NR 546 / NR546 Psychopharmacology Midterm Exam
Practice Test Actual 2023/2024 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Basic Neurobiology & Pharmacodynamics (10
Questions)
Q1: A patient on fluoxetine reports sexual dysfunction. Which antidepressant is most
likely to have a lower incidence of sexual side effects?
A. Paroxetine
B. Sertraline
C. Bupropion
D. Escitalopram
Correct Answer: C
Rationale: Correct because bupropion is the only antidepressant with a favorable
sexual side effect profile.
Q2: In the dopamine hypothesis of schizophrenia, psychosis is thought to be caused
by:
A. Decreased dopamine in the prefrontal cortex
B. Increased dopamine in the mesolimbic pathway
C. Decreased dopamine in the nigrostriatal pathway
D. Increased serotonin in the cortex
Correct Answer: B
Rationale: Correct because mesolimbic dopamine hyperactivity is associated with
positive symptoms.
Q3: The mechanism of action of selective serotonin reuptake inhibitors is:
A. Inhibition of serotonin reuptake and increased synaptic serotonin
B. Blockade of dopamine receptors
,C. Enhancement of GABA activity
D. NMDA receptor antagonism
Correct Answer: A
Rationale: Correct because SSRIs block serotonin transporters, increasing synaptic
serotonin.
Q4: The CYP2D6 enzyme is responsible for metabolizing which class of
medications?
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. Both B and C
Correct Answer: D
Rationale: Correct because CYP2D6 metabolizes many SSRIs and antipsychotics.
Q5: The NMDA receptor antagonist used in treatment-resistant depression is:
A. Ketamine
B. Dextromethorphan
C. Memantine
D. Amantadine
Correct Answer: A
Rationale: Correct because ketamine is an NMDA receptor antagonist approved for
TRD.
Q6: A patient on esketamine for TRD must be monitored for:
A. Dissociation
B. Hypertension
C. Sedation
D. All of the above
Correct Answer: D
Rationale: Correct because esketamine can cause all of these side effects.
Q7: A patient with bipolar depression is started on lumateperone. What is the
mechanism?
A. Dopamine receptor antagonist with serotonin modulation
B. Dopamine receptor agonist
C. Serotonin reuptake inhibitor
, D. NMDA antagonist
Correct Answer: A
Rationale: Correct because lumateperone is a dopamine antagonist with serotonin
properties.
Q8: A patient on brexpiprazole should be counseled that it is a:
A. Partial D2 agonist with serotonin modulation
B. Full D2 antagonist
C. Selective serotonin reuptake inhibitor
D. GABA-A agonist
Correct Answer: A
Rationale: Correct because brexpiprazole is a partial dopamine agonist with
serotonin effects.
Q9: Which medication is an atypical antidepressant that acts on dopamine and
norepinephrine?
A. Bupropion
B. Mirtazapine
C. Trazodone
D. Vilazodone
Correct Answer: A
Rationale: Correct because bupropion inhibits dopamine and norepinephrine
reuptake.
Q10: A patient on vortioxetine should be counseled about which potential benefit?
A. Weight loss
B. Improved cognition
C. Better sleep
D. Lower cost
Correct Answer: B
Rationale: Correct because vortioxetine is associated with cognitive improvement.
SECTION 2: Pharmacokinetics in Psychiatric Populations (8
Questions)
Practice Test Actual 2023/2024 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Basic Neurobiology & Pharmacodynamics (10
Questions)
Q1: A patient on fluoxetine reports sexual dysfunction. Which antidepressant is most
likely to have a lower incidence of sexual side effects?
A. Paroxetine
B. Sertraline
C. Bupropion
D. Escitalopram
Correct Answer: C
Rationale: Correct because bupropion is the only antidepressant with a favorable
sexual side effect profile.
Q2: In the dopamine hypothesis of schizophrenia, psychosis is thought to be caused
by:
A. Decreased dopamine in the prefrontal cortex
B. Increased dopamine in the mesolimbic pathway
C. Decreased dopamine in the nigrostriatal pathway
D. Increased serotonin in the cortex
Correct Answer: B
Rationale: Correct because mesolimbic dopamine hyperactivity is associated with
positive symptoms.
Q3: The mechanism of action of selective serotonin reuptake inhibitors is:
A. Inhibition of serotonin reuptake and increased synaptic serotonin
B. Blockade of dopamine receptors
,C. Enhancement of GABA activity
D. NMDA receptor antagonism
Correct Answer: A
Rationale: Correct because SSRIs block serotonin transporters, increasing synaptic
serotonin.
Q4: The CYP2D6 enzyme is responsible for metabolizing which class of
medications?
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. Both B and C
Correct Answer: D
Rationale: Correct because CYP2D6 metabolizes many SSRIs and antipsychotics.
Q5: The NMDA receptor antagonist used in treatment-resistant depression is:
A. Ketamine
B. Dextromethorphan
C. Memantine
D. Amantadine
Correct Answer: A
Rationale: Correct because ketamine is an NMDA receptor antagonist approved for
TRD.
Q6: A patient on esketamine for TRD must be monitored for:
A. Dissociation
B. Hypertension
C. Sedation
D. All of the above
Correct Answer: D
Rationale: Correct because esketamine can cause all of these side effects.
Q7: A patient with bipolar depression is started on lumateperone. What is the
mechanism?
A. Dopamine receptor antagonist with serotonin modulation
B. Dopamine receptor agonist
C. Serotonin reuptake inhibitor
, D. NMDA antagonist
Correct Answer: A
Rationale: Correct because lumateperone is a dopamine antagonist with serotonin
properties.
Q8: A patient on brexpiprazole should be counseled that it is a:
A. Partial D2 agonist with serotonin modulation
B. Full D2 antagonist
C. Selective serotonin reuptake inhibitor
D. GABA-A agonist
Correct Answer: A
Rationale: Correct because brexpiprazole is a partial dopamine agonist with
serotonin effects.
Q9: Which medication is an atypical antidepressant that acts on dopamine and
norepinephrine?
A. Bupropion
B. Mirtazapine
C. Trazodone
D. Vilazodone
Correct Answer: A
Rationale: Correct because bupropion inhibits dopamine and norepinephrine
reuptake.
Q10: A patient on vortioxetine should be counseled about which potential benefit?
A. Weight loss
B. Improved cognition
C. Better sleep
D. Lower cost
Correct Answer: B
Rationale: Correct because vortioxetine is associated with cognitive improvement.
SECTION 2: Pharmacokinetics in Psychiatric Populations (8
Questions)
