,LMR Georgette PMHNP Board Exam Review
(2026/2027) – High-Yield Board Prep (Questions
SECTION 1: SCIENTIFIC FOUNDATION &
NEUROBIOLOGY
1. A patient with major depressive disorder has failed two adequate
trials of SSRIs. Pharmacogenomic testing reveals a CYP2C19 poor
metabolizer phenotype. Which antidepressant selection is most
appropriate based on this result?
A) Escitalopram 10 mg daily, monitoring for increased side effects
B) Citalopram 40 mg daily, with dose reduction due to prolonged half-life
C) Sertraline 100 mg daily, as it is primarily metabolized by CYP3A4
D) Venlafaxine XR 75 mg daily, avoiding CYP2C19 metabolism
*C) Sertraline 100 mg daily, as it is primarily metabolized by CYP3A4 *
Rationale: Sertraline is not significantly metabolized by CYP2C19; it uses
CYP2B6 and 3A4. Escitalopram and citalopram are both metabolized by
CYP2C19; in poor metabolizers, they accumulate, increasing QTc risk
(citalopram) or side effects. Venlafaxine is metabolized by CYP2D6, not
relevant. Sertraline is a safe choice .
,2. The synapse converts the action potential into neurotransmission.
The action potential is a(n) ________ signal, and neurotransmission is
a(n) ________ signal.
A) Chemical; electrical
B) Electrical; chemical
C) Electrical; electrical
D) Chemical; chemical
*B) Electrical; chemical *
Rationale: The action potential is an electrical signal that travels down the
axon. When it reaches the synapse, it triggers the release of
neurotransmitters, which are chemical signals that cross the synaptic cleft to
the postsynaptic neuron .
3. Which of the following correctly pairs a neurotransmitter with its
primary site of production?
A) Dopamine – Locus coeruleus
B) Norepinephrine – Raphe nuclei
C) Serotonin – Raphe nuclei
D) Acetylcholine – Substantia nigra
*C) Serotonin – Raphe nuclei *
Rationale: Serotonin (5-HT) is primarily produced in the raphe nuclei of the
brainstem. Dopamine is produced in the ventral tegmental area (VTA) and
substantia nigra. Norepinephrine is produced in the locus coeruleus of the
pons .
4. The precursor of the monoamine neurotransmitters dopamine and
norepinephrine is:
, A) Tryptophan
B) Tyrosine
C) Glutamine
D) Choline
*B) Tyrosine *
Rationale: Tyrosine is the precursor for the catecholamines dopamine,
norepinephrine, and epinephrine. Tryptophan is the precursor for serotonin.
Tyrosine is converted to L-DOPA, then to dopamine, and finally to
norepinephrine .
5. The primary inhibitory neurotransmitter in the central nervous
system is:
A) Glutamate
B) Aspartate
C) GABA (gamma-aminobutyric acid)
D) Norepinephrine
*C) GABA (gamma-aminobutyric acid) *
Rationale: GABA is the primary inhibitory neurotransmitter in the CNS,
reducing neuronal excitability. Glutamate is the primary excitatory
neurotransmitter. Glycine is another inhibitory amino acid found primarily in
the spinal cord .
6. The Romberg test is used to assess:
A) Cranial nerve function
B) Cerebellar function and balance
C) Cognitive impairment
D) Sensory perception
(2026/2027) – High-Yield Board Prep (Questions
SECTION 1: SCIENTIFIC FOUNDATION &
NEUROBIOLOGY
1. A patient with major depressive disorder has failed two adequate
trials of SSRIs. Pharmacogenomic testing reveals a CYP2C19 poor
metabolizer phenotype. Which antidepressant selection is most
appropriate based on this result?
A) Escitalopram 10 mg daily, monitoring for increased side effects
B) Citalopram 40 mg daily, with dose reduction due to prolonged half-life
C) Sertraline 100 mg daily, as it is primarily metabolized by CYP3A4
D) Venlafaxine XR 75 mg daily, avoiding CYP2C19 metabolism
*C) Sertraline 100 mg daily, as it is primarily metabolized by CYP3A4 *
Rationale: Sertraline is not significantly metabolized by CYP2C19; it uses
CYP2B6 and 3A4. Escitalopram and citalopram are both metabolized by
CYP2C19; in poor metabolizers, they accumulate, increasing QTc risk
(citalopram) or side effects. Venlafaxine is metabolized by CYP2D6, not
relevant. Sertraline is a safe choice .
,2. The synapse converts the action potential into neurotransmission.
The action potential is a(n) ________ signal, and neurotransmission is
a(n) ________ signal.
A) Chemical; electrical
B) Electrical; chemical
C) Electrical; electrical
D) Chemical; chemical
*B) Electrical; chemical *
Rationale: The action potential is an electrical signal that travels down the
axon. When it reaches the synapse, it triggers the release of
neurotransmitters, which are chemical signals that cross the synaptic cleft to
the postsynaptic neuron .
3. Which of the following correctly pairs a neurotransmitter with its
primary site of production?
A) Dopamine – Locus coeruleus
B) Norepinephrine – Raphe nuclei
C) Serotonin – Raphe nuclei
D) Acetylcholine – Substantia nigra
*C) Serotonin – Raphe nuclei *
Rationale: Serotonin (5-HT) is primarily produced in the raphe nuclei of the
brainstem. Dopamine is produced in the ventral tegmental area (VTA) and
substantia nigra. Norepinephrine is produced in the locus coeruleus of the
pons .
4. The precursor of the monoamine neurotransmitters dopamine and
norepinephrine is:
, A) Tryptophan
B) Tyrosine
C) Glutamine
D) Choline
*B) Tyrosine *
Rationale: Tyrosine is the precursor for the catecholamines dopamine,
norepinephrine, and epinephrine. Tryptophan is the precursor for serotonin.
Tyrosine is converted to L-DOPA, then to dopamine, and finally to
norepinephrine .
5. The primary inhibitory neurotransmitter in the central nervous
system is:
A) Glutamate
B) Aspartate
C) GABA (gamma-aminobutyric acid)
D) Norepinephrine
*C) GABA (gamma-aminobutyric acid) *
Rationale: GABA is the primary inhibitory neurotransmitter in the CNS,
reducing neuronal excitability. Glutamate is the primary excitatory
neurotransmitter. Glycine is another inhibitory amino acid found primarily in
the spinal cord .
6. The Romberg test is used to assess:
A) Cranial nerve function
B) Cerebellar function and balance
C) Cognitive impairment
D) Sensory perception
