6630 Study Guide 2025: High-Yield Topics
for Success
Which mood stabilizer is most appropriate for targeting aggressive and impulsive symptoms by
decreasing dopaminergic neurotransmission?
A. Lithium (Lithane)
B. Valproate
C. Carbamazepine
D. Lamotrigine
Rationale: Lithium modulates dopaminergic neurotransmission and is effective in reducing
impulsivity and aggression. Valproate, carbamazepine, and lamotrigine are mood stabilizers but
do not primarily target dopaminergic pathways for aggression.
An 8-year-old patient is receiving an initial prescription for D-amphetamine. Which dose
demonstrates appropriate prescribing practices?
A. 2.5 mg
B. 5 mg
C. 10 mg
D. 15 mg
Rationale: Initial dosing for children is conservative to minimize side effects and assess
tolerance. Higher doses risk cardiovascular and CNS side effects.
Mrs. Kenner asks about treatments for her teenage daughter’s Internet addiction. Which
response demonstrates proper understanding of pharmacologic approaches?
A. Prescribe an SSRI immediately
B. Prescribe bupropion
C. Prescribe antipsychotics
D. "There are no evidence-based treatments for Internet addiction, but there are behavioral
therapies your daughter can try."
Rationale: Currently, no pharmacologic treatments are evidence-based for Internet addiction;
behavioral interventions are first-line. Prescribing medications is not supported.
,A 43-year-old adult asks about differences in treating ADHD in adults versus children. Which
factor is a major difference?
A. Adults require only behavioral therapy
B. Adults respond better to stimulants than children
C. Adults need lower doses of all medications
D. Comorbidities are more common in adults, impacting the prescription of additional agents.
Rationale: Adults with ADHD frequently have comorbidities such as anxiety or depression,
which influence medication choice. Behavioral therapy and dosing considerations may differ,
but comorbidities are the primary distinction.
A 71-year-old female patient is experiencing memory loss, apraxia, and agnosia. Which
medication is appropriate?
A. Donepezil
B. Rivastigmine
C. Memantine (Namenda)
D. Galantamine
Rationale: Memantine, an NMDA receptor antagonist, is indicated for moderate to severe
Alzheimer’s with memory and functional deficits such as apraxia and agnosia. Cholinesterase
inhibitors can help but may not be sufficient alone at this stage.
Why are SSRIs not consistently effective in treating diabetic peripheral neuropathic pain?
A. They block norepinephrine
B. "SSRIs only increase serotonin levels."
C. They act on dopamine receptors
D. They enhance GABAergic transmission
Rationale: Neuropathic pain often requires modulation of both serotonin and norepinephrine.
SSRIs only increasing serotonin makes them less effective than SNRIs. Dopamine or GABA effects
are not primary mechanisms.
When prescribing milnacipran (Savella) for fibromyalgia, what is the recommended approach?
A. Give full daily dose once daily
B. Start at maximum dose immediately
C. Split the daily dose into two doses after the first day
D. Administer only at bedtime
, Rationale: Milnacipran is typically titrated and split to reduce side effects like nausea and
increase tolerability. Starting at maximum dose or once daily increases risk of adverse effects.
What is a known cardiovascular risk associated with bupropion?
A. Bradycardia
B. Hypotension
C. Cardiac arrhythmias
D. Stroke
Rationale: Bupropion can increase the risk of cardiac arrhythmias, especially in patients with
pre-existing heart conditions. Bradycardia, hypotension, and stroke are not primary risks.
Which pharmacologic treatment is most appropriate for psychotic aggression to manage cortical
control and striatal hyperactivity?
A. Benzodiazepines
B. Lithium
C. Antipsychotics
D. SSRIs
Rationale: Antipsychotics target dopamine pathways in both cortical and subcortical regions,
helping regulate aggression and impulsivity. Benzodiazepines provide sedation only, lithium is
slower acting, and SSRIs are ineffective for acute psychotic aggression.
Slow-dose extended-release stimulants are most appropriate for which patient with ADHD?
A. 8-year-old patient
B. 12-year-old adolescent
C. Adult patient
D. 16-year-old patient
Rationale: Extended-release stimulants provide steady coverage for younger children who may
not adhere to multiple daily doses. Adolescents and adults can often use immediate-release
formulations or multiple daily dosing.
Which mood stabilizer is considered first-line for managing aggressive and impulsive behaviors
in adults?
A. Lithium (Lithane)
B. Valproate
for Success
Which mood stabilizer is most appropriate for targeting aggressive and impulsive symptoms by
decreasing dopaminergic neurotransmission?
A. Lithium (Lithane)
B. Valproate
C. Carbamazepine
D. Lamotrigine
Rationale: Lithium modulates dopaminergic neurotransmission and is effective in reducing
impulsivity and aggression. Valproate, carbamazepine, and lamotrigine are mood stabilizers but
do not primarily target dopaminergic pathways for aggression.
An 8-year-old patient is receiving an initial prescription for D-amphetamine. Which dose
demonstrates appropriate prescribing practices?
A. 2.5 mg
B. 5 mg
C. 10 mg
D. 15 mg
Rationale: Initial dosing for children is conservative to minimize side effects and assess
tolerance. Higher doses risk cardiovascular and CNS side effects.
Mrs. Kenner asks about treatments for her teenage daughter’s Internet addiction. Which
response demonstrates proper understanding of pharmacologic approaches?
A. Prescribe an SSRI immediately
B. Prescribe bupropion
C. Prescribe antipsychotics
D. "There are no evidence-based treatments for Internet addiction, but there are behavioral
therapies your daughter can try."
Rationale: Currently, no pharmacologic treatments are evidence-based for Internet addiction;
behavioral interventions are first-line. Prescribing medications is not supported.
,A 43-year-old adult asks about differences in treating ADHD in adults versus children. Which
factor is a major difference?
A. Adults require only behavioral therapy
B. Adults respond better to stimulants than children
C. Adults need lower doses of all medications
D. Comorbidities are more common in adults, impacting the prescription of additional agents.
Rationale: Adults with ADHD frequently have comorbidities such as anxiety or depression,
which influence medication choice. Behavioral therapy and dosing considerations may differ,
but comorbidities are the primary distinction.
A 71-year-old female patient is experiencing memory loss, apraxia, and agnosia. Which
medication is appropriate?
A. Donepezil
B. Rivastigmine
C. Memantine (Namenda)
D. Galantamine
Rationale: Memantine, an NMDA receptor antagonist, is indicated for moderate to severe
Alzheimer’s with memory and functional deficits such as apraxia and agnosia. Cholinesterase
inhibitors can help but may not be sufficient alone at this stage.
Why are SSRIs not consistently effective in treating diabetic peripheral neuropathic pain?
A. They block norepinephrine
B. "SSRIs only increase serotonin levels."
C. They act on dopamine receptors
D. They enhance GABAergic transmission
Rationale: Neuropathic pain often requires modulation of both serotonin and norepinephrine.
SSRIs only increasing serotonin makes them less effective than SNRIs. Dopamine or GABA effects
are not primary mechanisms.
When prescribing milnacipran (Savella) for fibromyalgia, what is the recommended approach?
A. Give full daily dose once daily
B. Start at maximum dose immediately
C. Split the daily dose into two doses after the first day
D. Administer only at bedtime
, Rationale: Milnacipran is typically titrated and split to reduce side effects like nausea and
increase tolerability. Starting at maximum dose or once daily increases risk of adverse effects.
What is a known cardiovascular risk associated with bupropion?
A. Bradycardia
B. Hypotension
C. Cardiac arrhythmias
D. Stroke
Rationale: Bupropion can increase the risk of cardiac arrhythmias, especially in patients with
pre-existing heart conditions. Bradycardia, hypotension, and stroke are not primary risks.
Which pharmacologic treatment is most appropriate for psychotic aggression to manage cortical
control and striatal hyperactivity?
A. Benzodiazepines
B. Lithium
C. Antipsychotics
D. SSRIs
Rationale: Antipsychotics target dopamine pathways in both cortical and subcortical regions,
helping regulate aggression and impulsivity. Benzodiazepines provide sedation only, lithium is
slower acting, and SSRIs are ineffective for acute psychotic aggression.
Slow-dose extended-release stimulants are most appropriate for which patient with ADHD?
A. 8-year-old patient
B. 12-year-old adolescent
C. Adult patient
D. 16-year-old patient
Rationale: Extended-release stimulants provide steady coverage for younger children who may
not adhere to multiple daily doses. Adolescents and adults can often use immediate-release
formulations or multiple daily dosing.
Which mood stabilizer is considered first-line for managing aggressive and impulsive behaviors
in adults?
A. Lithium (Lithane)
B. Valproate
