CHAMBERL AIN COLLEGE OF NURSING
School of Nursing · NR 546
NR 546 — Psychopharmacology
Academic Year: 2026/2027
Final Practice Exam · Question Bank
Question 1
Which of the following is considered first line treatment for depression?
A. SSRI
B. FGA
C. SNRI
D. MAOI
CORRECT ANSWER: A. SSRI
RATIONALE:
SSRIs are considered first-line treatment for depression due to their favorable side effect
profile, safety, and efficacy. They are better tolerated than TCAs and MAOIs, making them
the preferred initial choice for most patients with major depressive disorder.
, Question 2
Which medication is considered the best tolerated SSRI?
A. Venlafaxine
B. Bupropion
C. Sertraline
D. Escitalopram
CORRECT ANSWER: D. Escitalopram
RATIONALE:
Escitalopram is considered the best-tolerated SSRI due to its favorable side effect profile,
including less GI distress and fewer drug interactions compared to other SSRIs. It has a
clean pharmacological profile with minimal CYP450 interactions.
Question 3
During a 4 week follow up appointment, Rashida, who is prescribed Sertraline 25mg
qAM reports slight improvement in depression symptoms and tolerating medication
well. Which of the following should the PMHNP do?
A. Increase Sertraline dose
B. Switch to an SNRI
C. Switch to a different SSRI
D. Add Trazodone qHS for sleep.
CORRECT ANSWER: A. Increase Sertraline dose
RATIONALE:
At 4 weeks with only slight improvement, the sertraline dose should be increased. The
starting dose of 25mg is subtherapeutic for most patients; the typical therapeutic dose
range is 50-200mg. Since the patient is tolerating the medication well, dose escalation is
appropriate.
, Question 4
Which SSRI has a mild antihistamine effect?
A. Paroxetine
B. Fluoxetine
C. Citalopram
D. Sertraline
CORRECT ANSWER: C. Citalopram
RATIONALE:
Citalopram has mild antihistamine (H1) properties, which contribute to its sedative effects
and can be beneficial for patients with anxiety or insomnia. However, this effect is less
pronounced than with more sedating antidepressants like mirtazapine or trazodone.
Question 5
When treating a patient for major depression disorder which medication would the
PMHNP consider first?
A. Depakote
B. Selegiline
C. Escitalopram
D. Isocarboxazid
CORRECT ANSWER: C. Escitalopram
RATIONALE:
Escitalopram is a first-line SSRI for major depressive disorder. It has a favorable side effect
profile, minimal drug interactions, and is well-tolerated. Depakote is a mood stabilizer, while
selegiline and isocarboxazid are MAOIs typically reserved for treatment-resistant
depression.
, Question 6
Which of the following medication should be considered for a patient diagnosed with
major depressive disorder who reports "always forgetting to take my pills"?
A. Mirtazapine
B. Fluvoxamine
C. Fluoxetine
D. Carbamazepine
CORRECT ANSWER: C. Fluoxetine
RATIONALE:
Fluoxetine has a long half-life (1-3 days, with active metabolite up to 2 weeks), making it
more forgiving if a dose is missed. This is advantageous for patients with adherence
difficulties. Mirtazapine, fluvoxamine, and carbamazepine have shorter half-lives.
Question 7
Which medication should the PMHNP prescribe for a patient diagnosed with major
depressive disorder but takes multiple medications for other chronic conditions?
A. Sertraline
B. Escitalopram
C. Buspirone
D. Clonazepam
CORRECT ANSWER: B. Escitalopram
RATIONALE:
Escitalopram is the SSRI with the least potential for CYP450 drug interactions, making it the
safest choice for patients on multiple medications. Sertraline has some CYP interactions;
buspirone is an anxiolytic not an antidepressant; clonazepam is a benzodiazepine.
School of Nursing · NR 546
NR 546 — Psychopharmacology
Academic Year: 2026/2027
Final Practice Exam · Question Bank
Question 1
Which of the following is considered first line treatment for depression?
A. SSRI
B. FGA
C. SNRI
D. MAOI
CORRECT ANSWER: A. SSRI
RATIONALE:
SSRIs are considered first-line treatment for depression due to their favorable side effect
profile, safety, and efficacy. They are better tolerated than TCAs and MAOIs, making them
the preferred initial choice for most patients with major depressive disorder.
, Question 2
Which medication is considered the best tolerated SSRI?
A. Venlafaxine
B. Bupropion
C. Sertraline
D. Escitalopram
CORRECT ANSWER: D. Escitalopram
RATIONALE:
Escitalopram is considered the best-tolerated SSRI due to its favorable side effect profile,
including less GI distress and fewer drug interactions compared to other SSRIs. It has a
clean pharmacological profile with minimal CYP450 interactions.
Question 3
During a 4 week follow up appointment, Rashida, who is prescribed Sertraline 25mg
qAM reports slight improvement in depression symptoms and tolerating medication
well. Which of the following should the PMHNP do?
A. Increase Sertraline dose
B. Switch to an SNRI
C. Switch to a different SSRI
D. Add Trazodone qHS for sleep.
CORRECT ANSWER: A. Increase Sertraline dose
RATIONALE:
At 4 weeks with only slight improvement, the sertraline dose should be increased. The
starting dose of 25mg is subtherapeutic for most patients; the typical therapeutic dose
range is 50-200mg. Since the patient is tolerating the medication well, dose escalation is
appropriate.
, Question 4
Which SSRI has a mild antihistamine effect?
A. Paroxetine
B. Fluoxetine
C. Citalopram
D. Sertraline
CORRECT ANSWER: C. Citalopram
RATIONALE:
Citalopram has mild antihistamine (H1) properties, which contribute to its sedative effects
and can be beneficial for patients with anxiety or insomnia. However, this effect is less
pronounced than with more sedating antidepressants like mirtazapine or trazodone.
Question 5
When treating a patient for major depression disorder which medication would the
PMHNP consider first?
A. Depakote
B. Selegiline
C. Escitalopram
D. Isocarboxazid
CORRECT ANSWER: C. Escitalopram
RATIONALE:
Escitalopram is a first-line SSRI for major depressive disorder. It has a favorable side effect
profile, minimal drug interactions, and is well-tolerated. Depakote is a mood stabilizer, while
selegiline and isocarboxazid are MAOIs typically reserved for treatment-resistant
depression.
, Question 6
Which of the following medication should be considered for a patient diagnosed with
major depressive disorder who reports "always forgetting to take my pills"?
A. Mirtazapine
B. Fluvoxamine
C. Fluoxetine
D. Carbamazepine
CORRECT ANSWER: C. Fluoxetine
RATIONALE:
Fluoxetine has a long half-life (1-3 days, with active metabolite up to 2 weeks), making it
more forgiving if a dose is missed. This is advantageous for patients with adherence
difficulties. Mirtazapine, fluvoxamine, and carbamazepine have shorter half-lives.
Question 7
Which medication should the PMHNP prescribe for a patient diagnosed with major
depressive disorder but takes multiple medications for other chronic conditions?
A. Sertraline
B. Escitalopram
C. Buspirone
D. Clonazepam
CORRECT ANSWER: B. Escitalopram
RATIONALE:
Escitalopram is the SSRI with the least potential for CYP450 drug interactions, making it the
safest choice for patients on multiple medications. Sertraline has some CYP interactions;
buspirone is an anxiolytic not an antidepressant; clonazepam is a benzodiazepine.
