NSG 552 Exam 3: Psychopharmacology Comprehensive Study Guide
2026 – Wilkes University
1. Which of the following is the therapeutic range for Lithium in the
maintenance phase of Bipolar Disorder?
A. 0.6 - 1.2 mEq/L
B. 0.4 - 0.8 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.0 - 2.5 mEq/L
Answer: A
Rationale: The standard therapeutic range for lithium in maintenance treatment is 0.6 to
1.2 mEq/L. Levels above 1.5 mEq/L are considered toxic.
2. Which medication is most likely to cause Stevens-Johnson Syndrome (SJS) if
titrated too quickly?
A. Lithium
B. Valproic Acid
C. Lamotrigine
D. Gabapentin
Answer: C
Rationale: Lamotrigine requires a very slow titration schedule (start low, go slow) to
minimize the risk of life-threatening rashes like SJS.
,3. A patient taking Valproic Acid (Depakote) for Bipolar Disorder should have
which labs monitored regularly?
A. Liver Function Tests (LFTs) and CBC
B. Thyroid Stimulating Hormone (TSH)
C. Blood Urea Nitrogen (BUN) and Creatinine
D. Serum Calcium
Answer: A
Rationale: Valproic acid can cause hepatotoxicity and blood dyscrasias like
thrombocytopenia, necessitating LFT and CBC monitoring.
4. Which of the following drugs is a potent inducer of the CYP450 3A4 enzyme?
A. Lithium
B. Fluoxetine
C. Valproate
D. Carbamazepine
Answer: D
Rationale: Carbamazepine is a strong enzyme inducer, which often leads to decreased
levels of other medications and even itself through auto-induction.
5. Before starting Carbamazepine in a patient of Asian descent, which genetic
test is recommended?
A. CYP2D6
B. MTHFR
C. COMT
D. HLA-B*1502
Answer: D
Rationale: The HLA-B*1502 allele is associated with a high risk of SJS/TEN in Asian
populations taking carbamazepine.
, 6. Which antidepressant is preferred for a patient who is concerned about
weight gain and sexual dysfunction?
A. Paroxetine
B. Phenelzine
C. Amitriptyline
D. Bupropion
Answer: D
Rationale: Bupropion is an NDRI that lacks significant serotonergic activity, making it less
likely to cause weight gain or sexual side effects.
7. A patient taking an MAOI experiences a hypertensive crisis. This is most likely
due to the ingestion of:
A. Tyramine-rich foods
B. Grapefruit juice
C. Leafy green vegetables
D. Gluten
Answer: A
Rationale: MAOIs inhibit the breakdown of tyramine; high levels of tyramine cause a
massive release of norepinephrine, leading to hypertensive crisis.
8. Which symptom is most characteristic of Serotonin Syndrome compared to
Neuroleptic Malignant Syndrome (NMS)?
A. Hyperreflexia and myoclonus
B. Lead-pipe rigidity
C. Hyperthermia
D. Altered mental status
Answer: A
Rationale: Serotonin syndrome is characterized by neuromuscular hyperactivity
(hyperreflexia, myoclonus), whereas NMS involves ‘lead-pipe’ muscle rigidity.
2026 – Wilkes University
1. Which of the following is the therapeutic range for Lithium in the
maintenance phase of Bipolar Disorder?
A. 0.6 - 1.2 mEq/L
B. 0.4 - 0.8 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.0 - 2.5 mEq/L
Answer: A
Rationale: The standard therapeutic range for lithium in maintenance treatment is 0.6 to
1.2 mEq/L. Levels above 1.5 mEq/L are considered toxic.
2. Which medication is most likely to cause Stevens-Johnson Syndrome (SJS) if
titrated too quickly?
A. Lithium
B. Valproic Acid
C. Lamotrigine
D. Gabapentin
Answer: C
Rationale: Lamotrigine requires a very slow titration schedule (start low, go slow) to
minimize the risk of life-threatening rashes like SJS.
,3. A patient taking Valproic Acid (Depakote) for Bipolar Disorder should have
which labs monitored regularly?
A. Liver Function Tests (LFTs) and CBC
B. Thyroid Stimulating Hormone (TSH)
C. Blood Urea Nitrogen (BUN) and Creatinine
D. Serum Calcium
Answer: A
Rationale: Valproic acid can cause hepatotoxicity and blood dyscrasias like
thrombocytopenia, necessitating LFT and CBC monitoring.
4. Which of the following drugs is a potent inducer of the CYP450 3A4 enzyme?
A. Lithium
B. Fluoxetine
C. Valproate
D. Carbamazepine
Answer: D
Rationale: Carbamazepine is a strong enzyme inducer, which often leads to decreased
levels of other medications and even itself through auto-induction.
5. Before starting Carbamazepine in a patient of Asian descent, which genetic
test is recommended?
A. CYP2D6
B. MTHFR
C. COMT
D. HLA-B*1502
Answer: D
Rationale: The HLA-B*1502 allele is associated with a high risk of SJS/TEN in Asian
populations taking carbamazepine.
, 6. Which antidepressant is preferred for a patient who is concerned about
weight gain and sexual dysfunction?
A. Paroxetine
B. Phenelzine
C. Amitriptyline
D. Bupropion
Answer: D
Rationale: Bupropion is an NDRI that lacks significant serotonergic activity, making it less
likely to cause weight gain or sexual side effects.
7. A patient taking an MAOI experiences a hypertensive crisis. This is most likely
due to the ingestion of:
A. Tyramine-rich foods
B. Grapefruit juice
C. Leafy green vegetables
D. Gluten
Answer: A
Rationale: MAOIs inhibit the breakdown of tyramine; high levels of tyramine cause a
massive release of norepinephrine, leading to hypertensive crisis.
8. Which symptom is most characteristic of Serotonin Syndrome compared to
Neuroleptic Malignant Syndrome (NMS)?
A. Hyperreflexia and myoclonus
B. Lead-pipe rigidity
C. Hyperthermia
D. Altered mental status
Answer: A
Rationale: Serotonin syndrome is characterized by neuromuscular hyperactivity
(hyperreflexia, myoclonus), whereas NMS involves ‘lead-pipe’ muscle rigidity.
