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NSG 552 PSYCHOPHARMACOLOGY EXAM REVIEW-
WILKIES 2026 COMPLETE (105) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
PSYCHOPHARMACOLOGY
Prepare for the NSG 552 Psychopharmacology Exam Review (Wilkes) with this
comprehensive practice resource designed to strengthen your pharmacology
knowledge and exam readiness. It features exam-style questions covering
psychotropic medications, mechanisms of action, therapeutic uses, adverse effects,
patient monitoring, and evidence-based prescribing principles. Use it to reinforce key
concepts, assess your understanding, and build confidence before test day. An
excellent study aid for Wilkes nursing students preparing for the NSG 552
Psychopharmacology exam.
MULTIPLE CHOICE.
Question 1: A PMHNP student is studying the basic principles of
neurotransmission. Which neurotransmitter is the primary excitatory
neurotransmitter in the central nervous system?
A. GABA
B. Glutamate
C. Dopamine
D. Serotonin
Correct answer: B. Glutamate
Rationale: Glutamate is the major excitatory neurotransmitter in the CNS,
involved in learning, memory, and synaptic plasticity. GABA is the primary
inhibitory neurotransmitter. Dopamine and serotonin are
neuromodulators with more specific roles in reward, mood, and
cognition.
Question 2: Which cytochrome P450 enzyme is responsible for metabolizing
the largest percentage of psychotropic medications?
A. CYP2D6
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B. CYP3A4
C. CYP1A2
D. CYP2C19
Correct answer: B. CYP3A4
Rationale: CYP3A4 metabolizes approximately 50% of all medications,
including many psychotropics such as benzodiazepines, some
antidepressants, and antipsychotics. CYP2D6 is also critically important
in psychiatry but metabolizes a smaller percentage overall .
Question 3: A patient is a known CYP2D6 poor metabolizer. Which
antidepressant requires the most caution due to reliance on CYP2D6 for
metabolism?
A. Sertraline
B. Paroxetine
C. Bupropion
D. Venlafaxine
Correct answer: B. Paroxetine
Rationale: Paroxetine is both a substrate and a potent inhibitor of
CYP2D6. In poor metabolizers, paroxetine levels can be significantly
elevated, increasing side effects. Paroxetine also inhibits its own
metabolism .
Question 4: The therapeutic action of most antidepressants is believed to be
related to:
A. Immediate increase in synaptic neurotransmitters
B. Downstream effects including receptor adaptation, neurogenesis, and
increased BDNF
C. Blockade of voltage-gated sodium channels
D. Direct GABA receptor agonism
Correct answer: B. Downstream effects including receptor adaptation,
neurogenesis, and increased BDNF
Rationale: While antidepressants acutely increase monoamine levels
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within hours, the therapeutic effect takes weeks and is attributed to
downstream neuroplastic changes: receptor
downregulation/desensitization, increased brain-derived neurotrophic
factor (BDNF), and hippocampal neurogenesis. Immediate
neurotransmitter increase explains side effects, not efficacy .
Question 5: A drug that is a CYP450 inducer will have what effect on a
substrate medication?
A. Increase the substrate's plasma level
B. Decrease the substrate's plasma level
C. No effect
D. Prolong the substrate's half-life
Correct answer: B. Decrease the substrate's plasma level
Rationale: Enzyme inducers increase the rate of metabolism of substrate
drugs, reducing their plasma levels and potentially decreasing
therapeutic efficacy. Examples include carbamazepine, rifampin, and St.
John's Wort .
Question 6: What is the half-life of a drug?
A. The time it takes for the drug to reach peak plasma concentration
B. The time required for the plasma concentration of the drug to decrease by
50%
C. The time it takes for the drug to be completely eliminated
D. The duration of the drug's therapeutic effect
Correct answer: B. The time required for the plasma concentration of the
drug to decrease by 50%
Rationale: Half-life (t½) is the time required for the plasma concentration
to fall by 50%. It determines dosing frequency and the time to reach
steady state (approximately 4-5 half-lives) .
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Question 7: Which neurotransmitter is primarily associated with the "reward
pathway" and is implicated in substance use disorders?
A. Serotonin
B. Norepinephrine
C. Dopamine
D. Acetylcholine
Correct answer: C. Dopamine
Rationale: The mesolimbic pathway, which projects from the ventral
tegmental area to the nucleus accumbens, is the brain's primary "reward
pathway." Dopamine is the key neurotransmitter in this pathway, and most
drugs of abuse increase dopamine in this area .
Question 8: The blood-brain barrier (BBB) is composed primarily of:
A. Loose capillary walls that allow all substances to pass freely
B. Tight junctions between capillary endothelial cells, astrocytes, and efflux
transporters like P-glycoprotein
C. Neuronal cell bodies
D. Myelin sheaths
Correct answer: B. Tight junctions between capillary endothelial cells,
astrocytes, and efflux transporters like P-glycoprotein
Rationale: The BBB consists of endothelial cells with tight junctions,
surrounded by astrocytic end-feet, and contains efflux pumps that
actively transport substances out of the brain. This limits entry of many
drugs into the CNS .
Question 9: P-glycoprotein (P-gp) functions in the blood-brain barrier to:
A. Actively transport drugs into the brain
B. Actively efflux drugs out of the brain, limiting CNS penetration
C. Metabolize drugs within the brain
D. Produce cerebrospinal fluid
Correct answer: B. Actively efflux drugs out of the brain, limiting CNS
penetration
NSG 552 PSYCHOPHARMACOLOGY EXAM REVIEW-
WILKIES 2026 COMPLETE (105) CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
PSYCHOPHARMACOLOGY
Prepare for the NSG 552 Psychopharmacology Exam Review (Wilkes) with this
comprehensive practice resource designed to strengthen your pharmacology
knowledge and exam readiness. It features exam-style questions covering
psychotropic medications, mechanisms of action, therapeutic uses, adverse effects,
patient monitoring, and evidence-based prescribing principles. Use it to reinforce key
concepts, assess your understanding, and build confidence before test day. An
excellent study aid for Wilkes nursing students preparing for the NSG 552
Psychopharmacology exam.
MULTIPLE CHOICE.
Question 1: A PMHNP student is studying the basic principles of
neurotransmission. Which neurotransmitter is the primary excitatory
neurotransmitter in the central nervous system?
A. GABA
B. Glutamate
C. Dopamine
D. Serotonin
Correct answer: B. Glutamate
Rationale: Glutamate is the major excitatory neurotransmitter in the CNS,
involved in learning, memory, and synaptic plasticity. GABA is the primary
inhibitory neurotransmitter. Dopamine and serotonin are
neuromodulators with more specific roles in reward, mood, and
cognition.
Question 2: Which cytochrome P450 enzyme is responsible for metabolizing
the largest percentage of psychotropic medications?
A. CYP2D6
, Page 2 of 39
B. CYP3A4
C. CYP1A2
D. CYP2C19
Correct answer: B. CYP3A4
Rationale: CYP3A4 metabolizes approximately 50% of all medications,
including many psychotropics such as benzodiazepines, some
antidepressants, and antipsychotics. CYP2D6 is also critically important
in psychiatry but metabolizes a smaller percentage overall .
Question 3: A patient is a known CYP2D6 poor metabolizer. Which
antidepressant requires the most caution due to reliance on CYP2D6 for
metabolism?
A. Sertraline
B. Paroxetine
C. Bupropion
D. Venlafaxine
Correct answer: B. Paroxetine
Rationale: Paroxetine is both a substrate and a potent inhibitor of
CYP2D6. In poor metabolizers, paroxetine levels can be significantly
elevated, increasing side effects. Paroxetine also inhibits its own
metabolism .
Question 4: The therapeutic action of most antidepressants is believed to be
related to:
A. Immediate increase in synaptic neurotransmitters
B. Downstream effects including receptor adaptation, neurogenesis, and
increased BDNF
C. Blockade of voltage-gated sodium channels
D. Direct GABA receptor agonism
Correct answer: B. Downstream effects including receptor adaptation,
neurogenesis, and increased BDNF
Rationale: While antidepressants acutely increase monoamine levels
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within hours, the therapeutic effect takes weeks and is attributed to
downstream neuroplastic changes: receptor
downregulation/desensitization, increased brain-derived neurotrophic
factor (BDNF), and hippocampal neurogenesis. Immediate
neurotransmitter increase explains side effects, not efficacy .
Question 5: A drug that is a CYP450 inducer will have what effect on a
substrate medication?
A. Increase the substrate's plasma level
B. Decrease the substrate's plasma level
C. No effect
D. Prolong the substrate's half-life
Correct answer: B. Decrease the substrate's plasma level
Rationale: Enzyme inducers increase the rate of metabolism of substrate
drugs, reducing their plasma levels and potentially decreasing
therapeutic efficacy. Examples include carbamazepine, rifampin, and St.
John's Wort .
Question 6: What is the half-life of a drug?
A. The time it takes for the drug to reach peak plasma concentration
B. The time required for the plasma concentration of the drug to decrease by
50%
C. The time it takes for the drug to be completely eliminated
D. The duration of the drug's therapeutic effect
Correct answer: B. The time required for the plasma concentration of the
drug to decrease by 50%
Rationale: Half-life (t½) is the time required for the plasma concentration
to fall by 50%. It determines dosing frequency and the time to reach
steady state (approximately 4-5 half-lives) .
, Page 4 of 39
Question 7: Which neurotransmitter is primarily associated with the "reward
pathway" and is implicated in substance use disorders?
A. Serotonin
B. Norepinephrine
C. Dopamine
D. Acetylcholine
Correct answer: C. Dopamine
Rationale: The mesolimbic pathway, which projects from the ventral
tegmental area to the nucleus accumbens, is the brain's primary "reward
pathway." Dopamine is the key neurotransmitter in this pathway, and most
drugs of abuse increase dopamine in this area .
Question 8: The blood-brain barrier (BBB) is composed primarily of:
A. Loose capillary walls that allow all substances to pass freely
B. Tight junctions between capillary endothelial cells, astrocytes, and efflux
transporters like P-glycoprotein
C. Neuronal cell bodies
D. Myelin sheaths
Correct answer: B. Tight junctions between capillary endothelial cells,
astrocytes, and efflux transporters like P-glycoprotein
Rationale: The BBB consists of endothelial cells with tight junctions,
surrounded by astrocytic end-feet, and contains efflux pumps that
actively transport substances out of the brain. This limits entry of many
drugs into the CNS .
Question 9: P-glycoprotein (P-gp) functions in the blood-brain barrier to:
A. Actively transport drugs into the brain
B. Actively efflux drugs out of the brain, limiting CNS penetration
C. Metabolize drugs within the brain
D. Produce cerebrospinal fluid
Correct answer: B. Actively efflux drugs out of the brain, limiting CNS
penetration
