NSG 552 Psychopharmacology Exam 2 2026 – Wilkes University
1. A patient taking Lithium for Bipolar Disorder presents with coarse tremors,
ataxia, and confusion. What is the most likely cause?
A. Serotonin syndrome
B. Lithium toxicity
C. Neuroleptic malignant syndrome
D. Anticholinergic crisis
Answer: B
Rationale: Coarse tremors, ataxia, and confusion are hallmark signs of Lithium toxicity,
which typically occurs at serum levels above 1.5 mEq/L.
2. Which antidepressant is most likely to cause a hypertensive crisis if taken
with foods containing tyramine?
A. Sertraline
B. Bupropion
C. Amitriptyline
D. Phenelzine
Answer: D
Rationale: Phenelzine is an MAOI. MAOIs inhibit the breakdown of tyramine, leading to
excessive norepinephrine release and potentially fatal hypertensive crisis.
,3. Which lab value is most critical to monitor for a patient starting Clozapine?
A. Thyroid Stimulating Hormone (TSH)
B. Serum Creatinine
C. Absolute Neutrophil Count (ANC)
D. Liver Function Tests (LFTs)
Answer: C
Rationale: Clozapine carries a black box warning for agranulocytosis, necessitating
frequent monitoring of the Absolute Neutrophil Count (ANC).
4. What is the mechanism of action for Selective Serotonin Reuptake Inhibitors
(SSRIs)?
A. Inhibiting the breakdown of serotonin in the synapse
B. Increasing the sensitivity of post-synaptic receptors
C. Blocking the reuptake pump, increasing serotonin in the synaptic cleft
D. Acting as an agonist at the 5-HT1A receptor
Answer: C
Rationale: SSRIs work by blocking the presynaptic serotonin reuptake transporter (SERT),
which increases the concentration of serotonin available in the synaptic cleft.
5. A patient is prescribed Lamotrigine for mood stabilization. What is the most
serious side effect to warn the patient about?
A. Steven-Johnson Syndrome (SJS)
B. Agranulocytosis
C. Diabetes Insipidus
D. Weight gain
Answer: A
Rationale: Lamotrigine is associated with a risk of life-threatening rashes, including
Steven-Johnson Syndrome (SJS), requiring a slow dose titration.
, 6. Which medication is considered a first-line treatment for Generalized Anxiety
Disorder (GAD) due to its lack of addictive potential?
A. Alprazolam
B. Diazepam
C. Buspirone
D. Lorazepam
Answer: C
Rationale: Buspirone is a non-benzodiazepine anxiolytic that does not carry the risk of
physical dependence or withdrawal.
7. A patient on Haloperidol develops high fever, muscle rigidity, and autonomic
instability. What is the priority intervention?
A. Increase the dose of Haloperidol
B. Discontinue the antipsychotic and provide supportive care
C. Administer Diphenhydramine
D. Administer a dose of Flumazenil
Answer: B
Rationale: These symptoms indicate Neuroleptic Malignant Syndrome (NMS), a medical
emergency requiring immediate discontinuation of the offending agent.
8. What is the primary neurotransmitter involved in the reward circuit of the
brain and implicated in addiction?
A. GABA
B. Dopamine
C. Acetylcholine
D. Glutamate
Answer: B
Rationale: Dopamine release in the nucleus accumbens is the primary pathway for the
brain’s reward system and is central to the development of addiction.
1. A patient taking Lithium for Bipolar Disorder presents with coarse tremors,
ataxia, and confusion. What is the most likely cause?
A. Serotonin syndrome
B. Lithium toxicity
C. Neuroleptic malignant syndrome
D. Anticholinergic crisis
Answer: B
Rationale: Coarse tremors, ataxia, and confusion are hallmark signs of Lithium toxicity,
which typically occurs at serum levels above 1.5 mEq/L.
2. Which antidepressant is most likely to cause a hypertensive crisis if taken
with foods containing tyramine?
A. Sertraline
B. Bupropion
C. Amitriptyline
D. Phenelzine
Answer: D
Rationale: Phenelzine is an MAOI. MAOIs inhibit the breakdown of tyramine, leading to
excessive norepinephrine release and potentially fatal hypertensive crisis.
,3. Which lab value is most critical to monitor for a patient starting Clozapine?
A. Thyroid Stimulating Hormone (TSH)
B. Serum Creatinine
C. Absolute Neutrophil Count (ANC)
D. Liver Function Tests (LFTs)
Answer: C
Rationale: Clozapine carries a black box warning for agranulocytosis, necessitating
frequent monitoring of the Absolute Neutrophil Count (ANC).
4. What is the mechanism of action for Selective Serotonin Reuptake Inhibitors
(SSRIs)?
A. Inhibiting the breakdown of serotonin in the synapse
B. Increasing the sensitivity of post-synaptic receptors
C. Blocking the reuptake pump, increasing serotonin in the synaptic cleft
D. Acting as an agonist at the 5-HT1A receptor
Answer: C
Rationale: SSRIs work by blocking the presynaptic serotonin reuptake transporter (SERT),
which increases the concentration of serotonin available in the synaptic cleft.
5. A patient is prescribed Lamotrigine for mood stabilization. What is the most
serious side effect to warn the patient about?
A. Steven-Johnson Syndrome (SJS)
B. Agranulocytosis
C. Diabetes Insipidus
D. Weight gain
Answer: A
Rationale: Lamotrigine is associated with a risk of life-threatening rashes, including
Steven-Johnson Syndrome (SJS), requiring a slow dose titration.
, 6. Which medication is considered a first-line treatment for Generalized Anxiety
Disorder (GAD) due to its lack of addictive potential?
A. Alprazolam
B. Diazepam
C. Buspirone
D. Lorazepam
Answer: C
Rationale: Buspirone is a non-benzodiazepine anxiolytic that does not carry the risk of
physical dependence or withdrawal.
7. A patient on Haloperidol develops high fever, muscle rigidity, and autonomic
instability. What is the priority intervention?
A. Increase the dose of Haloperidol
B. Discontinue the antipsychotic and provide supportive care
C. Administer Diphenhydramine
D. Administer a dose of Flumazenil
Answer: B
Rationale: These symptoms indicate Neuroleptic Malignant Syndrome (NMS), a medical
emergency requiring immediate discontinuation of the offending agent.
8. What is the primary neurotransmitter involved in the reward circuit of the
brain and implicated in addiction?
A. GABA
B. Dopamine
C. Acetylcholine
D. Glutamate
Answer: B
Rationale: Dopamine release in the nucleus accumbens is the primary pathway for the
brain’s reward system and is central to the development of addiction.
