Page |1
NR 546 Advanced Pharmacology
Psychopharmacology
For PMHNP Final Exam 2025 | Questions and Correct Detailed Answers |A+
Grade |100% Guaranteed Pass.
MULTIPLE CHOICES
The nurse manager on the psychiatric unit was explaining to the new staff the differences between typical and
atypical antipsychotics. The nurse correctly states that atypical antipsychotics:
a. Remain in the system longer
b. Act more quickly to reduce delusions
c. Produce fewer extrapyramidal effects
d. Are risk free for neuroleptic malignant syndrome (NMS) - ANS ✓✓C
(Atypical antipsychotics produce less D2 blockade; thus movement disorders are less of a problem. No evidence
suggests that the medication remains in the system longer nor that it acts more quickly to reduce delusions. The
atypicals are not risk free for NMS.)
, Page |2
The nurse would assess for neuroleptic malignant syndrome (NMS) if a patient on haloperidol (Haldol) develops
a:
a. 30 mm Hg decrease in blood pressure reading
b. Respiratory rate of 24 respirations per minute
c. Temperature reading of 104 F
d. Pulse rate of 70 beats per minute - ANS ✓✓C
(Increased temperature is the cardinal sign of NMS. This BP is not a significant feature of NMS. There are no
significant findings to support the options related to respirations or pulse rate.)
A patient taking fluphenazine (Prolixin) complains of dry mouth and blurred vision. What would the nurse
assess as the likely cause of these symptoms?
a. Decreased dopamine at receptor sites
b. Blockade of histamine
c. Cholinergic blockade
d. Adrenergic blocking - ANS ✓✓C
(Fluphenazine administration produces blockade of cholinergic receptors giving rise to anticholinergic effects,
such as dry mouth, blurred vision, and constipation.)
Which behavior displayed by a patient receiving a typical antipsychotic medication would be assessed as
displaying behaviors characteristic of tardive dyskinesia (TD)?
, Page |3
a. Grimacing and lip smacking
b. Falling asleep in the chair and refusing to eat lunch
c. Experiencing muscle rigidity and tremors
d. Having excessive salivation and drooling - ANS ✓✓A
(TD manifests as abnormal movements of voluntary muscle groups after a prolonged period of dopamine
blockade. Movements may affect any muscle group, but muscles of the face, mouth, tongue, and digits are
commonly affected. Falling asleep is reflective of the sedative effect of these medications. Muscle rigidity and
drooling reflect EPS caused from imbalance between dopamine and acetylcholine.)
When the nurse realizes that a patient diagnosed with schizophrenia is not taking the prescribed oral haloperidol
(Haldol), which intervention would promote medication compliance?
a. Instructing the patient to have friends monitor his medications
b. Beginning administration of haloperidol (Haldol) decanoate
c. Writing instructions in detail for the patient to follow
d. Changing haloperidol to an atypical antipsychotic - ANS ✓✓B
(Haloperidol decanoate is a depot medication, given intramuscularly every 2 to 4 weeks. It is unknown whether
the patient has a support system. The patient probably received education, including written instructions prior to
discharge. Changing to another classification of medication would not necessarily improve compliance.)
When asked how tricyclic antidepressants affect neurotransmitter activity, the nurse should respond that they:
a. Decrease available dopamine.
, Page |4
b. Increase availability of norepinephrine and serotonin.
c. Make available increased amounts of monoamine oxidase.
d. Increase the effects of the chemical gamma-aminobutyric acid. - ANS ✓✓B
(Tricyclic antidepressants block neurotransmitter uptake, increasing the amounts of norepinephrine and
serotonin available. Decreasing dopamine is the action of typical antipsychotic medication. Increasing
monoamine oxidase is not the action of tricyclics. Benzodiazepines, not tricyclics, increase the effects of
GABA.)
A severely depressed patient has been prescribed clomipramine (Anafranil). For which medication side effects
should the patient be monitored?
a. Excess salivation and drooling
b. Muscle rigidity and restlessness
c. Polyuria and coarse hand tremors
d. Orthostatic hypotension and constipation - ANS ✓✓D
(Alpha1 blockade produces orthostatic hypotension, and cholinergic blockade produces constipation. Mild
tremors and urinary retention may occur. Drooling and excessive salvation may occur with SSRIs. Muscle
rigidity and restlessness may occur with antipsychotics.)
Which of these statements made by a patient taking the MAOI phenelzine (Nardil) would warrant further
instruction?
a. I often forget to wear sunscreen when I go outside.
NR 546 Advanced Pharmacology
Psychopharmacology
For PMHNP Final Exam 2025 | Questions and Correct Detailed Answers |A+
Grade |100% Guaranteed Pass.
MULTIPLE CHOICES
The nurse manager on the psychiatric unit was explaining to the new staff the differences between typical and
atypical antipsychotics. The nurse correctly states that atypical antipsychotics:
a. Remain in the system longer
b. Act more quickly to reduce delusions
c. Produce fewer extrapyramidal effects
d. Are risk free for neuroleptic malignant syndrome (NMS) - ANS ✓✓C
(Atypical antipsychotics produce less D2 blockade; thus movement disorders are less of a problem. No evidence
suggests that the medication remains in the system longer nor that it acts more quickly to reduce delusions. The
atypicals are not risk free for NMS.)
, Page |2
The nurse would assess for neuroleptic malignant syndrome (NMS) if a patient on haloperidol (Haldol) develops
a:
a. 30 mm Hg decrease in blood pressure reading
b. Respiratory rate of 24 respirations per minute
c. Temperature reading of 104 F
d. Pulse rate of 70 beats per minute - ANS ✓✓C
(Increased temperature is the cardinal sign of NMS. This BP is not a significant feature of NMS. There are no
significant findings to support the options related to respirations or pulse rate.)
A patient taking fluphenazine (Prolixin) complains of dry mouth and blurred vision. What would the nurse
assess as the likely cause of these symptoms?
a. Decreased dopamine at receptor sites
b. Blockade of histamine
c. Cholinergic blockade
d. Adrenergic blocking - ANS ✓✓C
(Fluphenazine administration produces blockade of cholinergic receptors giving rise to anticholinergic effects,
such as dry mouth, blurred vision, and constipation.)
Which behavior displayed by a patient receiving a typical antipsychotic medication would be assessed as
displaying behaviors characteristic of tardive dyskinesia (TD)?
, Page |3
a. Grimacing and lip smacking
b. Falling asleep in the chair and refusing to eat lunch
c. Experiencing muscle rigidity and tremors
d. Having excessive salivation and drooling - ANS ✓✓A
(TD manifests as abnormal movements of voluntary muscle groups after a prolonged period of dopamine
blockade. Movements may affect any muscle group, but muscles of the face, mouth, tongue, and digits are
commonly affected. Falling asleep is reflective of the sedative effect of these medications. Muscle rigidity and
drooling reflect EPS caused from imbalance between dopamine and acetylcholine.)
When the nurse realizes that a patient diagnosed with schizophrenia is not taking the prescribed oral haloperidol
(Haldol), which intervention would promote medication compliance?
a. Instructing the patient to have friends monitor his medications
b. Beginning administration of haloperidol (Haldol) decanoate
c. Writing instructions in detail for the patient to follow
d. Changing haloperidol to an atypical antipsychotic - ANS ✓✓B
(Haloperidol decanoate is a depot medication, given intramuscularly every 2 to 4 weeks. It is unknown whether
the patient has a support system. The patient probably received education, including written instructions prior to
discharge. Changing to another classification of medication would not necessarily improve compliance.)
When asked how tricyclic antidepressants affect neurotransmitter activity, the nurse should respond that they:
a. Decrease available dopamine.
, Page |4
b. Increase availability of norepinephrine and serotonin.
c. Make available increased amounts of monoamine oxidase.
d. Increase the effects of the chemical gamma-aminobutyric acid. - ANS ✓✓B
(Tricyclic antidepressants block neurotransmitter uptake, increasing the amounts of norepinephrine and
serotonin available. Decreasing dopamine is the action of typical antipsychotic medication. Increasing
monoamine oxidase is not the action of tricyclics. Benzodiazepines, not tricyclics, increase the effects of
GABA.)
A severely depressed patient has been prescribed clomipramine (Anafranil). For which medication side effects
should the patient be monitored?
a. Excess salivation and drooling
b. Muscle rigidity and restlessness
c. Polyuria and coarse hand tremors
d. Orthostatic hypotension and constipation - ANS ✓✓D
(Alpha1 blockade produces orthostatic hypotension, and cholinergic blockade produces constipation. Mild
tremors and urinary retention may occur. Drooling and excessive salvation may occur with SSRIs. Muscle
rigidity and restlessness may occur with antipsychotics.)
Which of these statements made by a patient taking the MAOI phenelzine (Nardil) would warrant further
instruction?
a. I often forget to wear sunscreen when I go outside.
