NUR612/NUR612 Exam 4 V1 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient is started on Fluoxetine for Major Depressive Disorder. What is the most
important teaching point regarding the onset of therapeutic effects?
A. The drug only works when taken as needed for mood.
B. Symptoms will improve within the first 24 hours.
C. If no change is felt in 3 days, double the dose.
D. Full effects may take 4 to 6 weeks to appear.
Answer: D
Rationale: Fluoxetine is a selective serotonin reuptake inhibitor that requires time to
adjust neurotransmitter levels in the brain. Patients must be informed that while side
effects may occur early, clinical improvement in mood typically takes several weeks.
Abruptly stopping or increasing the dose without medical supervision can lead to adverse
outcomes like withdrawal or serotonin syndrome.
2. When prescribing Lithium for bipolar disorder, which laboratory value is most critical to
monitor due to the risk of toxicity?
A. Serum calcium levels
B. Blood glucose levels
,C. Liver enzymes (AST/ALT)
D. Serum sodium levels
Answer: D
Rationale: Lithium is handled by the kidneys similarly to sodium, and a decrease in
sodium can lead to increased lithium retention. Low sodium levels or dehydration can
cause lithium levels to rise to toxic ranges quickly. Maintaining consistent salt and fluid
intake is essential for patients on this therapeutic regimen.
3. A patient taking Amitriptyline reports feeling dizzy when standing up. Which mechanism
explains this side effect?
A. Inhibition of serotonin reuptake
B. Alpha-1 adrenergic blockade
C. Activation of dopamine receptors
D. Blockade of calcium channels
Answer: B
Rationale: Amitriptyline is a tricyclic antidepressant that blocks alpha-1 adrenergic
receptors, leading to peripheral vasodilation and orthostatic hypotension. This effect
increases the risk of falls, especially in elderly populations who may have slower
compensatory mechanisms. Clinicians should advise patients to rise slowly from a seated
or lying position.
, 4. Which dietary restriction is mandatory for a patient prescribed Phenelzine?
A. Avoiding foods high in Vitamin K
B. Avoiding foods high in tyramine
C. Increasing intake of citrus fruits
D. Restricting fluid intake to 1 liter per day
Answer: B
Rationale: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that prevents the
breakdown of tyramine in the gut. High levels of tyramine can cause a massive release of
norepinephrine, leading to a life-threatening hypertensive crisis. Patients must strictly
avoid aged cheeses, cured meats, and fermented products while on this medication.
5. A patient on Haloperidol develops high fever, muscle rigidity, and autonomic instability.
What condition should the provider suspect?
A. Serotonin syndrome
B. Acute dystonic reaction
C. Anticholinergic toxicity
D. Neuroleptic Malignant Syndrome (NMS)
Answer: D
Rationale: Neuroleptic Malignant Syndrome is a rare but fatal reaction to antipsychotic
medications like Haloperidol. It is characterized by severe muscle lead-pipe rigidity,
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient is started on Fluoxetine for Major Depressive Disorder. What is the most
important teaching point regarding the onset of therapeutic effects?
A. The drug only works when taken as needed for mood.
B. Symptoms will improve within the first 24 hours.
C. If no change is felt in 3 days, double the dose.
D. Full effects may take 4 to 6 weeks to appear.
Answer: D
Rationale: Fluoxetine is a selective serotonin reuptake inhibitor that requires time to
adjust neurotransmitter levels in the brain. Patients must be informed that while side
effects may occur early, clinical improvement in mood typically takes several weeks.
Abruptly stopping or increasing the dose without medical supervision can lead to adverse
outcomes like withdrawal or serotonin syndrome.
2. When prescribing Lithium for bipolar disorder, which laboratory value is most critical to
monitor due to the risk of toxicity?
A. Serum calcium levels
B. Blood glucose levels
,C. Liver enzymes (AST/ALT)
D. Serum sodium levels
Answer: D
Rationale: Lithium is handled by the kidneys similarly to sodium, and a decrease in
sodium can lead to increased lithium retention. Low sodium levels or dehydration can
cause lithium levels to rise to toxic ranges quickly. Maintaining consistent salt and fluid
intake is essential for patients on this therapeutic regimen.
3. A patient taking Amitriptyline reports feeling dizzy when standing up. Which mechanism
explains this side effect?
A. Inhibition of serotonin reuptake
B. Alpha-1 adrenergic blockade
C. Activation of dopamine receptors
D. Blockade of calcium channels
Answer: B
Rationale: Amitriptyline is a tricyclic antidepressant that blocks alpha-1 adrenergic
receptors, leading to peripheral vasodilation and orthostatic hypotension. This effect
increases the risk of falls, especially in elderly populations who may have slower
compensatory mechanisms. Clinicians should advise patients to rise slowly from a seated
or lying position.
, 4. Which dietary restriction is mandatory for a patient prescribed Phenelzine?
A. Avoiding foods high in Vitamin K
B. Avoiding foods high in tyramine
C. Increasing intake of citrus fruits
D. Restricting fluid intake to 1 liter per day
Answer: B
Rationale: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that prevents the
breakdown of tyramine in the gut. High levels of tyramine can cause a massive release of
norepinephrine, leading to a life-threatening hypertensive crisis. Patients must strictly
avoid aged cheeses, cured meats, and fermented products while on this medication.
5. A patient on Haloperidol develops high fever, muscle rigidity, and autonomic instability.
What condition should the provider suspect?
A. Serotonin syndrome
B. Acute dystonic reaction
C. Anticholinergic toxicity
D. Neuroleptic Malignant Syndrome (NMS)
Answer: D
Rationale: Neuroleptic Malignant Syndrome is a rare but fatal reaction to antipsychotic
medications like Haloperidol. It is characterized by severe muscle lead-pipe rigidity,
