Psychopharmacology for Advanced Practice Nurses
Chapter Exam Questions
Course Introduction
This course provides advanced practice nurses with comprehensive knowledge of psychopharmacology, focusing on the principles and clinical application of psychiatric medications across diverse populations. Students will explore the pharmacokinetics, pharmacodynamics, and side effect profiles of major classes of psychotropic drugs, including antidepressants, antipsychotics, mood stabilizers, anxiolytics, and stimulants. Emphasis is placed on evidence-based medication management, patient safety, monitoring for adverse effects, drug interactions, and consideration of special populations such as pediatric, geriatric, and pregnant patients. The course prepares nurses to integrate pharmacological interventions with holistic care strategies in the management of complex mental health disorders.
Recommended Textbook
Psychiatric Advanced Practice Nursing 1st Edition by Perese
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Page 2
Chapter 1: Theoretical Framework of Practice
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Q1) Nobel Prize winner Eric Kandel demonstrated that the brain
A) Is plastic before birth but becomes hard-wired at birth
B) Has plasticity and can change during the first 3 years of life
C) Has plasticity that allows it to make new connections in response to learning
D) Is unable to make new connections after age 26
Answer: C
Q2) Temperament-a genetically influenced early form of personality-describes an infant's pattern of central nervous system responses and behaviors. Among the different types of temperament, which one is associated with more impairment of brain functioning and, in the absence of positive, nurturing parenting, is a risk factor for later development of psychiatric disorders?
A) Easy
B) Slow-to-warm-up/inhibited
C) Mixed
D) Difficult
Answer: D
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Chapter
Brain Functioning, Brain Development and Prenatal and
Perinatal Factors Disrupting Brain Development
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Q1) Which structure of the brain is involved in learning, processing information into memories, and assigning the time and the place to memories?
A) Hippocampus
B) Olfactory bulb
C) Limbic system
D) Occipital lobe
Answer: A
Q2) The function of this brain structure was formerly believed to be limited to maintaining balance and learning motor skills but is now believed to be involved in learning and emotions and may be involved in autism. It is the
A) Cerebellum
B) Insula
C) Corpus callosum
D) Pons
Answer: A
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Chapter 3: Postnatal Influences on Development of
Psychopathology
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Q1) Among children who have experienced chronic exposure to family violence, it has been found that
A) The children may lack capacity for emotional self-regulation.
B) Most of the children are able to integrate their experiences into a positive inner model of the world.
C) As adolescents, they have lower rates of aggressive behavior problems.
D) The rate of adult psychopathology is the same as that of the general population.
Answer: A
Q2) It is known that childhood exposure to maltreatment
A) Is associated with increased rates of physical and psychiatric disorders
B) Occurs in 10% of U.S. children
C) Is most often exposure to sexual abuse
D) Usually involves a perpetrator who is unknown to the child
Answer: A
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5
Chapter 4: Communicating, Interviewing and Assessing
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Q1) In a biopsychosocial assessment, which of the following questions might be used to assess the social domain?
A) Did any medical conditions precipitate the psychiatric symptoms?
B) Did the patient have any childhood attentional problems or school phobia?
C) Has the patient ever attempted suicide or harmed himself?
D) Have the symptoms affected the patient's social and work functioning?
Q2) Open-ended questions
A) Are useful in obtaining direct responses
B) Define the focus of interest
C) Are useful in the beginning of an interview
D) Define the boundaries of the therapeutic alliance
Q3) Validation is a communication strategy used to
A) Let the patient know that his or her feelings are reasonable.
B) Evaluate change in symptoms or behaviors.
C) Prompt the patient to continue talking.
D) Elicit more information about a response.
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6
Chapter 5: Case Formulation and Diagnosis, Differential
Diagnoses and Developing a Biopsychosocial Plan of Care
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Q1) A precipitating event might be
A) Financial losses or loss of housing
B) Chronic health problems
C) Childhood separations and anxiety disorders
D) Genetic influences and premature birth
Q2) Effective case formulation outcomes are stated
A) In terms of behaviors that must be changed
B) As incorporating efforts of others to achieve goal
C) In broad terms such as life satisfaction
D) As directly related to patients' identified problem or problems
Q3) The primary function of a biopsychosocial case formulation is to
A) Generate an understanding of the person as a whole
B) Identify comorbid medical illnesses
C) Assess the maturity of the patient's defense mechanisms
D) Determine patient's level of social support
Q4) Sociocultural factors have the strongest influence on
A) How diagnosis of a psychiatric disorder is accepted
B) The age of onset of symptoms of a psychiatric disorder
C) The gender distribution of the disorder
D) Prediction of response to psychoeducation
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Chapter 6: Psychopharmacotherapy
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Q1) A patient has been taking haloperidol (Haldol) IM, an antipsychotic drug, for years. You notice that he is grinding his teeth and smacking his lips frequently. You think that he may have
A) Tardive dyskinesia
B) Gustatory hallucinations
C) Spasms of the jaw
D) Parkinsonian symptoms
Q2) Which class of antidepressants has the most anticholinergic side effects?
A) Monoamine oxidase inhibitors (MAOIs)
B) Selective serotonin reuptake inhibitors (SSRIs)
C) Tricyclic antidepressants (TCAs)
D) Serotonin norepinephrine reuptake inhibitors (SNRIs)
Q3) Which of the following reactions is indicative of a dystonic reaction?
A) Oculogyric crisis and spasms of the back muscles
B) Tongue thrusting and lip-smacking movements
C) Pill-rolling hand movement and mask-like facial expression
D) Urinary retention and orthostatic hypotension
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Chapter 7: Psychotherapies
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Q1) The primary purpose of psychotherapy is to facilitate changes by the patient in order to
A) Reduce symptoms of distress
B) Address identified problems
C) Reduce burden on the family
D) Improve vocational functioning
Q2) The core principle of relational therapies that include psychodynamic psychotherapy and interpersonal psychotherapy is that current problems reflect
A) Learned behavioral responses
B) Failure to integrate life experiences
C) Problems with relationships with others
D) Distorted perceptions of ability to cope
Q3) Brief psychotherapy refers to a category of psychotherapies that brings about changes in patients through
A) Therapist-initiated, focused, emotionally corrective interventions
B) Helping patients to develop an understanding of childhood conflicts
C) Participation of family members in treatment sessions
D) Helping patients to develop insight through self-exploration
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9
Chapter 8: Psychosocial Interventions
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Q1) Support groups differ from self-help groups by
A) Use of a drop-in approach
B) Professional leadership
C) Theory of empowerment
D) Emphasis on mastery
Q2) The primary goal of psychological first aid is to
A) Provide a debriefing opportunity
B) Help the patient come to terms with the traumatic event
C) Promote material assistance
D) Educate victims of the possible sequelae such as post-traumatic stress disorder
Q3) Effective interventions to build social networks have been found to include all of the following except
A) Participating in groups that focus on adherence to medication
B) Building new relationships
C) Strengthening existing networks
D) Using ready-made friends or companions
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Chapter 9: Response to Stressors: Bridging Normal
Responses and Psychiatric Disorders
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Q1) It can be said of exposure to traumatic events that
A) The majority of people develop some form of psychopathology.
B) The development of adjustment disorder is likely to follow exposure to life-threatening traumatic events.
C) The normal reaction includes grief, anxiety, and thoughts of suicide.
D) Cognitive appraisal and style of coping have greater influence on outcome than the physical aspects of the traumatic event.
Q2) The key feature of adjustment disorder is
A) An anxiety response to a social event such as speaking in public
B) The response to a known stressor that occurs within 3 months of the stressor
C) A response to an event that is catastrophic, such as witnessing a murder
D) Pervasive anxiety related to a fear of being trapped in an enclosed place
Q3) The process of allostasis includes
A) Mobilization of energy, activation of cognition, and behavioral changes
B) Reduction of production of cortisol
C) Decreased levels of norepinephrine
D) Development of a state of exhaustion
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Page 11
Chapter 10: Phobias, Generalized Anxiety Disorder, Social
Anxiety Disorder and Panic Disorder
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Q1) In considering maintenance treatment for a patient with GAD who is anxious, agitated, and irritable and has sleep problems, which medication(s) might you select?
A) Bupropion (Wellbutrin)
B) A dopamine agonist
C) Paroxetine (Paxil) or sertraline (Zoloft)
D) Alprazolam (Xanax)
Q2) It can be said that in the fear system, the amygdala
A) Serves as a response center for danger and fear
B) Imprints the time and place of an event
C) Evaluates the event in relation to memories of previous experiences
D) Releases hormones that start a cascade of neurohormones and neurotransmitters that prepare the body to respond to a threat
Q3) Leonard avoids going out to eat with his family at restaurants. He is concerned that others may watch him and criticize his table manners. Which is the most likely diagnosis?
A) Agoraphobia
B) Specific situational phobia
C) Social anxiety disorder
D) Generalized anxiety disorder
Page 12
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Chapter 11: Acute Stress Disorder and Posttraumatic Stress Disorder
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Q1) The key feature of acute stress disorder is the presence of A) Sleep disturbances
B) Symptoms of dissociation
C) Increased arousal
D) Recurrent, intrusive thoughts
Q2) Which mental status variation are you most likely to expect for a client diagnosed as having post-traumatic stress disorder?
A) Thought: delusions of grandeur
B) Perceptual: derealization and depersonalization
C) Memory: impaired recent memory
D) Mood: inappropriate, silly
Q3) The current frontline treatment for acute stress disorder is A) Mood stabilizer medications
B) Interpersonal psychotherapy
C) Antianxiety medications
D) Trauma-focused cognitive behavioral therapy
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13
Obsessive-Compulsive
Spectrum Disorders
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Q1) In obsessive-compulsive disorder, patients are likely to experience
A) Obsessions as ego-syntonic
B) Extreme worrying about everyday concerns such as being late
C) Specific worries about the sight of blood
D) Obsessions of symmetry and need to have things just right
Q2) For one-third to one-half of patients with OCD, the onset of the symptoms is
A) After the age of 30 years
B) In the 30s and 40s
C) During childhood or adolescence
D) In middle age
Q3) It can be said of the obsession of hoarding that it is associated with
A) A fear of making a wrong decision in discarding things that might be needed in the future
B) Abnormalities of the fear/anxiety circuitry
C) A feeling that hoarding is ego-syntonic
D) Less severe symptoms and impairment of functioning than other obsessions
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Chapter 13: Depressive Disorders
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Q1) A young adult who works as a court reporter describes herself as being depressed most of the time and says she has been that way since her teens. She denies any weight loss or sleep disturbances. She describes problems with concentration, difficulty making decisions, and lack of energy that are causing her problems at work. Which of the following is the most likely diagnosis?
A) Dysthymia
B) Major depressive disorder with seasonal pattern
C) Major depressive disorder with atypical features
D) Major depressive disorder with melancholic features
Q2) Which of the following is a frontline treatment for insomnia in depressed elderly individuals?
A) Sleep hygiene
B) Benzodiazepines
C) Zolpidem
D) Trazodone
Q3) Compared with unipolar depression, the depressed phase of bipolar disorder
A) Has a later onset
B) Has a more gradual onset
C) Carries a greater risk for suicide
D) Is less frequently accompanied by psychotic symptoms in younger patients
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Chapter 14: Bipolar Disorder
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Q1) In treatment of the acute phase of mania, the focus is on
A) Protecting the patient's biopsychosocial safety
B) Educating the patient about social rhythms theory
C) Interventions that address impairment of vocational functioning
D) Interventions for self-management of finances
Q2) On clinical evaluation, patients with bipolar disorder have been found to have impairment of
A) Balance
B) Executive functioning
C) Production of speech
D) Spatial functioning
Q3) Manic episodes of bipolar disorder are thought be related to A) Changes in diet
B) Disruption of sleep-wake cycles
C) Female gender
D) Advanced age, over 60 years
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Chapter 15: Schizophrenia and Schizoaffective Disorder
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Q1) When used for treatment of a patient with schizophrenia, typical antipsychotics could be expected to be most effective for which of the following symptoms?
A) Social isolation
B) Ineffective individual coping
C) Hallucinations
D) Lack of ability to make decisions
Q2) Men with schizophrenia have
A) An older age of onset
B) Fewer negative symptoms
C) A more favorable premorbid history
D) A less favorable course
Q3) Which of the following features is associated with positive outcome among patients with schizophrenia?
A) Younger age of onset
B) Male gender
C) Living in an industrialized country
D) Having positive symptoms
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Chapter 16: Delirium and Dementia
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Q1) Regarding alcohol withdrawal delirium or delirium tremens, which of the following is true?
A) Symptoms may include hypersomnia and lack of energy.
B) Symptoms may include agitation and abnormal perceptions.
C) Symptom onset often begins with elevated mood.
D) Symptoms often begin within 12 hours of cessation of drinking.
Q2) Medications that are frequently used for patients with dementia are
A) Selective serotonin reuptake inhibitors
B) Selective norepinephrine reuptake inhibitors
C) Acetylcholinesterase inhibitors
D) Monoamine oxidase inhibitors
Q3) Which of the following symptoms is a core feature of frontal-temporal dementia?
A) Speech and language problems
B) Visual hallucinations
C) Confusion and disorientation
D) Loss of balance and falls
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18
Chapter 17: Dual Diagnosis
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Q1) The area of the brain that is involved in substance abuse is the reward center of the brain, which includes the
A) Brainstem
B) Thalamus
C) Cerebellum
D) Ventral tegmental area
Q2) Which of the following medications used to decrease alcohol consumption interferes with the metabolism of alcohol?
A) Naltrexone (ReVia)
B) Disulfiram (Antabuse)
C) Acamprosate (Campral)
D) Extended-release naltrexone injection
Q3) The action produced by cocaine that can cause symptoms of paranoia and hallucinations similar to symptoms of schizophrenia is related to
A) Increase of dopamine
B) Decrease of dopamine
C) Increase of norepinephrine
D) Decrease of glutamate
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19
Chapter 18: Personality Disorders
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Q1) In which of the following personality disorders would there likely be a lower rate of soft neurological signs?
A) Schizotypal
B) Dependent
C) Antisocial
D) Borderline
Q2) Impulsivity and suicidality are often associated with borderline personality disorder. Which of the following pharmacological interventions is frequently used to reduce impulsivity and suicidality?
A) Tricyclic antidepressants
B) Benzodiazepines
C) Selective serotonin reuptake inhibitors
D) Monoamine oxidase inhibitors
Q3) Patients with schizoid personality disorder are likely to
A) Desire relationships but avoid them because of fear of rejection
B) Have perceptual and cognitive distortions
C) Be suspicious, be jealous, and hold a grudge
D) Appear to be cold, aloof, and a loner
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Chapter 19: Prevention of Psychiatric Disorders
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Q1) In prevention of suicide among adults, the most effective intervention is
A) Screening of all patients for suicidal ideation by primary care clinicians
B) Providing debriefing after traumatic events
C) Restricting access to lethal means such as handguns and pesticides
D) Increasing public education programs about suicide
Q2) At this time, in the prevention of schizophrenia, the focus is on
A) Preventing adverse circumstances of birth
B) Promoting childhood resilience
C) Preventing prodromal symptoms from converting to schizophrenia
D) Preventing late-onset schizophrenia
Q3) A factor that has frequently been associated with children's increased risk of experiencing maltreatment is
A) Having two or more children in the family
B) Having a parent with mental illness and substance abuse
C) Having grandparents living with the family
D) Having a limited family budget for leisure activities
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