NR 546 Week 3 Exam V2 | NR 546
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 3
Exam) | Chamberlain University
1. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake Inhibitors
(SSRIs) to treat Major Depressive Disorder?
A. Serotonin
B. Norepinephrine
C. Dopamine
D. GABA
Answer: A
Rationale: SSRIs function by inhibiting the reuptake of serotonin (5-HT) at the presynaptic
neuron by blocking the SERT transporter. This leads to an increase in serotonin
concentration in the synaptic cleft, which enhances neurotransmission. Over time, this
pharmacological action is believed to cause desensitization of autoreceptors and improve
mood and anxiety symptoms.
2. A patient is prescribed Venlafaxine (Effexor). Which physiological parameter should the
PMHNP monitor closely at higher doses?
A. Blood glucose
,B. Blood pressure
C. Thyroid function
D. Serum calcium
Answer: B
Rationale: Venlafaxine is a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) that
exhibits dose-dependent effects. At low doses, it primarily inhibits serotonin reuptake, but
at doses above 150 mg, it significantly inhibits norepinephrine reuptake. Because
norepinephrine can cause vasoconstriction and increase heart rate, monitoring for
hypertension is essential for patient safety.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Fluoxetine
B. Sertraline
C. Bupropion
D. Escitalopram
Answer: C
Rationale: Bupropion acts as a Norepinephrine-Dopamine Reuptake Inhibitor (NDRI). It is
known to lower the seizure threshold, especially in patients with pre-existing risks such as
,epilepsy or electrolyte imbalances. Specifically, patients with anorexia or bulimia are at
higher risk for seizures while taking bupropion due to potential metabolic disturbances.
4. When switching a patient from a Selective Serotonin Reuptake Inhibitor (SSRI) to a
Monoamine Oxidase Inhibitor (MAOI), how long is the recommended washout period?
A. 24 hours
B. 14 days
C. 7 days
D. 30 days
Answer: B
Rationale: A washout period is necessary to prevent Serotonin Syndrome, a potentially
life-threatening condition caused by excess serotonin. Most SSRIs require a 14-day
washout period before starting an MAOI to ensure the SSRI has cleared the system.
Fluoxetine is a notable exception, requiring at least 5 weeks due to its long half-life of the
parent drug and its active metabolite.
5. Which of the following describes the mechanism of action of Mirtazapine?
A. Selective Serotonin Reuptake Inhibition
B. Monoamine Oxidase Inhibition
C. Alpha-2 Adrenergic Antagonism
D. Dopamine D2 receptor agonism
, Answer: C
Rationale: Mirtazapine is classified as a Noradrenergic and Specific Serotonergic
Antidepressant (NaSSA). It works primarily by blocking alpha-2 presynaptic autoreceptors
and heteroreceptors, which enhances the release of both norepinephrine and serotonin.
Additionally, it blocks 5-HT2 and 5-HT3 receptors, which helps reduce side effects like
anxiety and nausea commonly associated with other antidepressants.
6. A patient taking Phenelzine (Nardil) must avoid which of the following foods to prevent a
hypertensive crisis?
A. Leafy green vegetables
B. Whole grain breads
C. Citrus fruits
D. Aged cheeses and cured meats
Answer: D
Rationale: Phenelzine is an MAOI that inhibits the breakdown of tyramine in the
gastrointestinal tract. Tyramine is a sympathomimetic amine found in aged, fermented, or
cured foods that can cause a massive release of norepinephrine if not metabolized. This
sudden surge in norepinephrine can lead to dangerous elevations in blood pressure, known
as a hypertensive crisis.
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 3
Exam) | Chamberlain University
1. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake Inhibitors
(SSRIs) to treat Major Depressive Disorder?
A. Serotonin
B. Norepinephrine
C. Dopamine
D. GABA
Answer: A
Rationale: SSRIs function by inhibiting the reuptake of serotonin (5-HT) at the presynaptic
neuron by blocking the SERT transporter. This leads to an increase in serotonin
concentration in the synaptic cleft, which enhances neurotransmission. Over time, this
pharmacological action is believed to cause desensitization of autoreceptors and improve
mood and anxiety symptoms.
2. A patient is prescribed Venlafaxine (Effexor). Which physiological parameter should the
PMHNP monitor closely at higher doses?
A. Blood glucose
,B. Blood pressure
C. Thyroid function
D. Serum calcium
Answer: B
Rationale: Venlafaxine is a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) that
exhibits dose-dependent effects. At low doses, it primarily inhibits serotonin reuptake, but
at doses above 150 mg, it significantly inhibits norepinephrine reuptake. Because
norepinephrine can cause vasoconstriction and increase heart rate, monitoring for
hypertension is essential for patient safety.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Fluoxetine
B. Sertraline
C. Bupropion
D. Escitalopram
Answer: C
Rationale: Bupropion acts as a Norepinephrine-Dopamine Reuptake Inhibitor (NDRI). It is
known to lower the seizure threshold, especially in patients with pre-existing risks such as
,epilepsy or electrolyte imbalances. Specifically, patients with anorexia or bulimia are at
higher risk for seizures while taking bupropion due to potential metabolic disturbances.
4. When switching a patient from a Selective Serotonin Reuptake Inhibitor (SSRI) to a
Monoamine Oxidase Inhibitor (MAOI), how long is the recommended washout period?
A. 24 hours
B. 14 days
C. 7 days
D. 30 days
Answer: B
Rationale: A washout period is necessary to prevent Serotonin Syndrome, a potentially
life-threatening condition caused by excess serotonin. Most SSRIs require a 14-day
washout period before starting an MAOI to ensure the SSRI has cleared the system.
Fluoxetine is a notable exception, requiring at least 5 weeks due to its long half-life of the
parent drug and its active metabolite.
5. Which of the following describes the mechanism of action of Mirtazapine?
A. Selective Serotonin Reuptake Inhibition
B. Monoamine Oxidase Inhibition
C. Alpha-2 Adrenergic Antagonism
D. Dopamine D2 receptor agonism
, Answer: C
Rationale: Mirtazapine is classified as a Noradrenergic and Specific Serotonergic
Antidepressant (NaSSA). It works primarily by blocking alpha-2 presynaptic autoreceptors
and heteroreceptors, which enhances the release of both norepinephrine and serotonin.
Additionally, it blocks 5-HT2 and 5-HT3 receptors, which helps reduce side effects like
anxiety and nausea commonly associated with other antidepressants.
6. A patient taking Phenelzine (Nardil) must avoid which of the following foods to prevent a
hypertensive crisis?
A. Leafy green vegetables
B. Whole grain breads
C. Citrus fruits
D. Aged cheeses and cured meats
Answer: D
Rationale: Phenelzine is an MAOI that inhibits the breakdown of tyramine in the
gastrointestinal tract. Tyramine is a sympathomimetic amine found in aged, fermented, or
cured foods that can cause a massive release of norepinephrine if not metabolized. This
sudden surge in norepinephrine can lead to dangerous elevations in blood pressure, known
as a hypertensive crisis.
