NURS 660 Exam 3 V2 | NURS 660
Psychopharmacology and Advanced
Mental Health | Maryville University of
St. Louis | 2026 Q&A with Rationale
(Maryville NURS660 Exam 3 2026)
1. A 28-year-old female patient is being started on Lithium for Bipolar I Disorder. Which
baseline laboratory test is most critical to monitor throughout her treatment to prevent
toxicity?
A. Liver Function Tests (LFTs)
B. Complete Blood Count (CBC) with differential
C. Serum Creatinine and BUN
D. Serum Amylase
Answer: C
Rationale: Lithium is almost exclusively excreted by the kidneys and has a very narrow
therapeutic index. Any decline in renal function can lead to a rapid increase in serum
lithium levels, resulting in toxicity. Therefore, baseline and periodic monitoring of serum
creatinine and BUN are essential for safe prescribing.
2. When initiating Lamotrigine (Lamictal) for mood stabilization, the clinician must follow a
specific titration schedule. What is the primary reason for this slow titration?
A. To avoid the occurrence of hypertensive crisis
,B. To minimize the risk of weight gain and metabolic syndrome
C. To prevent the development of Stevens-Johnson Syndrome (SJS)
D. To allow the patient to adjust to sedative effects
Answer: C
Rationale: Lamotrigine carries a black box warning for serious, life-threatening rashes
including Stevens-Johnson Syndrome. The risk of developing this reaction is significantly
higher when the medication is started at high doses or titrated too quickly. Following the
manufacturer’s slow titration schedule is the most effective way to mitigate this risk.
3. A 10-year-old child is diagnosed with ADHD, Predominantly Hyperactive-Impulsive type.
Which of the following is the primary mechanism of action for Methylphenidate?
A. Selective inhibition of the Norepinephrine Transporter (NET) only
B. Agonism of Alpha-2 adrenergic receptors
C. Inhibition of Monoamine Oxidase Type B
D. Blockade of the Dopamine Transporter (DAT) and Norepinephrine Transporter (NET)
Answer: D
Rationale: Methylphenidate works primarily by blocking the reuptake of dopamine and
norepinephrine into the presynaptic neuron. By inhibiting the DAT and NET, it increases
the availability of these neurotransmitters in the synaptic cleft. This increased signaling in
the prefrontal cortex improves attention and reduces impulsivity.
, 4. Valproic Acid (Depakote) is prescribed for a patient with Bipolar Disorder. The clinician
should educate the patient on which rare but serious side effect involving the hematologic
system?
A. Agranulocytosis
B. Aplastic Anemia
C. Polycythemia Vera
D. Thrombocytopenia
Answer: D
Rationale: Valproic acid can cause a dose-related decrease in platelet counts, known as
thrombocytopenia. Patients should be monitored for signs of unusual bruising or bleeding,
especially before surgical procedures. Periodic CBC monitoring is necessary to ensure the
patient’s safety while on this medication.
5. Which of the following medications is an NMDA receptor antagonist used in the treatment
of moderate to severe Alzheimer’s Disease?
A. Donepezil (Aricept)
B. Rivastigmine (Exelon)
C. Galantamine (Razadyne)
D. Memantine (Namenda)
Answer: D
Psychopharmacology and Advanced
Mental Health | Maryville University of
St. Louis | 2026 Q&A with Rationale
(Maryville NURS660 Exam 3 2026)
1. A 28-year-old female patient is being started on Lithium for Bipolar I Disorder. Which
baseline laboratory test is most critical to monitor throughout her treatment to prevent
toxicity?
A. Liver Function Tests (LFTs)
B. Complete Blood Count (CBC) with differential
C. Serum Creatinine and BUN
D. Serum Amylase
Answer: C
Rationale: Lithium is almost exclusively excreted by the kidneys and has a very narrow
therapeutic index. Any decline in renal function can lead to a rapid increase in serum
lithium levels, resulting in toxicity. Therefore, baseline and periodic monitoring of serum
creatinine and BUN are essential for safe prescribing.
2. When initiating Lamotrigine (Lamictal) for mood stabilization, the clinician must follow a
specific titration schedule. What is the primary reason for this slow titration?
A. To avoid the occurrence of hypertensive crisis
,B. To minimize the risk of weight gain and metabolic syndrome
C. To prevent the development of Stevens-Johnson Syndrome (SJS)
D. To allow the patient to adjust to sedative effects
Answer: C
Rationale: Lamotrigine carries a black box warning for serious, life-threatening rashes
including Stevens-Johnson Syndrome. The risk of developing this reaction is significantly
higher when the medication is started at high doses or titrated too quickly. Following the
manufacturer’s slow titration schedule is the most effective way to mitigate this risk.
3. A 10-year-old child is diagnosed with ADHD, Predominantly Hyperactive-Impulsive type.
Which of the following is the primary mechanism of action for Methylphenidate?
A. Selective inhibition of the Norepinephrine Transporter (NET) only
B. Agonism of Alpha-2 adrenergic receptors
C. Inhibition of Monoamine Oxidase Type B
D. Blockade of the Dopamine Transporter (DAT) and Norepinephrine Transporter (NET)
Answer: D
Rationale: Methylphenidate works primarily by blocking the reuptake of dopamine and
norepinephrine into the presynaptic neuron. By inhibiting the DAT and NET, it increases
the availability of these neurotransmitters in the synaptic cleft. This increased signaling in
the prefrontal cortex improves attention and reduces impulsivity.
, 4. Valproic Acid (Depakote) is prescribed for a patient with Bipolar Disorder. The clinician
should educate the patient on which rare but serious side effect involving the hematologic
system?
A. Agranulocytosis
B. Aplastic Anemia
C. Polycythemia Vera
D. Thrombocytopenia
Answer: D
Rationale: Valproic acid can cause a dose-related decrease in platelet counts, known as
thrombocytopenia. Patients should be monitored for signs of unusual bruising or bleeding,
especially before surgical procedures. Periodic CBC monitoring is necessary to ensure the
patient’s safety while on this medication.
5. Which of the following medications is an NMDA receptor antagonist used in the treatment
of moderate to severe Alzheimer’s Disease?
A. Donepezil (Aricept)
B. Rivastigmine (Exelon)
C. Galantamine (Razadyne)
D. Memantine (Namenda)
Answer: D
