
including Stevens-Johnson Syndrome (SJS), necessitating a slow dose titration.
