Free Psychopharmacology MCQs with Answers

• A. Increased prolactin secretion
• B. Reduced thyroid hormone release
• C. Excess cortisol secretion
• D. Decreased adrenal function

Explanation: Risperidone can block dopamine and increase prolactin secretion, causing galactorrhoea, breast enlargement, or menstrual changes.

• A. I should keep my salt and fluid intake fairly consistent.
• B. I should avoid drinking water during hot weather.
• C. I should greatly increase my salt intake each day.
• D. I should stop eating foods that contain potassium.

Explanation: Sudden changes in sodium or fluid intake can alter lithium levels and increase the risk of toxicity.

• A. Serum creatinine and estimated renal function
• B. Serum amylase and faecal occult blood
• C. Prothrombin time and serum bilirubin
• D. Peak expiratory flow and oxygen saturation

Explanation: Lithium is eliminated mainly by the kidneys, so renal function should be assessed before and during treatment.

• A. Assist the patient to sit or lie down and check blood pressure.
• B. Offer the patient a high-protein snack before walking again.
• C. Encourage the patient to continue walking to build tolerance.
• D. Give the next dose early to prevent further dizziness.

Explanation: Amitriptyline can cause orthostatic hypotension, making a fall the immediate safety risk.

• A. Notify the prescriber about possible discontinuation symptoms.
• B. Tell the patient to double the next dose of paroxetine.
• C. Explain that these symptoms confirm a relapse of depression.
• D. Advise the patient to start another antidepressant without review.

Explanation: Abrupt withdrawal from paroxetine may cause dizziness, nausea, sensory disturbances, and irritability.

• A. Use sunscreen and avoid prolonged direct sunlight.
• B. Avoid all foods containing tyramine during treatment.
• C. Restrict daily fluid intake to prevent ankle swelling.
• D. Take the medicine only when severe anxiety occurs.

Explanation: Chlorpromazine can cause photosensitivity, so protective clothing, sunscreen, and avoidance of prolonged sunlight are appropriate.

• A. Complete blood count with platelet count
• B. Serum calcium with parathyroid hormone
• C. Urinalysis with urine ketone testing
• D. Thyroid antibodies with thyroid ultrasound

Explanation: Valproate can cause thrombocytopenia, which may present with bruising or bleeding.

• A. Take it immediately before bed when able to sleep.
• B. Take it early in the evening before preparing dinner.
• C. Take an extra tablet if sleep does not occur quickly.
• D. Drink alcohol with it to increase its sedative effect.

Explanation: Zolpidem should be taken immediately before bedtime when the patient can remain in bed for a full night.

• A. The patient sleeps longer and speaks less rapidly.
• B. The patient reports hearing fewer voices at night.
• C. The patient has increased appetite and weight gain.
• D. The patient develops a mild fine hand tremor.

Explanation: Improved sleep and reduced pressured speech suggest that manic activation is decreasing.

• A. They increase serotonin activity in the synaptic cleft.
• B. They block dopamine receptors in the basal ganglia.
• C. They increase gamma-aminobutyric acid at receptor sites.
• D. They prevent noradrenaline release from sympathetic nerves.

Explanation: Selective serotonin reuptake inhibitors reduce serotonin reuptake, increasing serotonin availability in the synaptic cleft.

• A. Administer both medicines with extra oral fluids
• B. Advise the patient to take ibuprofen only at bedtime
• C. Ask the prescriber to review the combination
• D. Give the lithium dose after the ibuprofen dose

Explanation: Ibuprofen and other nonsteroidal anti-inflammatory drugs can reduce renal lithium clearance and raise the serum lithium concentration.

• A. Akathisia
• B. Acute dystonia
• C. Drug-induced parkinsonism
• D. Tardive dyskinesia

Explanation: Akathisia causes inner restlessness and a compelling need to move. Dystonia causes sustained muscle spasms, parkinsonism causes tremor and…

• A. Assess bowel sounds and abdominal distension
• B. Obtain an electrocardiogram and monitor rhythm
• C. Ask about the patient's usual sleep pattern
• D. Check for increased appetite and weight gain

Explanation: Tricyclic antidepressant overdose can cause life-threatening cardiac conduction disturbances and dysrhythmias, so cardiac monitoring and…

• A. Place the patient in a quiet room and reassess later
• B. Hold the next antidepressant dose and notify the prescriber urgently
• C. Encourage the patient to drink water and walk slowly
• D. Administer the next dose with an antacid

Explanation: This presentation suggests a hypertensive crisis related to an interaction between an MAOI and a tyramine-containing food.

• A. “Valproate is safe throughout pregnancy when taken with food.”
• B. “Stop the medicine today if you miss one menstrual period.”
• C. “Discuss safer treatment options and effective contraception promptly.”
• D. “Double the dose during pregnancy to prevent mood episodes.”

Explanation: Valproate is associated with important fetal risks, including neural tube and other congenital abnormalities, so pregnancy planning…

• A. Stop it suddenly to prevent further sedation
• B. Reduce it only according to a supervised tapering plan
• C. Take two doses tomorrow if anxiety returns
• D. Replace it with alcohol during the taper

Explanation: Long-term benzodiazepine use can produce physical dependence, and abrupt withdrawal may cause severe anxiety, insomnia, tremors, seizures…

• A. Give the medicine late at night after the evening meal
• B. Give the medicine early in the day and monitor sleep
• C. Crush every sustained-release tablet before giving it
• D. Give an extra dose whenever the child is irritable

Explanation: Methylphenidate can cause insomnia, so morning administration helps limit sleep disturbance.

• A. “Stop it now if your voices have completely gone.”
• B. “Continue it as prescribed and discuss concerns before stopping.”
• C. “Take it only on days when you feel suspicious.”
• D. “Replace it with an over-the-counter sleep medicine.”

Explanation: Improvement usually reflects effective treatment, not elimination of the risk of relapse.

• A. The oral medicine prevents all injection-site pain
• B. The injection may require time to reach effective blood levels
• C. The oral medicine permanently replaces the injection
• D. The injection works only when taken with oral lithium

Explanation: Some long-acting injectable antipsychotics have a delayed onset or require oral overlap while therapeutic concentrations develop.

• A. Document the behaviour as expected sadness
• B. Assess for mania and notify the prescriber promptly
• C. Suggest vigorous exercise before the next dose
• D. Tell the patient to stop all medicines immediately

Explanation: Reduced need for sleep, pressured speech, grandiosity, and risky behaviour suggest a manic switch or an underlying bipolar disorder.