NSG 552 PSYCHOPHARMACOLOGY EXAM 1
WILKES UNIVERSITY –
ADVANCED PRACTICE PSYCHOPHARMACOLOGY
QUESTIONS AND 100% VERIFIED ANSWERS WITH RATIONALES
GRADED A+
GUARANTEED PASS ON THE FIRST ATTEMPT
1. A 28-year-old patient with major depressive disorder is started on fluoxetine.
Which of the following is the most important teaching point regarding the onset of
therapeutic effects?
A. Effects are typically seen within 24 hours.
B. Effects may take 4–6 weeks to fully manifest.
C. Improvement is immediate after the first dose.
D. Effects are usually seen after 1 year of continuous therapy.
Answer: B
Rationale: SSRIs like fluoxetine usually require 4–6 weeks for full antidepressant
effects due to gradual changes in neurotransmitter receptor sensitivity.
2. A patient reports dry mouth, constipation, and urinary retention after starting
amitriptyline. These adverse effects are most likely due to:
A. Dopamine receptor antagonism
B. Anticholinergic activity
C. Selective serotonin reuptake inhibition
D. NMDA receptor blockade
Answer: B
Rationale: Tricyclic antidepressants (TCAs) such as amitriptyline have strong
anticholinergic effects causing dry mouth, constipation, and urinary retention.
,3. Which of the following medications is classified as a typical antipsychotic?
A. Risperidone
B. Olanzapine
C. Haloperidol
D. Clozapine
Answer: C
Rationale: Haloperidol is a first-generation (typical) antipsychotic, primarily
acting as a D2 dopamine receptor antagonist. Risperidone, olanzapine, and
clozapine are atypical (second-generation) antipsychotics.
4. A patient on lithium therapy presents with coarse tremors, nausea, vomiting, and
diarrhea. The nurse should:
A. Increase the lithium dose
B. Check the patient’s serum lithium level
C. Reassure the patient that these are mild side effects
D. Discontinue all other medications
Answer: B
Rationale: These symptoms may indicate lithium toxicity; serum levels should be
checked immediately.
5. A patient taking MAOIs should avoid which of the following foods to prevent
hypertensive crisis?
A. Bananas
B. Aged cheeses
C. Fresh vegetables
D. Oatmeal
Answer: B
Rationale: MAOIs inhibit monoamine oxidase, which metabolizes tyramine. Aged
cheeses are high in tyramine, increasing the risk of hypertensive crisis.
,6. Which neurotransmitter is primarily implicated in the mechanism of action of
SSRIs?
A. Dopamine
B. Norepinephrine
C. Serotonin
D. Acetylcholine
Answer: C
Rationale: SSRIs selectively inhibit the reuptake of serotonin, increasing its
availability in the synaptic cleft.
7. A 42-year-old patient with schizophrenia has persistent negative symptoms.
Which antipsychotic is most effective for negative symptoms?
A. Haloperidol
B. Chlorpromazine
C. Clozapine
D. Fluphenazine
Answer: C
Rationale: Clozapine, a second-generation antipsychotic, is particularly effective
for negative and treatment-resistant symptoms of schizophrenia.
8. A patient reports feeling agitated, restless, and unable to sleep after starting an
SSRI. What is the most likely cause?
A. Serotonin syndrome
B. Initial activation effect of SSRIs
C. Lithium toxicity
D. Extrapyramidal symptoms
Answer: B
Rationale: SSRIs can cause early activation, especially in the first 1–2 weeks,
which may manifest as agitation and insomnia.
, 9. Which laboratory test is essential to monitor in a patient taking valproic acid?
A. Serum lithium levels
B. Liver function tests
C. Serum creatinine
D. Thyroid panel
Answer: B
Rationale: Valproic acid can cause hepatotoxicity; liver function tests should be
monitored regularly.
10. A patient on clozapine therapy should have regular monitoring for which
serious adverse effect?
A. Agranulocytosis
B. Hyperprolactinemia
C. Extrapyramidal symptoms
D. QT prolongation
Answer: A
Rationale: Clozapine carries a significant risk of agranulocytosis; regular CBC
monitoring is required.
11. Which class of antidepressants is most likely to cause orthostatic hypotension
in elderly patients?
A. SSRIs
B. SNRIs
C. TCAs
D. MAOIs
Answer: C
Rationale: TCAs block alpha-adrenergic receptors, which can lead to orthostatic
hypotension, particularly in elderly patients.
WILKES UNIVERSITY –
ADVANCED PRACTICE PSYCHOPHARMACOLOGY
QUESTIONS AND 100% VERIFIED ANSWERS WITH RATIONALES
GRADED A+
GUARANTEED PASS ON THE FIRST ATTEMPT
1. A 28-year-old patient with major depressive disorder is started on fluoxetine.
Which of the following is the most important teaching point regarding the onset of
therapeutic effects?
A. Effects are typically seen within 24 hours.
B. Effects may take 4–6 weeks to fully manifest.
C. Improvement is immediate after the first dose.
D. Effects are usually seen after 1 year of continuous therapy.
Answer: B
Rationale: SSRIs like fluoxetine usually require 4–6 weeks for full antidepressant
effects due to gradual changes in neurotransmitter receptor sensitivity.
2. A patient reports dry mouth, constipation, and urinary retention after starting
amitriptyline. These adverse effects are most likely due to:
A. Dopamine receptor antagonism
B. Anticholinergic activity
C. Selective serotonin reuptake inhibition
D. NMDA receptor blockade
Answer: B
Rationale: Tricyclic antidepressants (TCAs) such as amitriptyline have strong
anticholinergic effects causing dry mouth, constipation, and urinary retention.
,3. Which of the following medications is classified as a typical antipsychotic?
A. Risperidone
B. Olanzapine
C. Haloperidol
D. Clozapine
Answer: C
Rationale: Haloperidol is a first-generation (typical) antipsychotic, primarily
acting as a D2 dopamine receptor antagonist. Risperidone, olanzapine, and
clozapine are atypical (second-generation) antipsychotics.
4. A patient on lithium therapy presents with coarse tremors, nausea, vomiting, and
diarrhea. The nurse should:
A. Increase the lithium dose
B. Check the patient’s serum lithium level
C. Reassure the patient that these are mild side effects
D. Discontinue all other medications
Answer: B
Rationale: These symptoms may indicate lithium toxicity; serum levels should be
checked immediately.
5. A patient taking MAOIs should avoid which of the following foods to prevent
hypertensive crisis?
A. Bananas
B. Aged cheeses
C. Fresh vegetables
D. Oatmeal
Answer: B
Rationale: MAOIs inhibit monoamine oxidase, which metabolizes tyramine. Aged
cheeses are high in tyramine, increasing the risk of hypertensive crisis.
,6. Which neurotransmitter is primarily implicated in the mechanism of action of
SSRIs?
A. Dopamine
B. Norepinephrine
C. Serotonin
D. Acetylcholine
Answer: C
Rationale: SSRIs selectively inhibit the reuptake of serotonin, increasing its
availability in the synaptic cleft.
7. A 42-year-old patient with schizophrenia has persistent negative symptoms.
Which antipsychotic is most effective for negative symptoms?
A. Haloperidol
B. Chlorpromazine
C. Clozapine
D. Fluphenazine
Answer: C
Rationale: Clozapine, a second-generation antipsychotic, is particularly effective
for negative and treatment-resistant symptoms of schizophrenia.
8. A patient reports feeling agitated, restless, and unable to sleep after starting an
SSRI. What is the most likely cause?
A. Serotonin syndrome
B. Initial activation effect of SSRIs
C. Lithium toxicity
D. Extrapyramidal symptoms
Answer: B
Rationale: SSRIs can cause early activation, especially in the first 1–2 weeks,
which may manifest as agitation and insomnia.
, 9. Which laboratory test is essential to monitor in a patient taking valproic acid?
A. Serum lithium levels
B. Liver function tests
C. Serum creatinine
D. Thyroid panel
Answer: B
Rationale: Valproic acid can cause hepatotoxicity; liver function tests should be
monitored regularly.
10. A patient on clozapine therapy should have regular monitoring for which
serious adverse effect?
A. Agranulocytosis
B. Hyperprolactinemia
C. Extrapyramidal symptoms
D. QT prolongation
Answer: A
Rationale: Clozapine carries a significant risk of agranulocytosis; regular CBC
monitoring is required.
11. Which class of antidepressants is most likely to cause orthostatic hypotension
in elderly patients?
A. SSRIs
B. SNRIs
C. TCAs
D. MAOIs
Answer: C
Rationale: TCAs block alpha-adrenergic receptors, which can lead to orthostatic
hypotension, particularly in elderly patients.
