Wilkes Psychopharmacology NSG 552 Exam 3 Practice 2026 – Wilkes
University
1. What is the therapeutic serum range for Lithium during the maintenance
phase?
A. 0.4 - 0.6 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.0 - 2.5 mEq/L
Answer: C
Rationale: The standard therapeutic range for Lithium maintenance is 0.6 to 1.2 mEq/L.
Levels above 1.5 mEq/L are considered toxic.
2. Which antipsychotic medication is most associated with the risk of
agranulocytosis?
A. Risperidone
B. Clozapine
C. Olanzapine
D. Quetiapine
Answer: B
Rationale: Clozapine carries a black box warning for agranulocytosis, requiring regular
monitoring of the Absolute Neutrophil Count (ANC).
,3. What is the mechanism of action of Methylphenidate in the treatment of
ADHD?
A. Inhibition of serotonin reuptake
B. Blockade of dopamine and norepinephrine transporters
C. Antagonism of D2 receptors
D. Agonism of alpha-2 receptors
Answer: B
Rationale: Methylphenidate works primarily by blocking the reuptake of dopamine and
norepinephrine, increasing their availability in the synaptic cleft.
4. Which pathway is responsible for the movement-related side effects (EPS)
caused by D2 antagonists?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The nigrostriatal pathway controls motor function; blockade of D2 receptors
here leads to extrapyramidal symptoms (EPS).
5. A patient on Lamotrigine develops a widespread rash and mouth sores. What
is the most likely diagnosis?
A. Serotonin Syndrome
B. Stevens-Johnson Syndrome
C. Neuroleptic Malignant Syndrome
D. Metabolic Syndrome
Answer: B
Rationale: Stevens-Johnson Syndrome (SJS) is a rare but life-threatening skin reaction
associated with Lamotrigine, especially with rapid titration.
, 6. Which lab value must be monitored frequently for a patient taking Valproic
Acid?
A. Liver Function Tests (LFTs)
B. Thyroid Stimulating Hormone (TSH)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: A
Rationale: Valproic acid can cause hepatotoxicity and thrombocytopenia, necessitating the
monitoring of liver enzymes and platelet counts.
7. Which antipsychotic is known for having a ‘partial agonist’ effect at the D2
receptor?
A. Aripiprazole
B. Haloperidol
C. Chlorpromazine
D. Ziprasidone
Answer: A
Rationale: Aripiprazole is a D2 partial agonist, which helps modulate dopamine activity
rather than completely blocking it.
8. What is the primary treatment for Akathisia induced by antipsychotics?
A. Benztropine
B. Propranolol
C. Diphenhydramine
D. Lorazepam
Answer: B
Rationale: While anticholinergics work for dystonia, beta-blockers like Propranolol are the
first-line treatment for akathisia (restlessness).
University
1. What is the therapeutic serum range for Lithium during the maintenance
phase?
A. 0.4 - 0.6 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.0 - 2.5 mEq/L
Answer: C
Rationale: The standard therapeutic range for Lithium maintenance is 0.6 to 1.2 mEq/L.
Levels above 1.5 mEq/L are considered toxic.
2. Which antipsychotic medication is most associated with the risk of
agranulocytosis?
A. Risperidone
B. Clozapine
C. Olanzapine
D. Quetiapine
Answer: B
Rationale: Clozapine carries a black box warning for agranulocytosis, requiring regular
monitoring of the Absolute Neutrophil Count (ANC).
,3. What is the mechanism of action of Methylphenidate in the treatment of
ADHD?
A. Inhibition of serotonin reuptake
B. Blockade of dopamine and norepinephrine transporters
C. Antagonism of D2 receptors
D. Agonism of alpha-2 receptors
Answer: B
Rationale: Methylphenidate works primarily by blocking the reuptake of dopamine and
norepinephrine, increasing their availability in the synaptic cleft.
4. Which pathway is responsible for the movement-related side effects (EPS)
caused by D2 antagonists?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The nigrostriatal pathway controls motor function; blockade of D2 receptors
here leads to extrapyramidal symptoms (EPS).
5. A patient on Lamotrigine develops a widespread rash and mouth sores. What
is the most likely diagnosis?
A. Serotonin Syndrome
B. Stevens-Johnson Syndrome
C. Neuroleptic Malignant Syndrome
D. Metabolic Syndrome
Answer: B
Rationale: Stevens-Johnson Syndrome (SJS) is a rare but life-threatening skin reaction
associated with Lamotrigine, especially with rapid titration.
, 6. Which lab value must be monitored frequently for a patient taking Valproic
Acid?
A. Liver Function Tests (LFTs)
B. Thyroid Stimulating Hormone (TSH)
C. Serum Creatinine
D. Hemoglobin A1c
Answer: A
Rationale: Valproic acid can cause hepatotoxicity and thrombocytopenia, necessitating the
monitoring of liver enzymes and platelet counts.
7. Which antipsychotic is known for having a ‘partial agonist’ effect at the D2
receptor?
A. Aripiprazole
B. Haloperidol
C. Chlorpromazine
D. Ziprasidone
Answer: A
Rationale: Aripiprazole is a D2 partial agonist, which helps modulate dopamine activity
rather than completely blocking it.
8. What is the primary treatment for Akathisia induced by antipsychotics?
A. Benztropine
B. Propranolol
C. Diphenhydramine
D. Lorazepam
Answer: B
Rationale: While anticholinergics work for dystonia, beta-blockers like Propranolol are the
first-line treatment for akathisia (restlessness).
