NR546 | NR546 Advanced Pharmacology
Psychopharmacology for the PMHNP Wk 7 Final
Exam | Questions with Correct Answers and Expert
Explanation for Each Question | Chamberlain
1. A patient is prescribed Clozapine for treatment-resistant schizophrenia. Which
laboratory value is the most critical for the PMHNP to monitor regularly?
A. Liver function tests (LFTs)
B. Absolute Neutrophil Count (ANC)
C. Serum Potassium levels
D. Thyroid Stimulating Hormone (TSH)
Correct Answer: B
Expert Explanation: Clozapine carries a black box warning for agranulocytosis, a
potentially life-threatening drop in white blood cell counts. The PMHNP must
monitor the Absolute Neutrophil Count (ANC) via the Risk Evaluation and Mitigation
Strategy (REMS) program. If the ANC falls below specific thresholds, the medication
must be discontinued to prevent severe infection.
2. Which antidepressant is most likely to cause a hypertensive crisis if the patient
consumes foods high in tyramine?
A. Sertraline
,B. Venlafaxine
C. Phenelzine
D. Bupropion
Correct Answer: C
Expert Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that
inhibits the breakdown of tyramine in the gut. Excessive tyramine causes a massive
release of norepinephrine, leading to dangerous increases in blood pressure.
Patients taking MAOIs must adhere to a strict low-tyramine diet to avoid this
hypertensive crisis.
3. A patient presents with high fever, muscle rigidity, and autonomic instability after
starting Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Acute Dystonia
D. Akathisia
Correct Answer: B
Expert Explanation: Neuroleptic Malignant Syndrome (NMS) is a medical
emergency associated with dopamine-blocking agents like Haloperidol. It is
,characterized by ‘lead-pipe’ rigidity, hyperpyrexia, and altered mental status.
Treatment involves immediate discontinuation of the antipsychotic and supportive
care, sometimes including Dantrolene.
4. Which of the following medications is a partial agonist at the mu-opioid receptor
used for opioid use disorder?
A. Buprenorphine
B. Naltrexone
C. Methadone
D. Naloxone
Correct Answer: A
Expert Explanation: Buprenorphine acts as a partial agonist at the mu-opioid
receptor, providing enough stimulation to reduce cravings without causing the same
level of euphoria as full agonists. Because it has a high affinity but low intrinsic
activity, it can also displace full agonists and precipitate withdrawal if used too soon.
It is a cornerstone of Medication-Assisted Treatment (MAT) for opioid dependence.
5. A patient taking Lithium for Bipolar I Disorder reports coarse tremors, vomiting, and
confusion. What should the PMHNP suspect?
A. Lithium toxicity
B. Therapeutic Lithium levels
, C. Serotonin syndrome
D. Wernicke-Korsakoff syndrome
Correct Answer: A
Expert Explanation: Lithium toxicity is a dangerous condition that occurs when
serum levels exceed the narrow therapeutic index (usually >1.5 mEq/L). Symptoms
include gastrointestinal distress, ataxia, and coarse tremors, which are more severe
than the fine tremors seen at therapeutic levels. Immediate serum level testing and
hydration are necessary interventions.
6. Which neurotransmitter’s primary function is inhibitory within the Central Nervous
System (CNS)?
A. Glutamate
B. Dopamine
C. GABA
D. Norepinephrine
Correct Answer: C
Expert Explanation: Gamma-aminobutyric acid (GABA) is the major inhibitory
neurotransmitter in the brain. It works by opening chloride channels, which
Psychopharmacology for the PMHNP Wk 7 Final
Exam | Questions with Correct Answers and Expert
Explanation for Each Question | Chamberlain
1. A patient is prescribed Clozapine for treatment-resistant schizophrenia. Which
laboratory value is the most critical for the PMHNP to monitor regularly?
A. Liver function tests (LFTs)
B. Absolute Neutrophil Count (ANC)
C. Serum Potassium levels
D. Thyroid Stimulating Hormone (TSH)
Correct Answer: B
Expert Explanation: Clozapine carries a black box warning for agranulocytosis, a
potentially life-threatening drop in white blood cell counts. The PMHNP must
monitor the Absolute Neutrophil Count (ANC) via the Risk Evaluation and Mitigation
Strategy (REMS) program. If the ANC falls below specific thresholds, the medication
must be discontinued to prevent severe infection.
2. Which antidepressant is most likely to cause a hypertensive crisis if the patient
consumes foods high in tyramine?
A. Sertraline
,B. Venlafaxine
C. Phenelzine
D. Bupropion
Correct Answer: C
Expert Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that
inhibits the breakdown of tyramine in the gut. Excessive tyramine causes a massive
release of norepinephrine, leading to dangerous increases in blood pressure.
Patients taking MAOIs must adhere to a strict low-tyramine diet to avoid this
hypertensive crisis.
3. A patient presents with high fever, muscle rigidity, and autonomic instability after
starting Haloperidol. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
C. Acute Dystonia
D. Akathisia
Correct Answer: B
Expert Explanation: Neuroleptic Malignant Syndrome (NMS) is a medical
emergency associated with dopamine-blocking agents like Haloperidol. It is
,characterized by ‘lead-pipe’ rigidity, hyperpyrexia, and altered mental status.
Treatment involves immediate discontinuation of the antipsychotic and supportive
care, sometimes including Dantrolene.
4. Which of the following medications is a partial agonist at the mu-opioid receptor
used for opioid use disorder?
A. Buprenorphine
B. Naltrexone
C. Methadone
D. Naloxone
Correct Answer: A
Expert Explanation: Buprenorphine acts as a partial agonist at the mu-opioid
receptor, providing enough stimulation to reduce cravings without causing the same
level of euphoria as full agonists. Because it has a high affinity but low intrinsic
activity, it can also displace full agonists and precipitate withdrawal if used too soon.
It is a cornerstone of Medication-Assisted Treatment (MAT) for opioid dependence.
5. A patient taking Lithium for Bipolar I Disorder reports coarse tremors, vomiting, and
confusion. What should the PMHNP suspect?
A. Lithium toxicity
B. Therapeutic Lithium levels
, C. Serotonin syndrome
D. Wernicke-Korsakoff syndrome
Correct Answer: A
Expert Explanation: Lithium toxicity is a dangerous condition that occurs when
serum levels exceed the narrow therapeutic index (usually >1.5 mEq/L). Symptoms
include gastrointestinal distress, ataxia, and coarse tremors, which are more severe
than the fine tremors seen at therapeutic levels. Immediate serum level testing and
hydration are necessary interventions.
6. Which neurotransmitter’s primary function is inhibitory within the Central Nervous
System (CNS)?
A. Glutamate
B. Dopamine
C. GABA
D. Norepinephrine
Correct Answer: C
Expert Explanation: Gamma-aminobutyric acid (GABA) is the major inhibitory
neurotransmitter in the brain. It works by opening chloride channels, which
