NUR 552 PSYCHOPHARMACOLOGY EXAM 3"
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EXAM 3 PRACTICE QUESTIONS
NEWEST MODEL 2026 EXAM LATEST
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A patient with major depressive disorder reports, "I'm not sad anymore, but I
still feel flat and unmotivated." She has been on escitalopram for 10 weeks.
Which neurotransmitter deficit most likely persists?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
B — Dopamine
Rationale: Persistent flat affect, apathy, low motivation, and fatigue after SSRI =
reduced positive affect, driven by dopamine deficiency, not serotonin.
A 45-year-old man with depression and chronic diabetic neuropathy requires
pharmacologic treatment that addresses both conditions. Which
neurotransmitter systems should be prioritized?
A. Serotonin only
B. Dopamine only
C. Serotonin and norepinephrine
D. GABA and glutamate
C — Serotonin + Norepinephrine
Rationale: Neuropathic pain and depression share descending noradrenergic
pathways; SNRIs treat both.
A patient presents with hypersomnia, psychomotor retardation, apathy, and
fatigue. Which SSRI is pharmacologically best matched to this symptom
profile?
A. Paroxetine
B. Fluvoxamine
C. Fluoxetine
D. Citalopram
C — Fluoxetine
Rationale: Activating SSRI; 5-HT2C antagonism improves energy and motivation.
Best for hypersomnia and psychomotor retardation.
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Why do SNRIs improve concentration without causing euphoria?
A. They block dopamine reuptake globally
B. Dopamine increases occur only in the prefrontal cortex
C. Dopamine increases occur in the nucleus accumbens
D. They directly stimulate dopamine receptors
B — Dopamine increases only in the PFC
Rationale: NET inhibition increases dopamine only in the prefrontal cortex, improving
cognition without euphoria.
A patient experiences severe withdrawal symptoms after missing two doses of
an antidepressant. Which medication is most likely responsible?
A. Fluoxetine
B. Sertraline
C. Venlafaxine
D. Escitalopram
C — Venlafaxine
Rationale: Short half-life + strong NE effects = severe discontinuation syndrome.
Which brain region is most associated with anhedonia?
A. Amygdala
B. Hypothalamus
C. Nucleus accumbens
D. Cerebellum
C — Nucleus accumbens
Rationale: Core reward/pleasure center; dopaminergic dysfunction here =
anhedonia.
A patient on paroxetine complains of weight gain, sedation, and sexual
dysfunction. Which receptor activity most contributes to these effects?
A. Dopamine receptor agonism
B. Muscarinic antagonism
C. Alpha-1 agonism
D. NMDA antagonism
B — Muscarinic antagonism
Rationale: Paroxetine has anticholinergic effects → weight gain, sedation, sexual
dysfunction.
, Page 4 of 52
A 70-year-old patient on citalopram develops confusion and weakness. Which
lab abnormality is most concerning?
A. Elevated potassium
B. Hyponatremia
C. Elevated creatinine
D. Elevated glucose
B — Hyponatremia
Rationale: SSRIs can cause SIADH, especially in older adults → confusion,
weakness.
Which neurotransmitter is most associated with negative affect?
A. Dopamine
B. Serotonin
C. Norepinephrine
D. Histamine
B — Serotonin
Rationale: Negative affect (guilt, fear, anxiety, hostility) = serotonergic dysfunction.
A patient with treatment-resistant depression and psychotic features presents
with acute suicidality. Which intervention is most appropriate?
A. TMS
B. DBS
C. ECT
D. SSRI augmentation
C — ECT
Rationale: Fastest, most robust treatment for psychotic depression + suicidality.
A patient presents with depression dominated by reduced positive affect.
Which symptoms support this profile? (Select all that apply)
A. Loss of pleasure
B. Fatigue
C. Guilt
D. Low motivation
E. Hostility
A, B, D
Loss of pleasure, fatigue, low motivation = reduced positive affect.