Test 5 Question 3. While working in the emergency room you evaluate a patient with confusion, myoclonus, diarrhea, hypotension, tachycardia, and a normal creatine phosphokinase (CPK) level. The patient is not speaking. His family tells you that he was recently started on a new medication by his psychiatrist for treatment of bipolar disorder. They don’t know the name of the medication or what kind of medication it was. Using your astute clinical skills and significant psychiatric knowledge you narrow the diagnosis down to either neuroleptic malignant syndrome (NMS) or serotonin syndrome. But alas, you must pick one diagnosis for the medical record. Which one will it be and why?

Test 5 Question 7. Which one of the following is not an inhibitor of cytochrome P450 (CYP) 1A2?

Test 5 Question 27. A patient in treatment for bipolar disorder reports severe mid-upper abdominal pain radiating to the back, nausea, anorexia, fever, and evidence of acute abdominal pain. Pain is worse after eating and upon lying down. She is taking citalopram
and valproic acid. Which of the following tests would be most useful in making a diagnosis?

Test 5 Question 43. Which one of the following is not a substrate for CYP 2D6?

Test 5 Question 55. Caution should be exercised when prescribing which one of the following to a patient on carbamazepine because the combination will increase carbamazepine levels?

Test 5 Question 61. Why does mirtazapine decrease nausea?

Test 5 Question 73. Mirtazapine works via action on which of the following receptors?

Test 5 Question 91. Which of the following classes of psychotropic medications has the best documented treatment effects for agitation in the demented patient?

Test 5 Question 96. Which one of the following properties of atypical antipsychotics is hypothesized to be responsible for these medications being less likely to produce extrapyramidal side effects?

Test 5 Question 100. When triiodothyronine is added to a tricyclic antidepressant for augmentation, the clinician needs to be cautious if:

Test 5 Question 101. One of your patients has been taking zolpidem for sleep recently and started having sleep-walking episodes on the medication. She finds these episodes to be disturbing. She asks you about taking eszopiclone instead. Which of the following possible responses to her question is most accurate?

Test 5 Question 105. Which of the following is true about administering different mood stabilizers together?

Test 5 Question 109. Which of the following statements about benzodiazepines is correct?

Test 5 Question 112. The following choices are potential side effects of lithium except:

Test 5 Question 114. Which of the following terms refers to spastic contractions of discrete muscle groups such as the neck, tongue, eyes, or back?

Test 5 Question 115. Which one of the following is not an inducer of CYP 3A4?

Test 5 Question 120. A 67-year-old male carries a diagnosis of bipolar disorder and is being treated with carbamazepine. His family brings him to the ER because he has become confused and disoriented over the past 2 days. He is afebrile and has no neurological deficits. Although you could reasonably order any of the following tests to evaluate his condition, which of the following is most important that you check given the patient’s history?

Test 5 Question 121. Which of the following medications would be the best choice for a patient with psychosis and impaired hepatic function?

Test 5 Question 123. Which one of the following statements is false concerning desvenlafaxine extended-release tablets (Pristiq)?

Test 5 Question 128. Naltrexone extended-release injectable suspension (Vivitrol) is indicated for treatment of which of the following disorders?

Test 5 Question 130. Which of the following medications is a serotonin and norepinephrine reuptake inhibitor, lacks significant antihistaminic effects, can cause withdrawal symptoms if stopped abruptly, and has an indication for neuropathic pain?

Test 5 Question 126. Which one of the following statements is false concerning atomoxetine (Strattera)?

Test 5 Question 135. Which of the following statements is correct concerning clozapine?

Test 5 Question 147. Which of the following medications is a partial nicotine agonist that decreases craving and withdrawal in patients trying to stop smoking?

Test 5 Question 150. One of your patients asks you for information about mirtazapine. If you made all of the following statements to the patient, which one would be considered factually inaccurate?