NR546-FINALEXAM-PEARLS COMPLETE EXAM STUDY
GUIDE WITH PRACTICE QUESTIONS AND VERIFIED
ANSWERS 2025–2026
First line treatment for depression - correct answer -SSRIs
Common side effect of SSRIs - correct answer -sexual dysfunction
rapid cycling bipolar disorder - correct answer -Minimum of 4 episodes a year
Goal of antidepressant therapy - correct answer -complete remission of symptoms
Serotonin GI effects - correct answer -Due to the fact that 90% of 5HT receptors are located in
GI tract
best tolerated SSRI - correct answer -Escitalopram (Lexapro) also has fewest CYP interactions
Lithium levels - correct answer -Can be increased by NSAIDS and ACE inhibitors
Can be decreased by caffeine and mania
Unaffected by amiloride, furosemide, and sulindac
Lithium purpose - correct answer -Effective treatment for manic episodes, to prevent
reoccurrence and to a lower degree is effective in depressive episodes
Lamotrigine - correct answer -Well tolerated except for the propensity to cause a rash
Monoamines - correct answer -dopamine, norepinephrine, serotonin
,Lamotrigine - correct answer -Is a mood stabilizer
Lithium - correct answer -Well established to prevent suicide in clients with mood disorders
Lithium - correct answer -Has a narrow therapeutic window and requires law draws
1st line treatment for OCD - correct answer -SSRIs are first line. Benzodiazepines are not!!!
Primary action of hallucinogenic drugs such as LSD,mescaline, psilocybin, and MDMA - correct
answer -Agonism of 5HT2A receptors
Hallucinogens may have additional actions at other serotonin receptors (particularly 5HT1A and
5HT2C) and at other neurotransmitter systems, and MDMA in particular also blocks the
serotonin transporter (SERT)
Controls appetite - correct answer -hypothalamus serves as the brain center that controls
appetite by utilizing a complex set of circuits and regulators. One formulation of how the
hypothalamus does this is the notion that there is a major appetite stimulating pathway whose
actions are mediated by two peptides (neuropeptide Y and agouti-related protein)
Phentermine - correct answer -Acts like amphetamine, blocking both the dopamine transporter
(DAT) and the norepinephrine transporter (NET) and, at high doses, the vesicular monoamine
transporter (VMAT)
Buprenorphine - correct answer -Is also approved for <18 year olds
Disulfiram caution - correct answer -Alcohol reaction may occur within two weeks of alcohol
ingestion
, Methadone - correct answer -Is a full mu-receptor agonist with a long half-life, which can
prevent withdrawal symptoms for 24 hours and provide steady control of cravings throughout
the day. In addition to its opioid receptor activity, it is also an antagonist of the N-methyl-D-
aspartate (NMDA) receptor.
Hallucinogenic intoxication - correct answer -pupillary dilation, tachycardia, sweating,
palpitations, blurred vision, tremors, incoordination
Can be perceived as a panic attack and often called a bad trip.
Can experience an acute state of confusion (delirium) where the abuser is disoriented and
agitated.
Disulfiram - correct answer -Irreversibly inhibits aldehyde dehydrogenase resulting in build of
toxic levels of acetaldehyde
Acamprosate reduces glutamate release associated with alcohol withdrawal, naltrexone blocks
the enjoyment of heavy drinking through its action on reward circuitry.
sedative-hypnotics - correct answer -Act at GABA A receptor sites in reward circuits
Impulsive Disorders - correct answer -Focused on reward and associated with Mesolimbic
pathway
The Tuberomammillary nucleus (TMN) - correct answer -contains the on switch where as the
off switch is located in the ventrolateral preoptic nucleus (VLPO)
Guanfacine - correct answer -Is an alpha 2 agonist
Methylphenidate - correct answer -Is a dopamine norepinephrine multimodal
GUIDE WITH PRACTICE QUESTIONS AND VERIFIED
ANSWERS 2025–2026
First line treatment for depression - correct answer -SSRIs
Common side effect of SSRIs - correct answer -sexual dysfunction
rapid cycling bipolar disorder - correct answer -Minimum of 4 episodes a year
Goal of antidepressant therapy - correct answer -complete remission of symptoms
Serotonin GI effects - correct answer -Due to the fact that 90% of 5HT receptors are located in
GI tract
best tolerated SSRI - correct answer -Escitalopram (Lexapro) also has fewest CYP interactions
Lithium levels - correct answer -Can be increased by NSAIDS and ACE inhibitors
Can be decreased by caffeine and mania
Unaffected by amiloride, furosemide, and sulindac
Lithium purpose - correct answer -Effective treatment for manic episodes, to prevent
reoccurrence and to a lower degree is effective in depressive episodes
Lamotrigine - correct answer -Well tolerated except for the propensity to cause a rash
Monoamines - correct answer -dopamine, norepinephrine, serotonin
,Lamotrigine - correct answer -Is a mood stabilizer
Lithium - correct answer -Well established to prevent suicide in clients with mood disorders
Lithium - correct answer -Has a narrow therapeutic window and requires law draws
1st line treatment for OCD - correct answer -SSRIs are first line. Benzodiazepines are not!!!
Primary action of hallucinogenic drugs such as LSD,mescaline, psilocybin, and MDMA - correct
answer -Agonism of 5HT2A receptors
Hallucinogens may have additional actions at other serotonin receptors (particularly 5HT1A and
5HT2C) and at other neurotransmitter systems, and MDMA in particular also blocks the
serotonin transporter (SERT)
Controls appetite - correct answer -hypothalamus serves as the brain center that controls
appetite by utilizing a complex set of circuits and regulators. One formulation of how the
hypothalamus does this is the notion that there is a major appetite stimulating pathway whose
actions are mediated by two peptides (neuropeptide Y and agouti-related protein)
Phentermine - correct answer -Acts like amphetamine, blocking both the dopamine transporter
(DAT) and the norepinephrine transporter (NET) and, at high doses, the vesicular monoamine
transporter (VMAT)
Buprenorphine - correct answer -Is also approved for <18 year olds
Disulfiram caution - correct answer -Alcohol reaction may occur within two weeks of alcohol
ingestion
, Methadone - correct answer -Is a full mu-receptor agonist with a long half-life, which can
prevent withdrawal symptoms for 24 hours and provide steady control of cravings throughout
the day. In addition to its opioid receptor activity, it is also an antagonist of the N-methyl-D-
aspartate (NMDA) receptor.
Hallucinogenic intoxication - correct answer -pupillary dilation, tachycardia, sweating,
palpitations, blurred vision, tremors, incoordination
Can be perceived as a panic attack and often called a bad trip.
Can experience an acute state of confusion (delirium) where the abuser is disoriented and
agitated.
Disulfiram - correct answer -Irreversibly inhibits aldehyde dehydrogenase resulting in build of
toxic levels of acetaldehyde
Acamprosate reduces glutamate release associated with alcohol withdrawal, naltrexone blocks
the enjoyment of heavy drinking through its action on reward circuitry.
sedative-hypnotics - correct answer -Act at GABA A receptor sites in reward circuits
Impulsive Disorders - correct answer -Focused on reward and associated with Mesolimbic
pathway
The Tuberomammillary nucleus (TMN) - correct answer -contains the on switch where as the
off switch is located in the ventrolateral preoptic nucleus (VLPO)
Guanfacine - correct answer -Is an alpha 2 agonist
Methylphenidate - correct answer -Is a dopamine norepinephrine multimodal
