NSG 552 PSYCHOPHARMACOLOGY EXAM 3
WILKES UNIVERSITY
ADVANCED PRACTICE PSYCHOPHARMACOLOGY
QUESTIONS AND 100% VERIFIED ANSWERS WITH RATIONALES
GRADED A+
GUARANTEED PASS ON THE FIRST ATTEMPT
1. A patient presents with acute mania and requires rapid symptom control. Which
medication is preferred?
A. Lithium
B. Valproic acid
C. Lamotrigine
D. Carbamazepine
Answer: B
Rationale: Valproic acid has a rapid onset of action and is effective in controlling
acute manic episodes.
2. Which atypical antipsychotic is associated with the highest risk of
agranulocytosis?
A. Clozapine
B. Risperidone
C. Quetiapine
D. Olanzapine
Answer: A
Rationale: Clozapine carries a risk of agranulocytosis and requires regular CBC
monitoring.
,3. A patient on lithium therapy complains of mild tremor and nausea. Serum
lithium = 0.8 mEq/L. Most appropriate intervention:
A. Hold lithium immediately
B. Reassure and continue therapy
C. Increase dose
D. Switch to valproic acid
Answer: B
Rationale: Mild tremor and GI upset can occur at therapeutic levels; monitoring
and reassurance are appropriate.
4. Which antidepressant has the lowest risk of causing serotonin syndrome?
A. Fluoxetine
B. Paroxetine
C. Bupropion
D. Sertraline
Answer: C
Rationale: Bupropion does not significantly increase serotonin and has minimal
risk for serotonin syndrome.
5. A patient develops sudden fever, rigidity, and autonomic instability after starting
haloperidol. Lab shows elevated CPK. Diagnosis:
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Akathisia
D. Lithium toxicity
Answer: A
Rationale: NMS is characterized by hyperthermia, rigidity, autonomic instability,
and elevated CPK.
,6. Which mood stabilizer is preferred for bipolar depression due to its low risk of
inducing mania?
A. Lamotrigine
B. Lithium
C. Valproic acid
D. Carbamazepine
Answer: A
Rationale: Lamotrigine is effective for bipolar depression and rarely induces
mania.
7. Which antidepressant is most likely to cause sedation and weight gain?
A. Mirtazapine
B. Fluoxetine
C. Bupropion
D. Sertraline
Answer: A
Rationale: Mirtazapine antagonizes histamine receptors, leading to sedation and
increased appetite.
8. A patient taking carbamazepine develops fever, rash, and mucosal lesions. Most
serious concern:
A. Tardive dyskinesia
B. Stevens-Johnson syndrome
C. Serotonin syndrome
D. Lithium toxicity
Answer: B
Rationale: Severe dermatologic reactions including Stevens-Johnson syndrome
are rare but life-threatening.
, 9. Which SSRI is most activating and may exacerbate anxiety and insomnia?
A. Fluoxetine
B. Paroxetine
C. Citalopram
D. Escitalopram
Answer: A
Rationale: Fluoxetine is stimulating and may worsen insomnia in sensitive
patients.
10. A patient on risperidone develops galactorrhea and menstrual irregularities.
Mechanism:
A. Dopamine blockade in tuberoinfundibular pathway
B. Serotonin excess
C. GABA antagonism
D. NMDA antagonism
Answer: A
Rationale: Dopamine blockade in the tuberoinfundibular pathway increases
prolactin secretion.
11. Which benzodiazepine is preferred for alcohol withdrawal due to long-acting
effects?
A. Diazepam
B. Lorazepam
C. Clonazepam
D. Alprazolam
Answer: A
Rationale: Diazepam’s long half-life prevents withdrawal seizures and ensures
smoother detoxification.
WILKES UNIVERSITY
ADVANCED PRACTICE PSYCHOPHARMACOLOGY
QUESTIONS AND 100% VERIFIED ANSWERS WITH RATIONALES
GRADED A+
GUARANTEED PASS ON THE FIRST ATTEMPT
1. A patient presents with acute mania and requires rapid symptom control. Which
medication is preferred?
A. Lithium
B. Valproic acid
C. Lamotrigine
D. Carbamazepine
Answer: B
Rationale: Valproic acid has a rapid onset of action and is effective in controlling
acute manic episodes.
2. Which atypical antipsychotic is associated with the highest risk of
agranulocytosis?
A. Clozapine
B. Risperidone
C. Quetiapine
D. Olanzapine
Answer: A
Rationale: Clozapine carries a risk of agranulocytosis and requires regular CBC
monitoring.
,3. A patient on lithium therapy complains of mild tremor and nausea. Serum
lithium = 0.8 mEq/L. Most appropriate intervention:
A. Hold lithium immediately
B. Reassure and continue therapy
C. Increase dose
D. Switch to valproic acid
Answer: B
Rationale: Mild tremor and GI upset can occur at therapeutic levels; monitoring
and reassurance are appropriate.
4. Which antidepressant has the lowest risk of causing serotonin syndrome?
A. Fluoxetine
B. Paroxetine
C. Bupropion
D. Sertraline
Answer: C
Rationale: Bupropion does not significantly increase serotonin and has minimal
risk for serotonin syndrome.
5. A patient develops sudden fever, rigidity, and autonomic instability after starting
haloperidol. Lab shows elevated CPK. Diagnosis:
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Akathisia
D. Lithium toxicity
Answer: A
Rationale: NMS is characterized by hyperthermia, rigidity, autonomic instability,
and elevated CPK.
,6. Which mood stabilizer is preferred for bipolar depression due to its low risk of
inducing mania?
A. Lamotrigine
B. Lithium
C. Valproic acid
D. Carbamazepine
Answer: A
Rationale: Lamotrigine is effective for bipolar depression and rarely induces
mania.
7. Which antidepressant is most likely to cause sedation and weight gain?
A. Mirtazapine
B. Fluoxetine
C. Bupropion
D. Sertraline
Answer: A
Rationale: Mirtazapine antagonizes histamine receptors, leading to sedation and
increased appetite.
8. A patient taking carbamazepine develops fever, rash, and mucosal lesions. Most
serious concern:
A. Tardive dyskinesia
B. Stevens-Johnson syndrome
C. Serotonin syndrome
D. Lithium toxicity
Answer: B
Rationale: Severe dermatologic reactions including Stevens-Johnson syndrome
are rare but life-threatening.
, 9. Which SSRI is most activating and may exacerbate anxiety and insomnia?
A. Fluoxetine
B. Paroxetine
C. Citalopram
D. Escitalopram
Answer: A
Rationale: Fluoxetine is stimulating and may worsen insomnia in sensitive
patients.
10. A patient on risperidone develops galactorrhea and menstrual irregularities.
Mechanism:
A. Dopamine blockade in tuberoinfundibular pathway
B. Serotonin excess
C. GABA antagonism
D. NMDA antagonism
Answer: A
Rationale: Dopamine blockade in the tuberoinfundibular pathway increases
prolactin secretion.
11. Which benzodiazepine is preferred for alcohol withdrawal due to long-acting
effects?
A. Diazepam
B. Lorazepam
C. Clonazepam
D. Alprazolam
Answer: A
Rationale: Diazepam’s long half-life prevents withdrawal seizures and ensures
smoother detoxification.
