NSG552 Psychopharmacology Exam 2 Questions and Answers and
Explanations | Latest Wilkes University
1. Which laboratory value is most critical to monitor in a patient newly started
on Clozapine (Clozaril)?
A. Serum creatinine
B. Alanine aminotransferase (ALT)
C. Absolute Neutrophil Count (ANC)
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Explanation: Clozapine carries a black box warning for agranulocytosis; therefore, the
Absolute Neutrophil Count (ANC) must be monitored regularly to prevent life-threatening
infections.
2. A patient taking Lithium for Bipolar Disorder presents with coarse tremors,
ataxia, and confusion. What is the most likely cause?
A. Therapeutic side effects
B. Lithium toxicity
C. Serotonin syndrome
D. Akathisia
Answer: B
,Explanation: Coarse tremors, ataxia, and confusion are hallmark signs of Lithium toxicity,
which typically occurs when blood levels exceed 1.5 mEq/L.
3. Which mechanism of action is primarily responsible for the Extrapyramidal
Symptoms (EPS) associated with first-generation antipsychotics?
A. 5-HT2A antagonism
B. D2 receptor antagonism in the nigrostriatal pathway
C. Muscarinic acetylcholine blockade
D. H1 histamine antagonism
Answer: B
Explanation: Blockade of dopamine (D2) receptors in the nigrostriatal pathway leads to
movement disorders known as EPS.
4. A patient is prescribed Lamotrigine (Lamictal). Which instruction is most
important regarding the risk of Stevens-Johnson Syndrome?
A. Report any new skin rash immediately
B. Avoid drinking grapefruit juice
C. Take the medication only on an empty stomach
D. Maintain a high-sodium diet
Answer: A
Explanation: Lamotrigine carries a risk of life-threatening rashes, including Stevens-
Johnson Syndrome; patients must report any rash immediately.
,5. Which antidepressant class requires a low-tyramine diet to avoid a
hypertensive crisis?
A. SSRIs
B. SNRIs
C. MAOIs
D. TCAs
Answer: C
Explanation: Monoamine Oxidase Inhibitors (MAOIs) prevent the breakdown of tyramine,
which can lead to excessive norepinephrine release and hypertensive crisis if high-
tyramine foods are consumed.
6. What is the therapeutic range for Lithium in the maintenance phase of
Bipolar Disorder treatment?
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
Explanation: The standard therapeutic range for Lithium maintenance is 0.6 to 1.2 mEq/L,
though some patients are managed at slightly lower or higher levels depending on clinical
response.
, 7. Which medication is considered a first-line treatment for Generalized Anxiety
Disorder (GAD) due to its lack of abuse potential?
A. Alprazolam
B. Lorazepam
C. Diazepam
D. Buspirone
Answer: D
Explanation: Buspirone is a non-benzodiazepine anxiolytic that does not cause sedation or
physical dependence, making it suitable for long-term GAD management.
8. Which side effect of Second-Generation Antipsychotics (SGAs) is associated
with the greatest risk for cardiovascular disease?
A. Metabolic Syndrome
B. Hyperprolactinemia
C. Photosensitivity
D. Dry mouth
Answer: A
Explanation: Metabolic syndrome (weight gain, dyslipidemia, and insulin resistance) is a
major concern with SGAs like Olanzapine and Clozapine, increasing cardiovascular risk.
Explanations | Latest Wilkes University
1. Which laboratory value is most critical to monitor in a patient newly started
on Clozapine (Clozaril)?
A. Serum creatinine
B. Alanine aminotransferase (ALT)
C. Absolute Neutrophil Count (ANC)
D. Thyroid Stimulating Hormone (TSH)
Answer: C
Explanation: Clozapine carries a black box warning for agranulocytosis; therefore, the
Absolute Neutrophil Count (ANC) must be monitored regularly to prevent life-threatening
infections.
2. A patient taking Lithium for Bipolar Disorder presents with coarse tremors,
ataxia, and confusion. What is the most likely cause?
A. Therapeutic side effects
B. Lithium toxicity
C. Serotonin syndrome
D. Akathisia
Answer: B
,Explanation: Coarse tremors, ataxia, and confusion are hallmark signs of Lithium toxicity,
which typically occurs when blood levels exceed 1.5 mEq/L.
3. Which mechanism of action is primarily responsible for the Extrapyramidal
Symptoms (EPS) associated with first-generation antipsychotics?
A. 5-HT2A antagonism
B. D2 receptor antagonism in the nigrostriatal pathway
C. Muscarinic acetylcholine blockade
D. H1 histamine antagonism
Answer: B
Explanation: Blockade of dopamine (D2) receptors in the nigrostriatal pathway leads to
movement disorders known as EPS.
4. A patient is prescribed Lamotrigine (Lamictal). Which instruction is most
important regarding the risk of Stevens-Johnson Syndrome?
A. Report any new skin rash immediately
B. Avoid drinking grapefruit juice
C. Take the medication only on an empty stomach
D. Maintain a high-sodium diet
Answer: A
Explanation: Lamotrigine carries a risk of life-threatening rashes, including Stevens-
Johnson Syndrome; patients must report any rash immediately.
,5. Which antidepressant class requires a low-tyramine diet to avoid a
hypertensive crisis?
A. SSRIs
B. SNRIs
C. MAOIs
D. TCAs
Answer: C
Explanation: Monoamine Oxidase Inhibitors (MAOIs) prevent the breakdown of tyramine,
which can lead to excessive norepinephrine release and hypertensive crisis if high-
tyramine foods are consumed.
6. What is the therapeutic range for Lithium in the maintenance phase of
Bipolar Disorder treatment?
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
Explanation: The standard therapeutic range for Lithium maintenance is 0.6 to 1.2 mEq/L,
though some patients are managed at slightly lower or higher levels depending on clinical
response.
, 7. Which medication is considered a first-line treatment for Generalized Anxiety
Disorder (GAD) due to its lack of abuse potential?
A. Alprazolam
B. Lorazepam
C. Diazepam
D. Buspirone
Answer: D
Explanation: Buspirone is a non-benzodiazepine anxiolytic that does not cause sedation or
physical dependence, making it suitable for long-term GAD management.
8. Which side effect of Second-Generation Antipsychotics (SGAs) is associated
with the greatest risk for cardiovascular disease?
A. Metabolic Syndrome
B. Hyperprolactinemia
C. Photosensitivity
D. Dry mouth
Answer: A
Explanation: Metabolic syndrome (weight gain, dyslipidemia, and insulin resistance) is a
major concern with SGAs like Olanzapine and Clozapine, increasing cardiovascular risk.
