Regis College NU664C Family Psychiatric Mental Health I
MIDTERM Exam | Complete Practice Questions, Answers &
Detailed Rationales (2026/2027)
Question 1
Which neurotransmitter system is primarily targeted by selective
serotonin reuptake inhibitors (SSRIs) in the treatment of depression and
anxiety?
A. Serotonergic system (inhibiting the reuptake of serotonin at the
presynaptic terminal)
B. Dopaminergic system (stimulating D2 autoreceptors)
C. Cholinergic system (inhibiting acetylcholinesterase)
D. GABAergic system (acting as a positive allosteric modulator)
Correct Answer: A. Serotonergic system (inhibiting the reuptake of
serotonin at the presynaptic terminal)
Detailed Rationale: SSRIs selectively block the serotonin transporter
(SERT), increasing extracellular serotonin concentrations within the
synaptic cleft to enhance postsynaptic receptor signaling.
Question 2
What is the primary mechanism of action of atypical (second-
generation) antipsychotics compared to typical (first-generation)
antipsychotics?
A. Simultaneous blockade of serotonin 5-HT2A receptors and dopamine
D2 receptors
,B. Irreversible destruction of all dopamine pathways
C. Full agonism at central mu-opioid receptors
D. Selective inhibition of monoamine oxidase B
Correct Answer: A. Simultaneous blockade of serotonin 5-HT2A
receptors and dopamine D2 receptors
Detailed Rationale: Second-generation antipsychotics combine 5-HT2A
and D2 antagonism, which mitigates extrapyramidal symptoms (EPS) by
allowing dopamine neurotransmission in the nigrostriatal pathway.
Question 3
Which cytochrome P450 enzyme is most frequently implicated in
clinically significant drug-drug interactions due to its metabolism of a
wide array of psychotropic medications?
A. CYP2D6
B. CYP7A1
C. CYP4V2
D. CYP2E2
Correct Answer: A. CYP2D6
Detailed Rationale: CYP2D6 metabolizes many SSRIs, tricyclic
antidepressants, and antipsychotics; genetic polymorphisms and
enzyme inhibition/induction at this site profoundly affect serum drug
levels.
Question 4
,What is the primary clinical indication and mechanism of action of
lithium carbonate in mood disorders?
A. Acute mania and maintenance of Bipolar Disorder; modulates
second-messenger systems (e.g., inositol monophosphatase and protein
kinase C).
B. Treatment of refractory insomnia via GABA-A agonism.
C. Reversal of acute opioid overdose via mu-opioid antagonism.
D. Long-term management of Parkinson's disease tremor via dopamine
replacement.
Correct Answer: A. Acute mania and maintenance of Bipolar Disorder;
modulates second-messenger systems (e.g., inositol monophosphatase
and protein kinase C).
Detailed Rationale: Lithium remains a cornerstone gold standard for
Bipolar Disorder, acting intracellularly to dampen hyperexcitable
neuronal signaling cascades and promote neuroprotection.
Question 5
Which antidepressant class carries a severe hypertensive crisis risk
when co-administered with tyramine-rich foods or sympathomimetic
agents?
A. Monoamine Oxidase Inhibitors (MAOIs)
B. Selective Serotonin Reuptake Inhibitors (SSRIs)
C. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
D. Atypical antidepressants (e.g., bupropion)
Correct Answer: A. Monoamine Oxidase Inhibitors (MAOIs)
, Detailed Rationale: MAOIs inhibit the breakdown of dietary tyramine in
the gut; accumulated tyramine displaces norepinephrine in nerve
terminals, triggering massive vasoconstriction and hypertensive crises.
Question 6
What neuroendocrine monitoring is mandatory for patients prescribed
long-term Lithium therapy?
A. Thyroid-stimulating hormone (TSH) and renal function
(BUN/Creatinine)
B. Complete blood count (CBC) with white blood cell differential weekly
C. Glycated hemoglobin (HbA1c) every 3 months
D. Fasting lipid panel and liver enzymes exclusively
Correct Answer: A. Thyroid-stimulating hormone (TSH) and renal
function (BUN/Creatinine)
Detailed Rationale: Lithium concentrates in the thyroid and kidneys,
frequently causing hypothyroidism (lithium-induced goiter) and
nephrogenic diabetes insipidus or chronic renal impairment.
Question 7
What is the classic presentation of Neuroleptic Malignant Syndrome
(NMS), and what is the primary initial medical management?
A. High fever, "lead pipe" muscle rigidity, autonomic instability, and
altered mental status; immediately discontinue the offending
antipsychotic and provide supportive care or dantrolene/bromocriptine.
B. Flaccid paralysis, pinpoint pupils, and bradypnea; administer
naloxone.
MIDTERM Exam | Complete Practice Questions, Answers &
Detailed Rationales (2026/2027)
Question 1
Which neurotransmitter system is primarily targeted by selective
serotonin reuptake inhibitors (SSRIs) in the treatment of depression and
anxiety?
A. Serotonergic system (inhibiting the reuptake of serotonin at the
presynaptic terminal)
B. Dopaminergic system (stimulating D2 autoreceptors)
C. Cholinergic system (inhibiting acetylcholinesterase)
D. GABAergic system (acting as a positive allosteric modulator)
Correct Answer: A. Serotonergic system (inhibiting the reuptake of
serotonin at the presynaptic terminal)
Detailed Rationale: SSRIs selectively block the serotonin transporter
(SERT), increasing extracellular serotonin concentrations within the
synaptic cleft to enhance postsynaptic receptor signaling.
Question 2
What is the primary mechanism of action of atypical (second-
generation) antipsychotics compared to typical (first-generation)
antipsychotics?
A. Simultaneous blockade of serotonin 5-HT2A receptors and dopamine
D2 receptors
,B. Irreversible destruction of all dopamine pathways
C. Full agonism at central mu-opioid receptors
D. Selective inhibition of monoamine oxidase B
Correct Answer: A. Simultaneous blockade of serotonin 5-HT2A
receptors and dopamine D2 receptors
Detailed Rationale: Second-generation antipsychotics combine 5-HT2A
and D2 antagonism, which mitigates extrapyramidal symptoms (EPS) by
allowing dopamine neurotransmission in the nigrostriatal pathway.
Question 3
Which cytochrome P450 enzyme is most frequently implicated in
clinically significant drug-drug interactions due to its metabolism of a
wide array of psychotropic medications?
A. CYP2D6
B. CYP7A1
C. CYP4V2
D. CYP2E2
Correct Answer: A. CYP2D6
Detailed Rationale: CYP2D6 metabolizes many SSRIs, tricyclic
antidepressants, and antipsychotics; genetic polymorphisms and
enzyme inhibition/induction at this site profoundly affect serum drug
levels.
Question 4
,What is the primary clinical indication and mechanism of action of
lithium carbonate in mood disorders?
A. Acute mania and maintenance of Bipolar Disorder; modulates
second-messenger systems (e.g., inositol monophosphatase and protein
kinase C).
B. Treatment of refractory insomnia via GABA-A agonism.
C. Reversal of acute opioid overdose via mu-opioid antagonism.
D. Long-term management of Parkinson's disease tremor via dopamine
replacement.
Correct Answer: A. Acute mania and maintenance of Bipolar Disorder;
modulates second-messenger systems (e.g., inositol monophosphatase
and protein kinase C).
Detailed Rationale: Lithium remains a cornerstone gold standard for
Bipolar Disorder, acting intracellularly to dampen hyperexcitable
neuronal signaling cascades and promote neuroprotection.
Question 5
Which antidepressant class carries a severe hypertensive crisis risk
when co-administered with tyramine-rich foods or sympathomimetic
agents?
A. Monoamine Oxidase Inhibitors (MAOIs)
B. Selective Serotonin Reuptake Inhibitors (SSRIs)
C. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
D. Atypical antidepressants (e.g., bupropion)
Correct Answer: A. Monoamine Oxidase Inhibitors (MAOIs)
, Detailed Rationale: MAOIs inhibit the breakdown of dietary tyramine in
the gut; accumulated tyramine displaces norepinephrine in nerve
terminals, triggering massive vasoconstriction and hypertensive crises.
Question 6
What neuroendocrine monitoring is mandatory for patients prescribed
long-term Lithium therapy?
A. Thyroid-stimulating hormone (TSH) and renal function
(BUN/Creatinine)
B. Complete blood count (CBC) with white blood cell differential weekly
C. Glycated hemoglobin (HbA1c) every 3 months
D. Fasting lipid panel and liver enzymes exclusively
Correct Answer: A. Thyroid-stimulating hormone (TSH) and renal
function (BUN/Creatinine)
Detailed Rationale: Lithium concentrates in the thyroid and kidneys,
frequently causing hypothyroidism (lithium-induced goiter) and
nephrogenic diabetes insipidus or chronic renal impairment.
Question 7
What is the classic presentation of Neuroleptic Malignant Syndrome
(NMS), and what is the primary initial medical management?
A. High fever, "lead pipe" muscle rigidity, autonomic instability, and
altered mental status; immediately discontinue the offending
antipsychotic and provide supportive care or dantrolene/bromocriptine.
B. Flaccid paralysis, pinpoint pupils, and bradypnea; administer
naloxone.
