Advanced Psychopharmacology
Actual Study Guide – Weeks 1–8 Notes
Bundle – NR 546 – Chamberlain
University (2025/2026)
Comprehensive Study Assessment
Student ID: _________________ Date: _________________
Instructor: [Instructor Name] Course Mentor: [Mentor Name]
Time Limit: 120 minutes Total Points: 100 points
Question 1
Which neurotransmitter system is most implicated in the pathophysiology of
schizophrenia’s positive symptoms?
A. GABAergic system
B. Dopaminergic system
C. Serotonergic system
D. Cholinergic system
E. Histaminergic system
Correct Answer: B
Rationale: The dopamine hypothesis links hyperactive mesolimbic dopamine
pathways to positive symptoms like hallucinations. Chamberlain NR 546 Week 1
curriculum and Stahl’s Essential Psychopharmacology (5th ed., 2021, 2025
updates) emphasize this. APA schizophrenia guidelines (2025) and FDA-approved
antipsychotics target D2 receptors to mitigate symptoms.
,Question 2 (Case-Based)
A 30-year-old female with bipolar I disorder presents with acute mania. What is
the first-line pharmacotherapy?
A. Sertraline 50 mg daily
B. Lithium 300 mg BID with level monitoring
C. Lorazepam 1 mg PRN only
D. Aripiprazole 10 mg daily
E. Psychotherapy alone
Correct Answer: B
Rationale: Lithium is FDA-approved for acute mania and maintenance in bipolar
I, per APA bipolar guidelines (2025). Chamberlain NR 546 Week 4 notes
recommend starting at 300 mg BID, targeting 0.6–1.2 mEq/L. Aripiprazole (D) is a
second-line option; sertraline (A) risks mania escalation. BALANCE trial (2023)
supports lithium’s efficacy.
Question 3
What is the primary mechanism of action for SSRIs like escitalopram?
A. Dopamine D2 receptor blockade
B. Serotonin reuptake inhibition
C. GABA-A receptor agonism
D. NMDA receptor antagonism
E. Monoamine oxidase inhibition
Correct Answer: B
Rationale: SSRIs inhibit the serotonin transporter (SERT), increasing synaptic
serotonin levels. Chamberlain NR 546 Week 2 pharmacokinetics module and APA
depression guidelines (2025) endorse SSRIs for MDD/GAD. FDA labels note
delayed onset (4–6 weeks) due to neuroplastic changes like BDNF upregulation.
Question 4
,A patient on haloperidol develops parkinsonism. Which adjunct medication is most
appropriate?
A. Propranolol 20 mg BID
B. Benztropine 1 mg BID
C. Clonazepam 0.5 mg HS
D. Metoprolol 25 mg daily
E. Hydroxyzine 25 mg PRN
Correct Answer: B
Rationale: Benztropine, an anticholinergic, alleviates extrapyramidal symptoms
(EPS) like parkinsonism by blocking muscarinic receptors. Chamberlain NR 546
Week 3 antipsychotics module and APA schizophrenia guidelines (2025) support
this; FDA labels approve benztropine for EPS. Propranolol (A) treats akathisia, not
parkinsonism.
Question 5
What pharmacokinetic factor most impacts psychotropic dosing in the elderly?
A. Increased hepatic blood flow
B. Decreased renal clearance
C. Enhanced gastric absorption
D. Increased CYP450 activity
E. Higher albumin levels
Correct Answer: B
Rationale: Reduced renal clearance prolongs drug half-lives in elderly patients,
necessitating lower doses. Chamberlain NR 546 Week 1 notes and APA geriatric
guidelines (2025) advocate “start low, go slow.” AGS Beers Criteria (2024)
highlight risks of accumulation, e.g., with lorazepam. FDA labels adjust for renal
function.
Question 6 (Case-Based)
, A 22-year-old male with GAD fails buspirone 15 mg BID. What is the next-line
anxiolytic?
A. Alprazolam 0.25 mg TID
B. Venlafaxine XR 75 mg daily
C. Hydroxyzine 50 mg PRN
D. Propranolol 20 mg PRN
E. Diazepam 5 mg BID
Correct Answer: B
Rationale: Venlafaxine, an SNRI, is FDA-approved for GAD and avoids
benzodiazepine dependence risks. Chamberlain NR 546 Week 5 anxiolytics
module and APA GAD guidelines (2025) recommend SNRIs post-buspirone
failure. RCTs (2024) show 65% response rates for SNRIs in GAD.
Question 7
Which clozapine side effect requires immediate discontinuation?
A. Weight gain
B. Sedation
C. Agranulocytosis (ANC <500/mm³)
D. Constipation
E. Hypersalivation
Correct Answer: C
Rationale: Agranulocytosis (0.8% incidence) is life-threatening, requiring
clozapine cessation and weekly ANC monitoring per REMS. Chamberlain NR 546
Week 3 case studies, APA schizophrenia guidelines (2025), and FDA black-box
warnings emphasize this. Other side effects (A, B, D, E) are manageable.
Question 8 (Case-Based)
A 28-year-old pregnant female with MDD on fluoxetine relapses. What is the
safest adjustment?
Actual Study Guide – Weeks 1–8 Notes
Bundle – NR 546 – Chamberlain
University (2025/2026)
Comprehensive Study Assessment
Student ID: _________________ Date: _________________
Instructor: [Instructor Name] Course Mentor: [Mentor Name]
Time Limit: 120 minutes Total Points: 100 points
Question 1
Which neurotransmitter system is most implicated in the pathophysiology of
schizophrenia’s positive symptoms?
A. GABAergic system
B. Dopaminergic system
C. Serotonergic system
D. Cholinergic system
E. Histaminergic system
Correct Answer: B
Rationale: The dopamine hypothesis links hyperactive mesolimbic dopamine
pathways to positive symptoms like hallucinations. Chamberlain NR 546 Week 1
curriculum and Stahl’s Essential Psychopharmacology (5th ed., 2021, 2025
updates) emphasize this. APA schizophrenia guidelines (2025) and FDA-approved
antipsychotics target D2 receptors to mitigate symptoms.
,Question 2 (Case-Based)
A 30-year-old female with bipolar I disorder presents with acute mania. What is
the first-line pharmacotherapy?
A. Sertraline 50 mg daily
B. Lithium 300 mg BID with level monitoring
C. Lorazepam 1 mg PRN only
D. Aripiprazole 10 mg daily
E. Psychotherapy alone
Correct Answer: B
Rationale: Lithium is FDA-approved for acute mania and maintenance in bipolar
I, per APA bipolar guidelines (2025). Chamberlain NR 546 Week 4 notes
recommend starting at 300 mg BID, targeting 0.6–1.2 mEq/L. Aripiprazole (D) is a
second-line option; sertraline (A) risks mania escalation. BALANCE trial (2023)
supports lithium’s efficacy.
Question 3
What is the primary mechanism of action for SSRIs like escitalopram?
A. Dopamine D2 receptor blockade
B. Serotonin reuptake inhibition
C. GABA-A receptor agonism
D. NMDA receptor antagonism
E. Monoamine oxidase inhibition
Correct Answer: B
Rationale: SSRIs inhibit the serotonin transporter (SERT), increasing synaptic
serotonin levels. Chamberlain NR 546 Week 2 pharmacokinetics module and APA
depression guidelines (2025) endorse SSRIs for MDD/GAD. FDA labels note
delayed onset (4–6 weeks) due to neuroplastic changes like BDNF upregulation.
Question 4
,A patient on haloperidol develops parkinsonism. Which adjunct medication is most
appropriate?
A. Propranolol 20 mg BID
B. Benztropine 1 mg BID
C. Clonazepam 0.5 mg HS
D. Metoprolol 25 mg daily
E. Hydroxyzine 25 mg PRN
Correct Answer: B
Rationale: Benztropine, an anticholinergic, alleviates extrapyramidal symptoms
(EPS) like parkinsonism by blocking muscarinic receptors. Chamberlain NR 546
Week 3 antipsychotics module and APA schizophrenia guidelines (2025) support
this; FDA labels approve benztropine for EPS. Propranolol (A) treats akathisia, not
parkinsonism.
Question 5
What pharmacokinetic factor most impacts psychotropic dosing in the elderly?
A. Increased hepatic blood flow
B. Decreased renal clearance
C. Enhanced gastric absorption
D. Increased CYP450 activity
E. Higher albumin levels
Correct Answer: B
Rationale: Reduced renal clearance prolongs drug half-lives in elderly patients,
necessitating lower doses. Chamberlain NR 546 Week 1 notes and APA geriatric
guidelines (2025) advocate “start low, go slow.” AGS Beers Criteria (2024)
highlight risks of accumulation, e.g., with lorazepam. FDA labels adjust for renal
function.
Question 6 (Case-Based)
, A 22-year-old male with GAD fails buspirone 15 mg BID. What is the next-line
anxiolytic?
A. Alprazolam 0.25 mg TID
B. Venlafaxine XR 75 mg daily
C. Hydroxyzine 50 mg PRN
D. Propranolol 20 mg PRN
E. Diazepam 5 mg BID
Correct Answer: B
Rationale: Venlafaxine, an SNRI, is FDA-approved for GAD and avoids
benzodiazepine dependence risks. Chamberlain NR 546 Week 5 anxiolytics
module and APA GAD guidelines (2025) recommend SNRIs post-buspirone
failure. RCTs (2024) show 65% response rates for SNRIs in GAD.
Question 7
Which clozapine side effect requires immediate discontinuation?
A. Weight gain
B. Sedation
C. Agranulocytosis (ANC <500/mm³)
D. Constipation
E. Hypersalivation
Correct Answer: C
Rationale: Agranulocytosis (0.8% incidence) is life-threatening, requiring
clozapine cessation and weekly ANC monitoring per REMS. Chamberlain NR 546
Week 3 case studies, APA schizophrenia guidelines (2025), and FDA black-box
warnings emphasize this. Other side effects (A, B, D, E) are manageable.
Question 8 (Case-Based)
A 28-year-old pregnant female with MDD on fluoxetine relapses. What is the
safest adjustment?
