NR 546 / NR546 Psychopharmacology
Exam Questions and Answers
1. A client diagnosed with Alzheimer's disease has decided to stop treatment. The
nurse practitioner has educated the client that medication discontinuation will result
in the return of cognitive symptoms and the medication may not work as well if
restarted. The client would still like to stop the medication due to gastrointestinal side
effects. Which of the following medications requires tapering?
a. Rivastigmine
b. Donepezil
c. Galantamine
d. Memantine
ANS: B
2. Which of the following best describes the mechanism of action of Acamprosate?
a. Blocks mu-opioid receptors to reduce cravings
b. Reduces glutamate release associated with alcohol withdrawal
c. Irreversibly inhibits aldehyde dehydrogenase
d. Blocks oxidation of alcohol causing unpleasant symptoms
ANS: B
3. Which of the following best describes addiction?
a. A state of adaptation produced with repeated administration of certain drugs
b. A change in behavior caused by biochemical changes in the brain after continued
substance use characterized by preoccupation with and repeated use of a substance
despite negative outcomes
c. Physiological and psychological reactions that occur when use of a substance is
stopped abruptly
d. Condition following ingestion of a substance resulting in changes in level of
consciousness
ANS: B
4. Which of the following neurotransmitters are most implicated in ADHD genetics?
,a. Serotonin and GABA
b. Acetylcholine and glutamate
c. Dopamine and norepinephrine
d. Histamine and orexin
ANS: C
5. Which of the following best describes the neural network associated with ADHD?
a. Abnormalities in the hippocampus circuits and errors in synaptic development
b. Possibly due to abnormalities in the prefrontal cortex circuits or errors in the
synaptic pruning process; both selective and sustained attention are modulated by
the corticostriatal-thalamocortical (CSTC) loop
c. Dysfunction in the amygdala leading to emotional dysregulation
d. Overactivation of the mesolimbic dopamine pathway
ANS: B
6. Which of the following best describes the neural signaling associated with ADHD?
a. Serotonin is too high and dopamine is too low, causing emotional dysregulation
b. GABA is deficient, leading to overactivation of excitatory pathways
c. Norepinephrine and dopamine are too low, associated with inefficient information
processing in the prefrontal circuits
d. Acetylcholine is deficient, leading to memory and attention deficits
ANS: C
7. Which neuroanatomical area is most associated with ADHD symptoms?
a. Hippocampus
b. Amygdala
c. Prefrontal cortex
d. Nucleus accumbens
ANS: C
8. Which of the following is an example of an impulsivity symptom of ADHD?
a. Poor problem solving and difficulty completing tasks
,b. Lack of attention to detail and careless mistakes
c. Excessive talking, blurting things out, and interrupting
d. Losing things and forgetfulness
ANS: C
9. Which of the following is an example of a selective attention symptom of ADHD?
a. Fidgeting and leaving one's seat
b. Lack of attention to detail, careless mistakes, not listening, losing things
c. Difficulty completing tasks and disorganization
d. Excessive talking and interrupting
ANS: B
10. Which of the following is the most appropriate consideration when prescribing
benzodiazepines for alcohol withdrawal in older adults?
a. Benzodiazepines are the safest option and require no special monitoring
b. Acamprosate is the preferred first-line agent in older adults
c. Frequent monitoring is necessary when prescribing benzodiazepines and
Acamprosate should be used with caution
d. Disulfiram is the preferred agent for older adults with alcohol withdrawal
ANS: C
11. Which of the following statements is accurate regarding alcohol treatment in
pregnancy?
a. Acamprosate is the safest medication in pregnancy for alcohol use disorder
b. Naltrexone is commonly used to treat alcohol use disorder in pregnant women, but
its effects on the fetus remain largely unknown
c. Disulfiram is the preferred first-line agent in pregnancy
d. Benzodiazepines are safe and recommended for alcohol withdrawal in pregnancy
ANS: B
12. When should pharmacologic intervention be considered for alcohol withdrawal?
a. Only for mild withdrawal symptoms
, b. When the CIWA-Ar score is below 8
c. For individuals with moderate to severe withdrawal symptoms due to the risk of
increased morbidity and mortality
d. Only after nonpharmacologic treatments have failed for 72 hours
ANS: C
13. Which of the following is correct regarding an alcohol withdrawal
symptom-triggered regimen?
a. Administer benzodiazepine when CIWA-Ar score is 4 or above
b. Reassess CIWA-Ar every 4 hours only
c. Administer benzodiazepine when CIWA-Ar score is 8 or above; reassess every
hour; administer CIWA-Ar every 4-8 hours until score is lower than 8-10 for 24 hours
d. Use IV diazepam only; oral formulations are not appropriate
ANS: C
14. Which of the following are symptoms of mild alcohol withdrawal?
a. Hallucinations, seizures, and delirium tremens
b. Increased blood pressure, confusion, and mild hyperthermia
c. Anxiety, irritability, headache, insomnia, tremors, and nausea/vomiting
d. Disorientation, impaired attention, and death
ANS: C
15. Which of the following are symptoms of severe alcohol withdrawal?
a. Anxiety, irritability, and headache
b. Increased blood pressure, confusion, and rapid breathing
c. Hallucinations, seizures, disorientation, impaired attention, delirium tremens, and
death
d. Nausea, vomiting, and tremors
ANS: C
16. Which of the following are symptoms of moderate alcohol withdrawal?
a. Anxiety, irritability, and tremors
Exam Questions and Answers
1. A client diagnosed with Alzheimer's disease has decided to stop treatment. The
nurse practitioner has educated the client that medication discontinuation will result
in the return of cognitive symptoms and the medication may not work as well if
restarted. The client would still like to stop the medication due to gastrointestinal side
effects. Which of the following medications requires tapering?
a. Rivastigmine
b. Donepezil
c. Galantamine
d. Memantine
ANS: B
2. Which of the following best describes the mechanism of action of Acamprosate?
a. Blocks mu-opioid receptors to reduce cravings
b. Reduces glutamate release associated with alcohol withdrawal
c. Irreversibly inhibits aldehyde dehydrogenase
d. Blocks oxidation of alcohol causing unpleasant symptoms
ANS: B
3. Which of the following best describes addiction?
a. A state of adaptation produced with repeated administration of certain drugs
b. A change in behavior caused by biochemical changes in the brain after continued
substance use characterized by preoccupation with and repeated use of a substance
despite negative outcomes
c. Physiological and psychological reactions that occur when use of a substance is
stopped abruptly
d. Condition following ingestion of a substance resulting in changes in level of
consciousness
ANS: B
4. Which of the following neurotransmitters are most implicated in ADHD genetics?
,a. Serotonin and GABA
b. Acetylcholine and glutamate
c. Dopamine and norepinephrine
d. Histamine and orexin
ANS: C
5. Which of the following best describes the neural network associated with ADHD?
a. Abnormalities in the hippocampus circuits and errors in synaptic development
b. Possibly due to abnormalities in the prefrontal cortex circuits or errors in the
synaptic pruning process; both selective and sustained attention are modulated by
the corticostriatal-thalamocortical (CSTC) loop
c. Dysfunction in the amygdala leading to emotional dysregulation
d. Overactivation of the mesolimbic dopamine pathway
ANS: B
6. Which of the following best describes the neural signaling associated with ADHD?
a. Serotonin is too high and dopamine is too low, causing emotional dysregulation
b. GABA is deficient, leading to overactivation of excitatory pathways
c. Norepinephrine and dopamine are too low, associated with inefficient information
processing in the prefrontal circuits
d. Acetylcholine is deficient, leading to memory and attention deficits
ANS: C
7. Which neuroanatomical area is most associated with ADHD symptoms?
a. Hippocampus
b. Amygdala
c. Prefrontal cortex
d. Nucleus accumbens
ANS: C
8. Which of the following is an example of an impulsivity symptom of ADHD?
a. Poor problem solving and difficulty completing tasks
,b. Lack of attention to detail and careless mistakes
c. Excessive talking, blurting things out, and interrupting
d. Losing things and forgetfulness
ANS: C
9. Which of the following is an example of a selective attention symptom of ADHD?
a. Fidgeting and leaving one's seat
b. Lack of attention to detail, careless mistakes, not listening, losing things
c. Difficulty completing tasks and disorganization
d. Excessive talking and interrupting
ANS: B
10. Which of the following is the most appropriate consideration when prescribing
benzodiazepines for alcohol withdrawal in older adults?
a. Benzodiazepines are the safest option and require no special monitoring
b. Acamprosate is the preferred first-line agent in older adults
c. Frequent monitoring is necessary when prescribing benzodiazepines and
Acamprosate should be used with caution
d. Disulfiram is the preferred agent for older adults with alcohol withdrawal
ANS: C
11. Which of the following statements is accurate regarding alcohol treatment in
pregnancy?
a. Acamprosate is the safest medication in pregnancy for alcohol use disorder
b. Naltrexone is commonly used to treat alcohol use disorder in pregnant women, but
its effects on the fetus remain largely unknown
c. Disulfiram is the preferred first-line agent in pregnancy
d. Benzodiazepines are safe and recommended for alcohol withdrawal in pregnancy
ANS: B
12. When should pharmacologic intervention be considered for alcohol withdrawal?
a. Only for mild withdrawal symptoms
, b. When the CIWA-Ar score is below 8
c. For individuals with moderate to severe withdrawal symptoms due to the risk of
increased morbidity and mortality
d. Only after nonpharmacologic treatments have failed for 72 hours
ANS: C
13. Which of the following is correct regarding an alcohol withdrawal
symptom-triggered regimen?
a. Administer benzodiazepine when CIWA-Ar score is 4 or above
b. Reassess CIWA-Ar every 4 hours only
c. Administer benzodiazepine when CIWA-Ar score is 8 or above; reassess every
hour; administer CIWA-Ar every 4-8 hours until score is lower than 8-10 for 24 hours
d. Use IV diazepam only; oral formulations are not appropriate
ANS: C
14. Which of the following are symptoms of mild alcohol withdrawal?
a. Hallucinations, seizures, and delirium tremens
b. Increased blood pressure, confusion, and mild hyperthermia
c. Anxiety, irritability, headache, insomnia, tremors, and nausea/vomiting
d. Disorientation, impaired attention, and death
ANS: C
15. Which of the following are symptoms of severe alcohol withdrawal?
a. Anxiety, irritability, and headache
b. Increased blood pressure, confusion, and rapid breathing
c. Hallucinations, seizures, disorientation, impaired attention, delirium tremens, and
death
d. Nausea, vomiting, and tremors
ANS: C
16. Which of the following are symptoms of moderate alcohol withdrawal?
a. Anxiety, irritability, and tremors
