NSG 552 WILKES
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. A patient with Treatment-Resistant Schizophrenia is starting Clozapine. Which laboratory
value is the primary safety concern during the first six months of treatment?
A. Serum Creatinine
B. Alanine Aminotransferase (ALT)
C. Absolute Neutrophil Count (ANC)
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. The
ANC must be monitored weekly for the first 6 months to ensure it remains above 1500/µL.
2. The ‘Mesolimbic’ dopamine pathway is primarily associated with which symptoms in
Schizophrenia?
A. Positive symptoms such as hallucinations and delusions
B. Extrapyramidal symptoms (EPS)
,C. Negative symptoms and cognitive impairment
D. Hyperprolactinemia
Answer: A
Conceptual Explanation: Hyperactivity of dopamine in the mesolimbic pathway is
hypothesized to mediate the positive symptoms of psychosis.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
bulimia nervosa?
A. Sertraline
B. Mirtazapine
C. Venlafaxine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances common in eating disorders.
4. A patient taking Lithium presents with coarse tremors, ataxia, and confusion. The serum
lithium level is 2.1 mEq/L. What is the priority intervention?
A. Increase fluid intake and monitor
B. Hold the dose and prepare for possible hemodialysis
C. Administer a dose of Lorazepam
, D. Switch to Valproic Acid immediately
Answer: B
Conceptual Explanation: Lithium levels above 1.5 mEq/L indicate toxicity; levels above
2.0-2.5 mEq/L are severe and often require medical stabilization and potentially
hemodialysis.
5. Which mechanism of action defines a ‘Partial Agonist’ in psychopharmacology?
A. It blocks the receptor completely, preventing any signal transduction.
B. It activates the receptor to the same maximal extent as the endogenous ligand.
C. It binds to an allosteric site to enhance the effect of the primary neurotransmitter.
D. It activates the receptor to a submaximal level regardless of the concentration of the
drug.
Answer: D
Conceptual Explanation: Partial agonists act as ‘dimmer switches,’ providing some
activation but less than a full agonist, often acting as functional antagonists in high-
neurotransmitter states.
6. The blockade of dopamine in which pathway leads to increased prolactin levels?
A. Nigrostriatal
B. Mesocortical
C. Tuberoinfundibular
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM PREP
QUESTIONS AND ANSWERS
1. A patient with Treatment-Resistant Schizophrenia is starting Clozapine. Which laboratory
value is the primary safety concern during the first six months of treatment?
A. Serum Creatinine
B. Alanine Aminotransferase (ALT)
C. Absolute Neutrophil Count (ANC)
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. The
ANC must be monitored weekly for the first 6 months to ensure it remains above 1500/µL.
2. The ‘Mesolimbic’ dopamine pathway is primarily associated with which symptoms in
Schizophrenia?
A. Positive symptoms such as hallucinations and delusions
B. Extrapyramidal symptoms (EPS)
,C. Negative symptoms and cognitive impairment
D. Hyperprolactinemia
Answer: A
Conceptual Explanation: Hyperactivity of dopamine in the mesolimbic pathway is
hypothesized to mediate the positive symptoms of psychosis.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
bulimia nervosa?
A. Sertraline
B. Mirtazapine
C. Venlafaxine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances common in eating disorders.
4. A patient taking Lithium presents with coarse tremors, ataxia, and confusion. The serum
lithium level is 2.1 mEq/L. What is the priority intervention?
A. Increase fluid intake and monitor
B. Hold the dose and prepare for possible hemodialysis
C. Administer a dose of Lorazepam
, D. Switch to Valproic Acid immediately
Answer: B
Conceptual Explanation: Lithium levels above 1.5 mEq/L indicate toxicity; levels above
2.0-2.5 mEq/L are severe and often require medical stabilization and potentially
hemodialysis.
5. Which mechanism of action defines a ‘Partial Agonist’ in psychopharmacology?
A. It blocks the receptor completely, preventing any signal transduction.
B. It activates the receptor to the same maximal extent as the endogenous ligand.
C. It binds to an allosteric site to enhance the effect of the primary neurotransmitter.
D. It activates the receptor to a submaximal level regardless of the concentration of the
drug.
Answer: D
Conceptual Explanation: Partial agonists act as ‘dimmer switches,’ providing some
activation but less than a full agonist, often acting as functional antagonists in high-
neurotransmitter states.
6. The blockade of dopamine in which pathway leads to increased prolactin levels?
A. Nigrostriatal
B. Mesocortical
C. Tuberoinfundibular
