NR565 | NR565 Advanced Pharmacology
Fundamentals Exam 3 v2 | Questions with Correct
Answers and Expert Explanation for Each Question
| Chamberlain
1. A patient diagnosed with depression is started on Fluoxetine (Prozac). Which
education should the nurse practitioner provide regarding the onset of therapeutic
effects?
A. Symptoms will significantly improve within 24 to 48 hours.
B. Maximum effectiveness is usually achieved within 1 week.
C. The drug only works if taken on an as-needed basis for acute sadness.
D. Full therapeutic effects may take 4 to 6 weeks to occur.
Correct Answer: D
Expert Explanation: Fluoxetine is a Selective Serotonin Reuptake Inhibitor (SSRI)
that requires several weeks to reach steady state and therapeutic levels. Patients
often feel initial side effects before the mood-lifting benefits begin. It is crucial to
manage patient expectations to ensure adherence during the first month of therapy.
2. When prescribing Amitriptyline (Elavil) for a patient with chronic pain, which side
effect profile should be monitored most closely?
A. Excessive salivation and diarrhea
,B. Hypertension and increased energy levels
C. Anticholinergic effects such as dry mouth, blurred vision, and urinary retention
D. Significant weight loss and insomnia
Correct Answer: C
Expert Explanation: Amitriptyline is a Tricyclic Antidepressant (TCA) known for
its strong anticholinergic properties. These effects occur because TCAs block
muscarinic receptors throughout the body. Monitoring is essential, especially in
elderly patients who are more prone to confusion and falls associated with these
side effects.
3. A patient taking Phenelzine (Nardil) for depression must be instructed to avoid
which of the following foods to prevent a hypertensive crisis?
A. Aged cheeses and red wine
B. Fresh green leafy vegetables
C. Whole grain breads and cereals
D. Citrus fruits and juices
Correct Answer: A
Expert Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that
prevents the breakdown of tyramine. Ingestion of tyramine-rich foods like aged
,cheese, cured meats, and red wine can lead to a massive release of norepinephrine.
This results in severe vasoconstriction and a potentially fatal hypertensive crisis.
4. Which laboratory value is most important to monitor in a patient receiving Lithium
for bipolar disorder?
A. Serum calcium levels
B. Serum sodium levels
C. Liver function tests
D. Amylase and lipase
Correct Answer: B
Expert Explanation: Lithium is a salt and is handled by the kidneys in a manner
similar to sodium. If sodium levels drop, the kidneys will retain lithium to
compensate, leading to toxic lithium levels. Maintaining a consistent sodium intake
and monitoring serum levels is vital for safety.
5. A patient is started on Valproic acid (Depakote) for seizure control. Which
laboratory tests should be performed at baseline and periodically?
A. Renal function and chest X-ray
B. Liver function tests and platelet count
C. Serum electrolytes and uric acid
, D. Vitamin B12 and folate levels
Correct Answer: B
Expert Explanation: Valproic acid carries black box warnings for hepatotoxicity
and pancreatitis. It can also cause thrombocytopenia, especially at higher doses.
Regular monitoring of LFTs and CBC with platelets is required to detect early signs
of organ damage or hematologic issues.
6. Which of the following is a primary safety concern for a patient starting Clozapine
(Clozaril) for treatment-resistant schizophrenia?
A. Agranulocytosis
B. Hypertensive crisis
C. Excessive weight loss
D. Persistent dry cough
Correct Answer: A
Expert Explanation: Clozapine is associated with a risk of severe agranulocytosis,
which is a life-threatening decrease in white blood cell count. Because of this risk,
patients must participate in a strict REMS program that requires frequent blood
monitoring. This medication is typically reserved for patients who have failed other
antipsychotic trials.
Fundamentals Exam 3 v2 | Questions with Correct
Answers and Expert Explanation for Each Question
| Chamberlain
1. A patient diagnosed with depression is started on Fluoxetine (Prozac). Which
education should the nurse practitioner provide regarding the onset of therapeutic
effects?
A. Symptoms will significantly improve within 24 to 48 hours.
B. Maximum effectiveness is usually achieved within 1 week.
C. The drug only works if taken on an as-needed basis for acute sadness.
D. Full therapeutic effects may take 4 to 6 weeks to occur.
Correct Answer: D
Expert Explanation: Fluoxetine is a Selective Serotonin Reuptake Inhibitor (SSRI)
that requires several weeks to reach steady state and therapeutic levels. Patients
often feel initial side effects before the mood-lifting benefits begin. It is crucial to
manage patient expectations to ensure adherence during the first month of therapy.
2. When prescribing Amitriptyline (Elavil) for a patient with chronic pain, which side
effect profile should be monitored most closely?
A. Excessive salivation and diarrhea
,B. Hypertension and increased energy levels
C. Anticholinergic effects such as dry mouth, blurred vision, and urinary retention
D. Significant weight loss and insomnia
Correct Answer: C
Expert Explanation: Amitriptyline is a Tricyclic Antidepressant (TCA) known for
its strong anticholinergic properties. These effects occur because TCAs block
muscarinic receptors throughout the body. Monitoring is essential, especially in
elderly patients who are more prone to confusion and falls associated with these
side effects.
3. A patient taking Phenelzine (Nardil) for depression must be instructed to avoid
which of the following foods to prevent a hypertensive crisis?
A. Aged cheeses and red wine
B. Fresh green leafy vegetables
C. Whole grain breads and cereals
D. Citrus fruits and juices
Correct Answer: A
Expert Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI) that
prevents the breakdown of tyramine. Ingestion of tyramine-rich foods like aged
,cheese, cured meats, and red wine can lead to a massive release of norepinephrine.
This results in severe vasoconstriction and a potentially fatal hypertensive crisis.
4. Which laboratory value is most important to monitor in a patient receiving Lithium
for bipolar disorder?
A. Serum calcium levels
B. Serum sodium levels
C. Liver function tests
D. Amylase and lipase
Correct Answer: B
Expert Explanation: Lithium is a salt and is handled by the kidneys in a manner
similar to sodium. If sodium levels drop, the kidneys will retain lithium to
compensate, leading to toxic lithium levels. Maintaining a consistent sodium intake
and monitoring serum levels is vital for safety.
5. A patient is started on Valproic acid (Depakote) for seizure control. Which
laboratory tests should be performed at baseline and periodically?
A. Renal function and chest X-ray
B. Liver function tests and platelet count
C. Serum electrolytes and uric acid
, D. Vitamin B12 and folate levels
Correct Answer: B
Expert Explanation: Valproic acid carries black box warnings for hepatotoxicity
and pancreatitis. It can also cause thrombocytopenia, especially at higher doses.
Regular monitoring of LFTs and CBC with platelets is required to detect early signs
of organ damage or hematologic issues.
6. Which of the following is a primary safety concern for a patient starting Clozapine
(Clozaril) for treatment-resistant schizophrenia?
A. Agranulocytosis
B. Hypertensive crisis
C. Excessive weight loss
D. Persistent dry cough
Correct Answer: A
Expert Explanation: Clozapine is associated with a risk of severe agranulocytosis,
which is a life-threatening decrease in white blood cell count. Because of this risk,
patients must participate in a strict REMS program that requires frequent blood
monitoring. This medication is typically reserved for patients who have failed other
antipsychotic trials.
