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NR 546 Final Exam – Advanced Psychopharmacology
| Study Guide | Practice Questions & Answers | Latest
Update <RECENTLY TAKEN AND SUCCESS
WITNESSED!!>
1. A 45-year-old patient with major depressive disorder reports significant gastrointestinal
distress three days after initiating sertraline. What is the most appropriate response from the
PMHNP?
A. "Stop the medication immediately and go to the emergency department."
B. "Double your dose and symptoms will subside faster."
C. "Most side effects resolve within 4-5 days as your body adjusts."
D. "Take sertraline only with food to prevent these symptoms."
Correct Answer: C
Most GI side effects from SSRIs are transient and typically resolve within the first week as the
body adapts to increased serotonin levels.
2. Which medication should be avoided in a 66-year-old patient with major depressive disorder,
anxiety, and a recent fall?
A. Citalopram
B. Sertraline
C. Paroxetine
D. Aripiprazole
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Correct Answer: C
Paroxetine has strong anticholinergic properties and is associated with increased fall risk in
elderly patients due to sedation, orthostatic hypotension, and impaired cognition.
3. A patient with bipolar disorder reports suicidal ideations. Which medication should the
PMHNP consider?
A. Valproic acid
B. Lithium
C. Escitalopram
D. Ziprasidone
Correct Answer: B
Lithium has demonstrated efficacy in reducing suicide risk in patients with bipolar disorder and
is the only mood stabilizer with this specific indication.
4. What is the mechanism of action for tricyclic antidepressants regarding neurotransmitter
reuptake?
A. Dopamine and Histamine
B. Norepinephrine and Serotonin
C. GABA and Acetylcholine
D. Dopamine and GABA
Correct Answer: B
TCAs block the reuptake of both norepinephrine and serotonin at the presynaptic membrane,
increasing their availability in the synaptic cleft.
5. A patient prescribed disulfiram attends a party and consumes alcohol. Which symptoms would
be expected?
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A. Sedation and euphoria
B. Nystagmus and agitation
C. Hallucinations and tremors
D. Palpitations and vomiting
Correct Answer: D
Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation when alcohol
is consumed, resulting in flushing, palpitations, nausea, and vomiting.
6. Which SSRI is associated with the highest risk of discontinuation syndrome when abruptly
stopped?
A. Fluoxetine
B. Sertraline
C. Paroxetine
D. Citalopram
Correct Answer: C
Paroxetine has a short half-life and lacks active metabolites, making it more likely to cause
withdrawal symptoms upon abrupt discontinuation.
7. A 70-year-old patient with major depressive disorder reports a 40-pound weight loss. Which
medication should be considered for addition?
A. Quetiapine
B. Mirtazapine
C. Valproic acid
D. Paroxetine
Correct Answer: B
,2|Page
NR 546 Final Exam – Advanced Psychopharmacology
| Study Guide | Practice Questions & Answers | Latest
Update <RECENTLY TAKEN AND SUCCESS
WITNESSED!!>
1. A 45-year-old patient with major depressive disorder reports significant gastrointestinal
distress three days after initiating sertraline. What is the most appropriate response from the
PMHNP?
A. "Stop the medication immediately and go to the emergency department."
B. "Double your dose and symptoms will subside faster."
C. "Most side effects resolve within 4-5 days as your body adjusts."
D. "Take sertraline only with food to prevent these symptoms."
Correct Answer: C
Most GI side effects from SSRIs are transient and typically resolve within the first week as the
body adapts to increased serotonin levels.
2. Which medication should be avoided in a 66-year-old patient with major depressive disorder,
anxiety, and a recent fall?
A. Citalopram
B. Sertraline
C. Paroxetine
D. Aripiprazole
,3|Page
Correct Answer: C
Paroxetine has strong anticholinergic properties and is associated with increased fall risk in
elderly patients due to sedation, orthostatic hypotension, and impaired cognition.
3. A patient with bipolar disorder reports suicidal ideations. Which medication should the
PMHNP consider?
A. Valproic acid
B. Lithium
C. Escitalopram
D. Ziprasidone
Correct Answer: B
Lithium has demonstrated efficacy in reducing suicide risk in patients with bipolar disorder and
is the only mood stabilizer with this specific indication.
4. What is the mechanism of action for tricyclic antidepressants regarding neurotransmitter
reuptake?
A. Dopamine and Histamine
B. Norepinephrine and Serotonin
C. GABA and Acetylcholine
D. Dopamine and GABA
Correct Answer: B
TCAs block the reuptake of both norepinephrine and serotonin at the presynaptic membrane,
increasing their availability in the synaptic cleft.
5. A patient prescribed disulfiram attends a party and consumes alcohol. Which symptoms would
be expected?
, 4|Page
A. Sedation and euphoria
B. Nystagmus and agitation
C. Hallucinations and tremors
D. Palpitations and vomiting
Correct Answer: D
Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation when alcohol
is consumed, resulting in flushing, palpitations, nausea, and vomiting.
6. Which SSRI is associated with the highest risk of discontinuation syndrome when abruptly
stopped?
A. Fluoxetine
B. Sertraline
C. Paroxetine
D. Citalopram
Correct Answer: C
Paroxetine has a short half-life and lacks active metabolites, making it more likely to cause
withdrawal symptoms upon abrupt discontinuation.
7. A 70-year-old patient with major depressive disorder reports a 40-pound weight loss. Which
medication should be considered for addition?
A. Quetiapine
B. Mirtazapine
C. Valproic acid
D. Paroxetine
Correct Answer: B
